Faculty Opinions recommendation of Hypersensitivity reactions to rifampin. Pathogenetic mechanisms, clinical manifestations, management strategies, and review of the anaphylactic-like reactions.

Hymenoptera stings are generally well-tolerated and usually cause limited local reactions, characterized by self-resolving erythema and edema associated with pain. However, Hymenoptera stings can induce immediate and delayed hypersensitivity reactions. In addition to these manifestations, unusual reactions to Hymenoptera stings have been reported. The latter are defined as unusual because of their atypical characteristics. They may differ from classical hypersensitivity reactions due to the stings' particular localization and the unusual involvement of one or more specific organs. Although unusual reactions to Hymenoptera stings are infrequent, it is essential for clinicians to know the possible related clinical manifestations. Here, we review the available literature and propose a diagnostic and management algorithm. At present, there are no defined guidelines for most of the unusual reactions to Hymenoptera stings, which should be managed in a tailored way according to the specifical clinical manifestations presented by the patients. Further studies are needed to better define these conditions and the underlying pathogenetic mechanisms to improve the diagnostic and therapeutic approach.

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Early Biomarkers for Severe Drug Hypersensitivity Reactions

Current Pharmaceutical Design ◽

10.2174/1381612825666191107105440 ◽

2019 ◽

Vol 25 (36) ◽

pp. 3829-3839 ◽

Cited By ~ 1

Author(s):

Adriana Ariza ◽

Maria J. Torres ◽

Carmen Moreno-Aguilar ◽

Rubén Fernández-Santamaría ◽

Tahia D. Fernández

Keyword(s):

Drug Exposure ◽

Drug Hypersensitivity ◽

Clinical Manifestations ◽

Skin Tests ◽

Time Interval ◽

Hypersensitivity Reactions ◽

Early Biomarkers ◽

Immunological Mechanisms ◽

Drug Hypersensitivity Reactions ◽

Delayed Reactions

Drug hypersensitivity reactions (DHRs) are typically classified into immediate and delayed reactions based on the time interval between drug exposure and onset of symptoms. Clinical manifestations range from mild to severe and life-threatening reactions. The most severe clinical entities are anaphylaxis and anaphylactic shock for immediate reactions, and severe cutaneous adverse reactions such as Steven Johnson Syndrome and Toxic Epidermal Necrolysis for delayed reactions. The diagnosis is complex and challenging, as drug provocation tests and even skin tests can be very risky procedures, which makes them not recommended. Therefore, it is necessary to search for useful early biomarkers to manage the diagnosis of these reactions. These biomarkers could be useful to determine the clinical entity, but not to identify the culprit drug. Some of the currently available biomarkers are few genetic associations of drug allergy with polymorphisms of human leukocyte antigen (HLA), the detection of inflammatory and lipid mediators in serum, or the detection of cytokines, chemokines, and cytotoxic markers in skin biopsies. In this literature review, it has been summarize the immunological mechanisms involved in severe reactions, both immediate and delayed, and different early biomarkers: those currently used for the diagnosis of these reactions as well as possible early biomarkers that could be useful with further studies to standardize their clinical use.

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INVESTIGATION OF MEDICALLY INDUCED SKIN REACTIONS BASED ON THE ANALYSIS OF REPORTS OF ADVERSE DRUG REACTIONS IN THE REPUBLIC OF CRIMEA (FROM 2009 TO 2016)

Pharmacy & Pharmacology ◽

10.19163/2307-9266-2019-7-1-32-41 ◽

2019 ◽

Vol 7 (1) ◽

pp. 32-41 ◽

Cited By ~ 1

Author(s):

A. V. Matveev ◽

А. E. Krasheninnikov ◽

E. A. Egorova ◽

Е. I. Konyaeva

Keyword(s):

