Rush immunotherapy in two cats with atopic skin syndrome

Case series summary Two cats with feline atopic skin syndrome (FASS) were included in this case series. They were diagnosed with FASS by a combination of history, physical examination and exclusion of other pruritic diseases. They underwent rush immunotherapy (RIT) after determination of offending environmental allergens by either serum IgE or intradermal testing. Cats were premedicated with an antihistamine and hospitalized for the day to undergo the procedure and to ensure adequate observation. Allergen extracts were administered subcutaneously at increasing concentrations every 30 mins until the maintenance dose of 20,000 protein nitrogen units/ml was reached. Both cats successfully completed RIT without any adverse reactions and their clinical signs improved afterwards. RIT appears to be an alternative treatment option for cats with FASS. Larger studies are needed to more accurately assess the safety and long-term efficacy of RIT in the feline patient, as well as the incidence of adverse reactions and optimal premedication protocol. Further evaluation of the route of injections for RIT is also warranted. Relevance and novel information RIT has been reported to be a safe treatment option in canine atopic dermatitis. Its use in FASS is limited to a pilot study of four cats. The purpose of this series was to describe two additional cats that underwent RIT using a different premedication protocol.

Rush Immunotherapy Using Ifn-Gamma for Cefazoline Allergy

Cefazolin is a first generation cephalosporin widely used for preoperative antibiotic prophylaxis. Although cefazolin hypersensitivity constitutes a potential life-threatening condition with serious consequences, correct diagnosis of cefazolin hypersensitivity is not straightforward for various reasons. A graded challenge is perhaps the most reliable in vivo test for the diagnosis of cefazolin allergy. Desensitization is performed by the cautious administration of incremental doses of the drug to the patient. In the case of intravenous drug, the challenge and desensitization has been regarded as extremely dangerous. IFN-gamma has allergen-specific tolerogenic effects, together with the administration of allergens. Moreover, IFN-gamma was introduced for desensitization for aspirin and cefaclor. In this case report, two cases were described concerning challenge test and desensitization for anaphylactic drug allergy for intravenous cefazolin using IFN-gamma.