severe allergic reaction
Recently Published Documents


TOTAL DOCUMENTS

83
(FIVE YEARS 38)

H-INDEX

10
(FIVE YEARS 2)

Author(s):  
Maryam Ameri ◽  
Meysam Abolmaali ◽  
Sayed Mohammed Jawad Alwedaie ◽  
Mohammad Nabavi ◽  
Neda Rahimian ◽  
...  

Since the beginning of the COVID-19 pandemic, efforts have been made to design safe and effective vaccines against SARS-CoV-2. Numerous vaccines have been designed and tested in limited clinical trials in various countries. Among them, the Sputnik V vaccine has shown a relatively safe profile and, to our knowledge, has no associated major side effects. We describe the case of a 40-year-old female healthcare worker who developed severe persistent eczematous lesions on the second day after she received the first dose of the Sputnik vaccine. The eczematous lesions were refractory to an antihistamine and persisted at the 1 month follow-up. Severe persistent eczematous lesions should be viewed as a potential side effect of vaccination with the Sputnik V vaccine. Moreover, a severe allergic reaction to a COVID-2019 vaccine may indicate the vaccine is ineffective in the recipient.


2021 ◽  
Vol 2 ◽  
Author(s):  
Wannada Laisuan

Vaccine anaphylaxis is rare; however, severe allergic reactions after administration of a coronavirus disease 2019 (COVID-19) vaccines have been reported. Excipients in the vaccine may play a role in severe allergic reactions post-vaccination. Various mechanisms, including IgE-mediated pathways, direct mass cell stimulation via the Mas-related G protein-coupled receptor-X2, and complement pathway activation, have been proposed to cause the anaphylaxis. Skin testing, using the basophil activation test, has been used to clarify the mechanism of the anaphylaxis and provide safety information for the next injection. Here, we review the current evidence and suggested approaches for patients who experienced an immediate severe allergic reaction to the first dose of a COVID-19 vaccine.


2021 ◽  
pp. 56-61
Author(s):  
V. M. Svistushkin ◽  
G. N. Nikiforova ◽  
A. V. Zolotova ◽  
E. S. Novtseva

Patients with complaints of coughing make up a significant percentage of doctors in various specialties. Cough is not an independent disease, in most clinical cases it is a symptom of a respiratory disease. In acute respiratory pathology, the cough is usually short-lived and stops after the eradication of the infectious agent and the relief of inflammatory changes. It is important therapeutically to provide a reduction in the duration and relief of cough, as well as the prevention of complications. An effective symptomatic agent in the treatment of coughs of various origins, including inflammatory diseases of the respiratory tract, are herbal preparations. The fairly widespread use of phytopreparations in clinical practice is due to their high safety, physiological action, availability and effectiveness. The pharmacological action of these drugs in respiratory infections is manifested by antiinflammatory, cytoprotective, antiviral and antioxidant effects, multifactorial improvement of mucociliary cleansing processes. One of these phytopreparations is a monocomponent syrup with expectorant, mucolytic and antispasmodic. The therapeutic effect of drug is explained by the presence in the composition of triterpene glycosides (saponins) from the leaves of Hedera helix . The effectiveness and safety of drug is proved by a sufficient volume of clinical studies and observations. Literature data show that Hedera helix leaf preparations significantly reduce the severity of acute respiratory infections of the upper respiratory tract.Virtually none of the patients had severe side effects. Allergic reactions were recorded in less than 0.5% of cases, with no mention of a severe allergic reaction of the anaphylaxis type. Thus, the drug of plant origin in the form of drops can be successfully used in patients with symptoms of acute respiratory diseases.