Adverse Reactions ◽

Drug Hypersensitivity ◽

Clinical Manifestations ◽

World Health ◽

Report Cards ◽

Hypersensitivity Reactions ◽

Drug Reactions ◽

Skin Reactions ◽

Drug Hypersensitivity Reactions ◽

The Republic

Drug hypersensitivity reactions are among the most important problems that arise when using drugs. The occurrence of such reactions in the population is at least 7% and tends to a constant increase. The most frequent manifestations of drug hypersensitivity reactions are medically induced skin lesions.The aimof this research was to study and analyze the cases of development of skin drug reactions on the basis of the reports on the adverse reactions (ADRs) of the drugs, registered in the Republic of Crimea in the period from 2009 to 2016.Materials and methods.The objects of the research were report cards about the adverse reactions, registered in the regional base (registry) of spontaneous messages called ARCADe (Adverse Reactions in Crimea, Autonomic Database) for the period from 2009 to 2016. During the analysis of the report cards, 2,698 cases of the development of skin drug reactions arising in response to the use of drugs in patients were selected. The study of the frequency of occurrence of skin drug reactions in the application of various groups of drugs was carried out taking into account the codes of the Anatomical Therapeutic Chemical (ATC) Сlassification System of drugs of the World Health Organization (WHO).Results.Of the study showed that the development of skin drug reactions was most often associated with the use of antimicrobial agents for internal use, nonsteroidal anti-inflammatory drugs (NSAIDs), drugs for the treatment of diseases of the gastrointestinal tract and agents that affect the nervous system. Among the clinical manifestations of skin drug reactions, generalized and localized rashes prevailed, and itching and hyperemia of the skin were much less common in patients. The analysis of age categories showed that the most frequently medically induced reactions occurred in children from birth to 3 years, as well as in the age group of patients from 46 to 60 years. The risk factors identified in the course of the analysis, were female gender, early childhood and old age, as well as the presence of aggravated drug allergy history.Conclusion.Drug hypersensitivity reactions create certain difficulties in clinical practice related to the diagnosis, treatment and prophylaxis, and may also cause danger to health or life of patients. In this connection, the study of such adverse reactions is the most important task of practical health care and requires direct participation of doctors of all specialties.

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Clinical and bioimpedance features of manifestations of chronic non-bacterial prostatitis with an inflammatory component in young men

Andrology and Genital Surgery ◽

10.17650/1726-9784-2021-22-1-38-42 ◽

2021 ◽

Vol 22 (1) ◽

pp. 38-42

Author(s):

Yu. Vinnik ◽

А. V. Kuzmenko ◽

А. А. Amelchenko

Keyword(s):

Chronic Prostatitis ◽

Clinical Manifestations ◽

Extracellular Fluid ◽

Young Men ◽

Component Composition ◽

The Body ◽

Pathogenetic Mechanisms ◽

Bacterial Prostatitis ◽

Comprehensive Survey ◽

Inflammatory Component

Introduction. Chronic prostatitis is the most common androurological disease affecting mainly young and middle-aged men. The variety of pathogenetic mechanisms and clinical manifestations, the tendency to recurrence necessitate the search for new methods of examination and monitoring of this disease. This can be facilitated by the study of bioimpedance parameters in patients with chronic prostatitis.Purpose of the study. To identify bioimpedance and clinical features of the manifestations of chronic non-bacterial prostatitis with an inflammatory component (CNPIC) in young men.Materials and methods. In the period from 2018 to 2020, on the basis of Krasnoyarsk Interdistrict Clinical Hospital No 4, a comprehensive survey of 80 men with CNPIC of the first period of adulthood from 22 to 35 years was conducted using valid questionnaires. Bioimpedansometry was carried out using a complex KM-AR-01, grade “DIAMANT-AIST mini”.Results. Pain predominates in the clinical picture of CNPIC, dysuric disorders are less pronounced. The examined men had pronounced deviations of the component composition of the body due to an increase in fat mass and extracellular fluid volume, which, due to common pathogenetic mechanisms, can support chronic inflammation and influence treatment outcomes.Conclusion. Bioimpedansometry can be a promising method in complex diagnostics and subsequent objective monitoring of the course of CNPIC.

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Awareness About Oral Cancer Among Dental Students

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl3.3044 ◽

2020 ◽

Vol 11 (SPL3) ◽

pp. 892-895

Author(s):

Nishanthi R ◽

Ashok Velayudhan ◽

Dhanraj Ganapathy

Keyword(s):

Risk Factors ◽

Oral Cancer ◽

Management Strategies ◽

Clinical Manifestations ◽

Dental Students ◽

Cancer Knowledge ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Self Administered Questionnaire

Oral cancer affects people in the 6th and seventh many years of existence with a background marked by smoking tobacco and, or liquor utilization. Early acknowledgement and referral are basic as less treatment is required to decrease mortality and morbidity. Past examinations have demonstrated that oral cancer can be quiet in symptoms with attention to primal signs being increasingly advantageous in diagnosis. To assessing oral cancer knowledge and awareness among undergraduate dental studentsA cross-sectional survey was done with a self-administered questionnaire with 10 questions circulated among 100 dental students. The questionnaire assessed the awareness about oral cancer, their risk factors, clinical manifestations, diagnosis and management strategies. The responses were recorded and analysed. 96 % of dental students were aware of oral cancer.95% said smoking and tobacco-related products are the major risk factors of oral cancer.85% were aware of clinical manifestation of oral cancer.71% were aware of the diagnosis of oral cancer and 65% were aware of management strategies for oral cancer.Greater part of the responders in this investigation had satisfactory information about clinical indications of oral cancer. Efforts ought to be made to develop inspirational disposition towards avoidance of oral cancer. There is a necessity to present instructions on counteraction, early referral and demonstrative techniques for oral cancer.

