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1/10. Mechanisms responsible for delayed and immediate hemolytic transfusion reactions in a patient with anti-E Jk(b) Di(b) and anti-HLA alloantibodies.

    Immediate hemolytic transfusion reactions (IHTR) occurred in the course of delayed hemolytic transfusion reactions (DHTR). An 84-year-old man had received a blood transfusion 20 years ago. Progressive anemia developed, because of continuous bleeding from a bladder tumor. He was transfused with concentrated red blood cells (CRC) which were Rh-E antigen negative, because he had anti-E antibodies (day 0). He received CRC on day 3, and underwent resection of bladder tumor on day 6. Although crossmatch-compatible CRCs were prepared for the operation, those were not required and were kept in a refrigerator in the ward. On day 9, when a CRC kept in the ward was transfused, he suddenly had a IHTR. In order to analyze a mechanism of IHTR, the anti-Jk(b) and anti-Di(b) antibodies, anti-HLA antibodies and the concentrations of inflammatory cytokines were measured in serum samples. The anti-Jk(b) and anti-Di(b) antibodies increased prior to IHTR experienced on day 9. The concentrations of IL-6 and IL-1beta increased from day 2, while the concentration of IL-8 increased from day 7. The anti-HLA class I antibody could be detected 2 days before IHTR. Thus, the anti-Jk(b) and anti-Di(b) antibodies induced the production of inflammatory cytokines and symptoms of DHTR and IHTR. The anti-HLA class I antibody could be produced in spite of using the filer for removing leukocytes, and may take part in the induction of IHTR. Further, blood products should be transfused soon after completing a crossmatch test in patients with anti-RBC alloantibodies.
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2/10. angioedema induced by inhalation of vapours from cooked white bean in a child.

    BACKGROUND: There are few references of allergic reaction to beans in childhood. We report the case of a seven years old boy who suffered from angioedema associated to inhalation of vapours from cooked white bean. methods: skin prick tests (SPT) were performed by prick-by-prick with cooked white bean and legumes. It was also determined total IgE and specific IgE antibodies to bean and legumes with the use of the CAP enzymo-immunoassay. Subsequently, a oral challenge test was carried out with white bean. RESULTS: The prick-by-prick with white bean was positive in our case, and negative in ten controls patients. Specific IgE in patient serum, assayed by CAP was positive for white bean and green bean. The patient developed angioedema after ingestion cooked white bean. CONCLUSION: we demonstrated a type I hypersensitivity to white bean in a seven years old child by SPT, specific IgE antibodies and challenge test.
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keywords = white
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3/10. Contact urticaria from carboxymethylcellulose in white chalk.

    BACKGROUND: Carboxymethylcellulose (CMC) is widely used in consumer goods, foods, and medicaments as a binder, emulsifier, and viscosity enhancer. Cases of immediate and delayed allergic reactions to this anionic cellulose polymer have been reported. OBJECTIVE: To report a case of contact urticaria from CMC in chalk, with possible cross-reaction to methyl hydroxyethylcellulose (MHEC). METHOD: patch tests with readings at 48 and 96 hours were performed with the North American Contact dermatitis Group standard series and benzisothiazolinone. Open and prick tests with readings after 30 minutes were performed with two brands of chalk as well as with various petrolatum and aqueous dilutions of CMC, MHEC, oleic acid, and calcium carbonate. RESULTS: The patient developed strong urticarial reactions during open tests with both powdered chalks and had milder reactions to the open test with CMC 10% aqueous (aq) and to prick testing with CMC 0.1% aq. No reaction to MHEC or any of the other ingredients of the chalks was observed. No relevant delayed reaction was noted. CONCLUSION: CMC can cause contact urticaria. It remains unclear why our patient reacted more strongly to the chalk than to CMC itself. We speculate that the abrasive nature of the chalk enhances the cutaneous penetration of CMC or that calcium carbonate, the main ingredient of the chalk, acts as an adjuvant. It is also possible that CMC and MHEC cross-react and that our negative results with MHEC may be due to improper testing technique or concentrations.
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ranking = 0.16435856772004
keywords = white
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4/10. Buckwheat anaphylaxis: an unusual allergen in taiwan.

    IgE-mediated hypersensitivity to buckwheat is common in korea, japan, and some other Asian countries. However, buckwheat is not a common allergen in taiwan. We report a woman with asthma who had anaphylactic shock, generalized urticaria, and an acute exacerbation of asthma five minutes after ingesting buckwheat. The patient underwent skin prick and Pharmacia CAP testing (Uppsala, sweden) for specific IgE to buckwheat, white sesame and soybean as well as other common allergens in taiwan including dermatophagoides pteronyssinus (Dp), D. farinae (Df), cat and dog dander, cockroach, egg white, cow milk and codfish. The patient had a strongly positive skin prick test response to buckwheat and positive reactions to Dp and latex. Specific IgE results were class 6 for buckwheat, class 4 for Dp and Df, and class 2 for dog dander, wheat, sesame and soybean. Results of an open food challenge with white sesame and soybean were negative. Although buckwheat is a rare allergen in taiwan, it can cause extremely serious reactions and should be considered in patients presenting with anaphylaxis after exposure to buckwheat.
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5/10. Monosodium glutamate-related orofacial granulomatosis. review and case report.