2021 ◽  
Author(s):  
Zhenglin Quan ◽  
Huanchao Zeng ◽  
Zhicheng Fang ◽  
Xianyi Yang

Abstract Background Severe allergic reactions and life-threatening multiple organ injury or failure are common after severe stings. However, reports on wasp stings complicated with continual hypolipoproteinaemia are scarce in the literature and there is no consensus for its therapeutic management. Methods This case is a 49-year-old female patient who developed severe allergic reaction and multiple organ failure after severe wasp stings and complicated with sustained hypolipoproteinaemia. Her clinical characteristics and the change of lipid levels are described. During the hospitalization, we did not perform any intervention for dyslipidemia. Results The patient’s blood lipid levels were decreased after numerous wasp stings. In particular, the HDL-C was linear over all five days(nadir, 0.21mmol/L on day 5), and the level gradually recovered to normal till day 17. At the same time, the patient occurs severe inflammatory response and multiple organ dysfunction syndrome, especially liver failure. The 3 months follow-up of the patient was remarkable with normal lipid level and she was doing well in normal daily activities. Conclusion We highlight the hypolipoproteinaemia that might occur in the patient who after severe wasp stings. This study initially confirmed that there is some correlation between abnormal blood lipid metabolism and the evolution of the condition. Whether dyslipidemia in wasp stings is associated with hemolysis and inflammatory reaction is unclear, and further investigation would be required. As far as we know, this is the first report of persisting hypolipoproteinaemia after wasp stings. The clinical research and prolonged follow-up are yet to be concluded, and large-scale clinical studies need to be performed.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4280-4280
Author(s):  
Krishna G Badami

Abstract In three recent cases an initial transfusion-related adverse event (TRAE) occurred that had a significant respiratory component, and other features suggesting a severe allergic reaction. All were treated as such. Shortly after treatment the nature of the event changed to something resembling transfusion-associated circulatory overload (TACO). These cases suggest the possibility that a severe TRAE that is not TACO may precipitate TACO. In other words, some transfusions, sometimes, may deliver a 'double whammy'. A possible mechanism might be through the development of Takotsubo, or stress, cardiomyopathy - a cause of acute, reversible, heart failure. Takotsubo cardiomyopathy typically presents with chest pain or shortness of breath. Ventricular wall dysfunction occurs, and characteristic echocardiographic abnormalities are seen. ECG and biochemical features suggest cardiac ischaemia. It is commoner in post-menopausal women. A range of 'stressors' - hypotension, asthma attacks, accidents, medical procedures, pain, bad news, etc. - may precipitate it. 1 Catecholamines such as adrenaline are believed to play a central role. They cause direct toxicity to the myocardium, and also coronary artery spasm, and increased cardiac workload. 2 One other such case is reported. There, a 48 years old post-menopausal woman developed acute reversible heart failure with the features of Takotsubo cardiomyopathy, following urticaria and pruritus, whilst having a platelet transfusion. No adrenaline was given, but the authors postulate that adrenergic and histaminergic elements may have combined to produce the effect on the heart. 3 Thus, in some patients the 'perfect storm' compounded of borderline cardiac function,catecholamine release (secondary to the stress of the underlying disorder, the transfusion, and the TRAE),histamine release (in allergic TRAE),the treatment of the allergic reaction with adrenalinerecent or ongoing volume overload may be sufficient to precipitate or exacerbate TACO. Careful consideration of cases with similar features is needed. Potential precipitating factors are modifiable or preventable. References: 1. https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome 2. https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.116.027121 3. Zhou JQ, Choe E, Ang L, et al. Stress-induced cardiomyopathy associated with a transfusion reaction: A case of potential crosstalk between the histaminic and adrenergic systems. Exp Clin Cardiol.2011; 16: 30-32 Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 10 (19) ◽  
pp. 4369
Author(s):  
Juliette Bardet ◽  
Noémie Laverdure ◽  
Mathieu Fusaro ◽  
Capucine Picard ◽  
Lorna Garnier ◽  
...  

The NLRC4 inflammasome is part of the human immune innate system. Its activation leads to the cleavage of pro-inflammatory cytokines IL-1β and IL-18, promoting inflammation. NLRC4 gain-of-function (GOF) mutations have been associated with early-onset recurrent fever, recurrent macrophagic activation syndrome and enterocolitis. Herein, we describe two new patients with NLRC4 mutations. The first case presented with recurrent fever and vasoplegic syndrome, gut symptoms and urticarial rashes initially misdiagnosed as a severe protein-induced enterocolitis syndrome. The second case had recurrent macrophage activation syndrome (MAS) and shock, suggesting severe infection. We identified two NLRC4 mutations, on exon 4, within the nucleotide-binding protein domain (NBD). After a systematic review of NLRC4 GOF mutations, we highlight the wide spectrum of this disease with a limited genotype–phenotype correlation. Vasoplegic shock was only reported in patients with mutation in the NBD. Diagnosing this new entity combined with gastrointestinal symptoms and vasoplegic shocks is challenging. It mimics severe allergic reaction or sepsis. The plasma IL-18 level and genetic screening are instrumental to make a final diagnosis.


