1/19. Severe anaphylactic reaction after primary exposure to aprotinin.aprotinin is widely used to prevent bleeding and reduce blood transfusions after open heart surgical procedures. Because it is a foreign protein, aprotinin has allergenic potential. We report a case of near-fatal anaphylactic reaction to primary aprotinin exposure in a child successfully treated using cardiopulmonary bypass support. The possibility of an allergic reaction must be considered whenever this drug is used.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/19. adult onset grape hypersensitivity causing life threatening anaphylaxis.BACKGROUND: Adverse reactions to foods are encountered much less frequently in adults than in the children. adult onset hypersensitivity to grapes has not been previously reported. OBJECTIVE: Evaluation of a case of anaphylaxis that occurred as a result of the consumption of white grapes (vitis vinifera). methods AND RESULTS: A 28-year-old woman experienced generalized urticaria, facial/oropharyngeal angioedema, and dizziness after eating a bunch of white grapes. She was treated in an emergency room for anaphylaxis. Previously, she had experienced two similar episodes after eating white grapes. The grape prick skin tests were strongly positive forming a pseudopod type reaction. The total serum IgE was 1918 ng/mL. The grape-specific serum IgE was weakly positive by the modified RAST and negative in the Pharmacia-Upjohn Cap System. CONCLUSION: hypersensitivity to a commonly consumed fruit such as grapes can develop late in life causing a near-fatal anaphylaxis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/19. Anaphylactoid reactions to paracetamol.The toxic effects of paracetamol in overdose quantities are well recognised but the occurrence of anaphylactoid reactions to paracetamol is infrequently identified by consumers and health care professionals. Nevertheless adverse reactions to this drug, even in therapeutic doses, can have fatal or near fatal consequences. A case of an anaphylactoid reaction to paracetamol is described.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/19. A near-fatal hypersensitivity reaction to abacavir: case report and literature review.A near-fatal hypersensitivity reaction to abacavir developed in a 62-year-old hiv-seropositive man who had been sensitized 17 months before presentation. Six days after he was rechallenged, acute respiratory distress developed, requiring mechanical ventilation for 2 weeks. Four days after extubation, he was again rechallenged. Hours later, the patient experienced anaphylactic shock, requiring mechanical ventilation for 3 weeks, aggressive volume resuscitation, and vasopressor support. Recovery was complicated by acute tubular necrosis, digital necrosis, and a GI bleed. This report reviews the mechanisms of action, efficacy, and adverse reactions of abacavir and illustrates the danger of serially rechallenging patients with this agent.- - - - - - - - - - ranking = 5keywords = near (Clic here for more details about this article) |
5/19. An unusual case of anaphylaxis. Mold in pancake mix.Anaphylactic reactions involve contact with an antigen that evokes an immune reaction that is harmful. This type of reaction is a rapidly developing immunologic reaction termed a type I hypersensitivity reaction. The antigen complexes with an IgE antibody that is bound to mast cells and basophils in a previously sensitized individual. Upon re-exposure, vasoactive and spasmogenic substances are released that act on vessels and smooth muscle. The reaction can be local or systemic and may be fatal. The authors report the death of a 19-year-old white male who had a history of "multiple allergies," including pets, molds, and penicillin. One morning, he and his friends made pancakes with a packaged mix that had been opened and in the cabinet for approximately 2 years. The friends stopped eating the pancakes because they said that they tasted like "rubbing alcohol." The decedent continued to eat the pancakes and suddenly became short of breath. He was taken to a nearby clinic, where he became unresponsive and died. At autopsy, laryngeal edema and hyperinflated lungs with mucous plugging were identified. Microscopically, edema and numerous degranulating mast cells were identified in the larynx. The smaller airways contained mucus, and findings of chronic asthma were noted. serum tryptase was elevated at 14.0 ng/ml. The pancake mix was analyzed and found to contain a total mold count of 700/g of mix as follows: penicillium, fusarium, mucor, and aspergillus. Witness statements indicate that the decedent ate two pancakes; thus he consumed an approximate mold count of 21,000. The decedent had a history of allergies to molds and penicillin, and thus was allergic to the molds in the pancake mix. The authors present this unusual case of anaphylaxis and a review of the literature.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/19. Risks of BCG intralesional therapy: an experience with melanoma.A nearly fatal allergic reaction to intratumor BCG injections was associated with a complete remission of recurrent malignant melanoma. Clinical course and histologic sections suggested both anaphylactic and Arthus reactions. The occurrence of reactions at BCG injection sites as well as at uninjected sites of tumor suggests common BCG and melanoma antigens. The management of events involved in this often fatal postimmunotherapy complication involves the early administration of parenteral fluids, antituberculous therapy, antihistamines, and possible steroids. The prophylactic use of antihistamines and an in-hospital administration of intralesional BCG immunotherapy are strongly suggested. In the future, prophylactic INH may prove to be both therapeutically efficacious and protective against infectious complications.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/19. hypersensitivity reactions to cisplatin and carboplatin--a report on six cases.Anaphylactic reactions to platinum compounds are well recognised, but uncommon. These vary from true type I reactions to direct histamine release due to nonimmunological mechanisms. We present 6 cases to illustrate this--5 due to cisplatin and a report of this occurring with carboplatin--with a near fatal outcome in 3 of the cases.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
8/19. anaphylaxis and asthma in a scrimshander due to deer bone dust.A boilermaker who engraved deer bone (scrimshaw) as his artistic vocation developed recurrent anaphylaxis while scraping deer bones. These bones has been boiled in NaClO and dried, leaving residual NaOH and altered deer protein. He had recurrent episodes of anaphylaxis when exposed to the bone dust. The anaphylaxis appears to be the result of exposure of traumatized skin to NaOH and antigen with sufficient absorption of antigen to result in anaphylaxis, although inhalation may have been contributory. The most severe, near fatal episode of anaphylaxis may have been worsened by captopril. The patient's reaction by prick test to protein extracted in buffered saline from the deer bones boiled in NaClO and NaOH but not to natural deer protein suggested IgE antibody against deer protein altered by boiling in alkali. The scrimshander is now working with deer bone after prophylactic therapy and control of exposure.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/19. Nearly fatal idiopathic anaphylactic reaction resulting in cardiovascular collapse and myocardial infarction.We report a case of nearly fatal cardiovascular collapse attributable to an idiopathic anaphylactic reaction in a 76-year-old man. The event began with gastrointestinal symptoms of abdominal cramps, diarrhea, nausea, and vomiting as manifestations of IA. The patient subsequently progressed to develop urticaria, flushing, cardiovascular symptoms of chest pain, hypotension, and eventually cardiovascular collapse and myocardial infarction over a five-hour interval. This case emphasizes that the potential for life-threatening cardiovascular events from IA exists in patients without previously defined cardiac risk factors.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/19. The use of dextran-40 during percutaneous transluminal coronary angioplasty: a report of three cases of anaphylactoid reactions--one near fatal.Successful percutaneous transluminal coronary angioplasty is achieved by fracture of the atheromatous plaque and perhaps dilatation of the arterial walls to increase the luminal diameter of the artery. Because this "controlled" injury stimulates platelet adhesion on the subendothelial matrix, the use of dextran-40 in addition to heparin has been advocated. The overall incidence of Dextran-induced anaphylactoid reactions at our institution was 0.6% and of severe life-threatening reactions, 0.2%. With the recent doubts cast on the efficacy of dextran-40, the question arises regarding its routine use in PTCA.- - - - - - - - - - ranking = 4keywords = near (Clic here for more details about this article) |
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