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Non-immediate drug hypersensitivity reactions secondary to intravitreal anti-vascular endothelial growth factors

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05353-3 ◽

2021 ◽

Author(s):

E. Moret ◽

A. Ambresin ◽

C. Gianniou ◽

J. Bijon ◽

C. Besse-Hayat ◽

...

Keyword(s):

Growth Factors ◽

Drug Hypersensitivity ◽

Clinical Manifestations ◽

Drug Discontinuation ◽

Vascular Endothelial Growth Factors ◽

Vascular Endothelial ◽

Hypersensitivity Reactions ◽

Anti Vegf ◽

Drug Hypersensitivity Reactions ◽

Endothelial Growth Factors

Abstract Purpose To describe a series of non-immediate drug hypersensitivity reactions after intravitreal anti-vascular endothelial growth factors (anti-VEGFs). Patients and methods Retrospective report of 6 patients with cutaneous non-immediate drug hypersensitivity reactions following intravitreal anti-VEGF injections, 4 after ranibizumab, 1 after bevacizumab and 1 after aflibercept. Results Clinical manifestations ranged from mild maculopapular rash, purpura to severe generalized erythroderma, with or without systemic involvement such as microscopic hematuria and proteinuria or fever. In two out of the six patients, reintroduction of either the same or an alternative anti-VEGF drug did induce a recurrence of the drug hypersensitivity reaction, while 4 patients showed no recurrence. Conclusion Cutaneous non-immediate drug hypersensitivity reactions secondary to intravitreal anti-VEGF may occur. Continuation of the same drug or switch to another anti-VEGF may either induce recurrence or be well supported by the patient. The decision of drug discontinuation should be guided by the severity of the disease.

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Porcine Reproducive and Respiratory Syndrome (PRRS) and secondary co-infections: New aspects, economic impact and update situation in Greece

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.14982 ◽

2017 ◽

Vol 58 (2) ◽

pp. 157 ◽

Cited By ~ 1

Author(s):

V. G. PAPATSIROS (Β.Γ. ΠΑΠΑΤΣΙΡΟΣ) ◽

C. ALEXOPOULOS (Κ. ΑΛΕΞΟΠΟΥΛΟΣ) ◽

S. C. KYRIAKIS (Σ.Κ. ΚΥΡΙΑΚΗΣ)

Keyword(s):