Author(s):  
Zoe Morou ◽  
Emilia Vassilopoulou ◽  
Petros Galanis ◽  
Athina Tatsioni ◽  
Nikolaos G. Papadopoulos ◽  
...  

<b><i>Background:</i></b> Food allergy (FA) in children impacts their own and their family quality of life (QoL). The association of specific FA factors with the various domains of health-related QoL (HRQL) in children is unclear. <b><i>Objective:</i></b> The aim of this study was to evaluate FA characteristics in primary school children as determinants of components of HRQL. <b><i>Methods:</i></b> Children with FA were recruited from the allergy clinic of a tertiary children’s hospital. Demographic and clinical data were retrieved from their records, and 3 HRQL questionnaires were administered: the FA QoL Questionnaire-Child Form (FAQLQ-CF), the FA independent measure (FAIM), and the Pediatric QoL Questionnaire (PedsQL™). Stepwise multiple linear regression analysis was carried out to investigate the correlation between FA characteristics and the scores on the HRQL scales. Bonferroni correction for multiple comparisons was set at <i>p</i> &#x3c; 0.0002. <b><i>Results:</i></b> Of 172 primary schoolchildren with FA invited to take part, 110 participated (response rate 64%), of whom 83 (75.5%) were male, aged 7.5–12.3 years (mean 10.0 ± 1.4) years. From 38 demographic and clinical characteristics, 10 were excluded on initial data analysis and 28 proceeded to bivariate analysis with the scores on FAQLQ-CF, FAIM, PedsQL™, and their subscales. Most of the 28 showed no correlation with the scores; only 4 were entered into multivariate analysis with FAQLQ-CF and PedsQL™ scores, none of which, finally showed significant association. <b><i>Conclusion:</i></b> The HRQL of children with FA did not depend on gender, age, number, and type of allergen or the characteristics of the most severe allergic reaction.


2021 ◽  
Vol 4 (12) ◽  
pp. 01-04
Author(s):  
José Polavieja

A 53-year-old man with a known allergy to metamizole presented for acute gonalgia, receiving metamizole by mistake. He suffers a severe allergy reaction accompanied by chest pain and signs of acute lower myocardial infarction, which subsides with treatment of anaphylactic shock and fibrinolysis, without observing intracoronary thrombus or signs of complication of atherosclerotic plaque. LEARNING OBJECTIVE An exceptional clinical case is presented illustrating an acute myocardial infarction related to a severe allergic reaction. In addition, a review of the optimal management of this entity is carried out. We intend to make this entity known, which should be suspected in the appropriate clinical setting


Author(s):  
Bahgat Z. Gerges ◽  
Joel Rosenblatt ◽  
Y-Lan Truong ◽  
Ruth A. Reitzel ◽  
Isaam Raad

Abstract Chlorhexidine is an antimicrobial agent widely used for infection prevention in medical settings. Nevertheless, allergic reactions ranging from mild to severe have been reported following its use. In this review, we analyzed all case reports published between the introduction of chlorhexidine and the end of 2019 for allergic responses associated with the use of medical devices and or other medical products containing chlorhexidine (CHX) to ascertain the prevalence of severe CHX allergic reactions and what practices might best mitigate those risks. In total, 77 publications containing 124 reported cases of allergic reactions were grouped into 3 product categories, catheters, semisolids, and fluid products. The country, type of reaction, route of sensitization, allergy confirmation, and intervention or mitigation was extracted for each case. Overall, 30 cases were associated with catheters, 46 cases were associated with semisolid products, and 48 cases were associated with the use of other medical products. Severe cases were managed with intravenous fluids, steroids, and epinephrine (adrenaline). None of the reported cases were fatal. The allergy risks can be mitigated by better warning and training clinicians and by recording and screening patient histories for CHX presensitization from prior exposure. For patients undergoing pre-use blood tests, IgE antibody screens can also be performed. Finally, as a precaution in the event a rare severe allergic reaction occurs, procedure carts and rooms can be prestocked with injectable epinephrine and other rapidly acting anti-inflammatory medications.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 534-535
Author(s):  
J. Avouac ◽  
R. Cougnaud Murail ◽  
C. Goulvestre ◽  
S. Dumas ◽  
A. Moltó ◽  
...  