    A case is reported in a 15-year-old white girl who had a swollen lower face and lips; a diagnosis of orofacial granulomatosis was made. It was suspected that her condition had an allergic basis because an increase in clinical signs and symptoms was shown to be related to the food additive monosodium glutamate. Treatment with a restricted diet resulted in resolution of the facial swelling.
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ranking = 0.041089641930011
keywords = white
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6/10. Systemic allergic reaction to pine nuts.

    This case report describes a systemic reaction due to ingestion of pine nuts, confirmed by an open, oral provocation test. Skin prick testing with the aqueous allergen revealed an immediate positive prick test, and histamine release from basophil leukocytes to the aqueous allergen was demonstrated. radioallergosorbent test demonstrated specific IgE antibodies to pine nuts. In a review of medical literature, we found no reports of either oral provocation tests confirming a systemic reaction due to ingestion of pine nuts or demonstration of specific IgE antibodies.
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7/10. Occupational sensitivity to Alphitobius diaperinus (Panzer) (lesser mealworm).

    Alphitobius diaperinus is an important beetle in the grain and poultry industries. We evaluated three individuals with work-related symptoms of asthma, rhinitis, conjunctivitis, urticaria, and angioedema on exposure to the insect. Prick skin tests with extracts prepared from the larval, pupal, and adult life stages were positive in all three patients. Specific IgE antibodies to these extracts were demonstrated by RAST or radioimmunoassay. RAST and radioimmunoassay inhibition confirmed the specificity of IgE binding and further demonstrated immunologic cross-reactivity between the three life stages. Peripheral blood leukocytes from two of the individuals demonstrated significant histamine release when they were compared with cells from nonexposed atopic and normal control subjects. The proteins in the extracts of each life stage were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. More than 30 protein bands were detected in each of the extracts; however, the patterns of separation were different for each life stage. After immunoblotting and autoradiography, IgE-binding proteins were recognized by sera from all three individuals in the larval extract at 90 kilodaltons (kd), in the pupal extract at 90, 64, and 38 kd, and in the adult extract at 84 kd. Additionally, several other proteins were identified as being allergenic in some of the patients. We conclude that these three patients developed IgE-mediated sensitivity to A. diaperinus antigens as the result of occupational exposure. To our knowledge, this is the first description of sensitivity to this grain beetle.
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keywords = leukocytes
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8/10. Occupational allergy in horticulture: demonstration of immediate-type allergic reactivity to freesia and paprika plants.

    patients A and M developed allergic symptoms when working in a greenhouse with paprika plants and freesia plants, respectively. The possible involvement of an IgE-mediated mechanism was investigated with the skin prick test, radioallergosorbent test (RAST) and the histamine release test (HRT). Paprika flower, leaf and stem extract released 58, 47 and 43% of the total amount of histamine from washed leukocytes of patient A. In serum A IgE antibodies against paprika leaves and flowers could be demonstrated by RAST (11% binding of 125I-anti-IgE added). Freesia flower and stem extract released 46 and 43% histamine, respectively, from washed leukocytes of patient M. In the RAST, specific IgE antibodies against freesia flowers and stems were found in serum M (37% binding of 125I-anti-IgE added).
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9/10. Immediate hypersensitivity to seminal fluid and atopic dermatitis.

    A woman with atopic dermatitis experienced anaphylactic episodes following intercourse with her husband, with subsequent exacerbations of her atopic dermatitis. Skin testing and an in vitro leukocyte histamine release assay established the diagnosis of immediate hypersensitivity to her husband's seminal fluid; delayed hypersensitivity to seminal fluid could not be demonstrated. Antigen was found in the seminal fluid of nonrelated men. Radioallergosorbent testing detected the presence of circulating IgE antibodies specific for seminal plasma protein. immunotherapy with seminal plasma may have limited the severity of a subsequent reaction. serum from the husband and nonrelated men also contained antigen that provoked histamine release from the patient's leukocytes in vitro. The antigen in serum was associated with the globulin fraction and had a temporal relationship to ejaculation, appearing within 12 hours of ejaculation and disappearing within four days.
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10/10. Atopic asthma caused by candida albicans acid protease: case reports.

    Two cases of atopic asthma caused by acid protease produced by candida albicans are reported. Both patients had high levels of serum IgE antibodies against the acid protease and showed positive conjunctival and immediate bronchial responses when challenged with the protease. Significant histamine release was detected in both patients when their peripheral leukocytes were challenged with the protease antigen. These findings clearly showed that C. albicans acid protease is the causative allergen of atopic asthma.
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