Respiratory Disease ◽

Clinical Manifestation ◽

Management Strategies ◽

Clinical Manifestations ◽

Meat Production ◽

Finishing Pigs ◽

Pork Meat ◽

Swine Industry ◽

Prrs Virus ◽

The Cost

The clinical manifestations of PRRS virus infection vary from subclinical to severe reproductive failure and/or respiratory disease. Severity of PRRS virus associated disease may result from interactions among factors involving differences in virulence among PRRS virus isolates, probable recombination between the different isolates that are responsible for the clinical manifestation of PRRS in the same farm, differences in concurrent infections (other viruses and bacteria) and hygiene monitoring programme. It is known that viruses and bacteria interacted and the most common model of this interaction is that pathogens bacteria complicate the lesions that are due to viruses. PRRS virus induces predisposition to Streptococcus suis in nursery age pigs and increases susceptibility to Salmonella choleraesuis, Bordetella bronchiseptica and Mycoplasma hyopneumoniae. Furthermore, PRRS virus is involved in aetiology and predispose to appearance of Porcine Respiratory Disease Complex (PRDC) Postweaning Multisystemic Wasting Syndrome (PMWS) and Porcine Dermatitis and Nephropathy Syndrome (PDNS). The respiratory form of PRRS co-infection with Aujeszky' disease causes severe losses in swine herds due to respiratory problems. In cases of PRRS co-infections with other agents, the cost of pork meat production is raised from the treatments and other special management strategies. Up to date, in Greece, PRRS is appeared with the enzootic form (independendy of the season) with elevations and declines. In Greek swine industry, PRRS virus is involved as primary pathogen agent in cautions of mortality of growing/finishing pigs. During the last years, the presence of the new syndromes of PRDC, PMWS and PDNS causes additional economical losses and increases the cost of Greek pork meat production. The unpublished data of editors indicate that during last year, PRRS caused severe losses in Greek swine industry. Cases of PRRS were noticed in farms which purchased gilts or piglets without keeping out preventive facilities of biosecurity as quarantine, serology examinations etc. The syndrome was appeared with the respiratory form in growing/finishing pigs associated with severe losses, due to the entrance of «new» different isolates of PRRS virus from the purchase of gilts or piglets. It is probably that these «new» different isolates were more virulent than the preexisted isolates or/and predominated with them. In cases, where severe respiratory signs in growing/finishing pigs and no or moderate reproductive form of PRRS were noticed, it is probable that the vaccinations of sows against PRRS did not protect the growing/finishing pigs or the «new» different isolates of PRRS virus had more respiratory than reproductive tropism or coexistenced in all earlier circumstances. Today, PRRS is a dangerous risk factor for the Greek swine industry and for this reason it is important to apply all preventive facilities as: vaccinations, reduction of the introduction gilts and maintenance of a grandparent nucleus in the farm for producing gilts, quarantine and serological monitoring for all introduced animals (gilts and piglets), as well as the purchase of animals from PRRS-negative farms. The purchase of piglets has to be avoided because it induces negative effects on the clinical manifestation and control of PRRS.

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Clinical and molecular spectrum associated with Polymerase-γ related disorders

Journal of Child Neurology ◽

10.1177/08830738211067065 ◽

2022 ◽

pp. 088307382110670

Author(s):

Ruchika Jha ◽

Harshkumar Patel ◽

Rachana Dubey ◽

Jyotindra N. Goswami ◽

Chandana Bhagwat ◽

...

Keyword(s):

Age Of Onset ◽

Pediatric Population ◽

Single Gene ◽

Management Strategies ◽

Clinical Manifestations ◽

Progressive External Ophthalmoplegia ◽

Leigh Disease ◽

Pathogenic Variants ◽

Phenotype Analysis

Background POLG pathogenic variants are the commonest single-gene cause of inherited mitochondrial disease. However, the data on clinicogenetic associations in POLG-related disorders are sparse. This study maps the clinicogenetic spectrum of POLG-related disorders in the pediatric population. Methods Individuals were recruited across 6 centers in India. Children diagnosed between January 2015 and August 2020 with pathogenic or likely pathogenic POLG variants and age of onset <15 years were eligible. Phenotypically, patients were categorized into Alpers-Huttenlocher syndrome; myocerebrohepatopathy syndrome; myoclonic epilepsy, myopathy, and sensory ataxia; ataxia-neuropathy spectrum; Leigh disease; and autosomal dominant / recessive progressive external ophthalmoplegia. Results A total of 3729 genetic reports and 4256 hospital records were screened. Twenty-two patients with pathogenic variants were included. Phenotypically, patients were classifiable into Alpers-Huttenlocher syndrome (8/22; 36.4%), progressive external ophthalmoplegia (8/22; 36.4%), Leigh disease (2/22; 9.1%), ataxia-neuropathy spectrum (2/22; 9.1%), and unclassified (2/22; 9.1%). The prominent clinical manifestations included developmental delay (n = 14; 63.7%), neuroregression (n = 14; 63.7%), encephalopathy (n = 11; 50%), epilepsy (n = 11; 50%), ophthalmoplegia (n = 8; 36.4%), and liver dysfunction (n = 8; 36.4%). Forty-four pathogenic variants were identified at 13 loci, and these were clustered at exonuclease (18/44; 40.9%), linker (13/44; 29.5%), polymerase (10/44; 22.7%), and N-terminal domains (3/44; 6.8%). Genotype-phenotype analysis suggested that serious outcomes including neuroregression (odds ratio [OR] 11, 95% CI 2.5, 41), epilepsy (OR 9, 95% CI 2.4, 39), encephalopathy (OR 5.7, 95% CI 1.4, 19), and hepatic dysfunction (OR 4.6, 95% CI 21.3, 15) were associated with at least 1 variant involving linker or polymerase domain. Conclusions We describe the clinical subgroups and their associations with different POLG domains. These can aid in the development of follow-up and management strategies of presymptomatic individuals.

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