Background:The bioequivalence between rituximab (RTX) originator and its biosimilar GP2013 has been demonstrated in rheumatoid arthritis (RA) (1). A recent randomized controlled trial suggested in a selected population a very low immunogenicity of GP2013 in RA (<1%) (2).Objectives:To study in daily practice the risk of immunogenicity of patients treated with GP2013 for their chronic inflammatory rheumatic disorder.Methods:Prospective routine care study carried out between September 2018 and August 2020 in the Rheumatology department of Cochin Hospital. We consecutively included patients treated with the biosimilar RTX GP2013, systematically used in the department since March 2018. Samples were taken before each infusion in order to detect anti-RTX antibodies (Ab) and RTX residual concentrations by ELISA (Lisa Tracker Duo Rituximab, LTR005, Theradiag).Results:We included 159 consecutive patients treated with GP2013 (124 women, 78%) with a mean age of 59±13 years and a mean disease duration of 18±11 years. Among these 159 patients, 108 (68%) had RA and 51 had another disease (16 systemic sclerosis (SSc), 15 mixed connective tissue disease (MCTD), 5 systemic lupus (SLE), 5 inflammatory myopathies (MI), 5 undifferentiated polyarthritis, 2 juvenile idiopathic arthritis (JIA) and 3 primary Sjögren’s syndromes). 137 patients (86%) were receiving associated disease-modifying therapy (DMARD), mainly methotrexate (111/137 patients, 81%). 120 patients (75%) were in maintenance therapy with originator RTX (cumulative dose of RTX: 3.5±6g) before the switch to GP2013 in March 2018. Originator RTX was not re-established during the entire treatment period. The other 39 patients (25%) treated with GP2013 were naïve of originator RTX.The analysis of the first sample, performed before the second GP2013 infusion, identified 8 patients (5 RA, 1 SLE, 1 MCTD and 1 SSc) with positive anti-RTX antibodies (prevalence 5%), with rates varying between 6 and >100ng/mL and undetectable residual RTX concentrations. Among these 8 patients, 6 had previously received originator RTX and 2 were RTX-naïve patients. There was a trend for higher body mass index in patients with positive anti-RTX antibodies (28±7 vs. 25±6 kg/m2, p=0.12), and no association was observed between anti-RTX immunization and age, disease duration, combination with conventional DMARD, mean interval between infusions or cumulative RTX dose.Among the 8 immunized patients, two groups could be isolated: i) a group of 5 patients (3 RA, 1 SLE, 1 SSc) with low antibody levels (6-22 ng/mL) and no significant clinical consequences (absence of treatment discontinuation and loss of efficacy after 13±4 months of follow-up, only one minor allergic reaction) and ii) a group of 3 patients (2 RA, 1 MCTD) with a high antibody levels (≥100ng/mL) and meaningful clinical consequences: one severe allergic reaction during the second GP2013 infusion leading to treatment discontinuation, and a loss of efficacy with incomplete B depletion in 2 patients leading to RTX dose escalation from 500 mg to 1 g. Among the 151 patients not immunized at the time of the first sample, no severe allergic reaction and 6 minor allergic reactions were noted under GP2013.Conclusion:The immunogenicity of patients treated with RTX is a rare event with possible clinical and biological consequences, especially in patients with high antibody levels.References:[1]Smolen et al, Ann Rheum Dis 2017[2]Tony et al, Arthritis Care Res 2019Disclosure of Interests:None declared


Sign in / Sign up

Export Citation Format

Share Document