1/26. The treatment of bovine collagen allergy with cyclosporin.BACKGROUND: Bovine collagen is currently the most common substance used in soft-tissue augmentation. Although patients should undergo routine skin testing for allergy to bovine collagen prior to treatment, hypersensitivity reactions may rarely still occur. Previously, there have been no reliable methods of treatment for these reactions, and physicians could only reassure patients that the reaction would slowly disappear. OBJECTIVE. The use of oral cyclosporin in a patient with hypersensitivity to bovine collagen was evaluated. methods: A patient with an allergic reaction to implanted bovine collagen was started on cyclosporin 175 mg p.o. bid (5 mg/kg/day) after no improvement was seen after treatment with oral and topical steroids. The cyclosporin was started on Day 23 of the allergic reaction. RESULTS: Improvement in the itching and redness was noted by Day 28 of the allergic reaction, and complete clinical resolution of the allergic reaction was noted on Day 41. On Day 47, the cyclosporin was stopped without recurrence of symptoms. The patient did not experience side effects from cyclosporin, and her blood pressure and renal function remained normal. CONCLUSION: This case report shows that oral cyclosporin A may be a safe and effective treatment for bovine collagen hypersensitivity.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
2/26. Unusual skin reaction to silicone content in breast implants.We present a patient who had a long history of unsuccessful bilateral mammary operations with insertion and extraction of various implants, some of which were filled with silicone gel, others with saline. In addition to complications in the tissue surrounding the prosthesis, she had distant widespread skin lesions which, we believe, were due to leakage from the implant. A cutaneous test with material from various implants, such as the gel content and the shells, caused an unusually prolonged inflammatory response, which was difficult to classify as being either irritative or allergic. Macromorphologically and histologically, the provoked lesions resembled the previous cutaneous lesions. We believe that the patient's complications are due to an unusual host response to silicone.- - - - - - - - - - ranking = 7keywords = plant (Clic here for more details about this article) |
3/26. Allergic reaction to spinal cord stimulator.OBJECTIVE: The objective was to report on the possibility of allergic reaction to the components of a spinal cord stimulator. DESIGN: We describe a severe allergic reaction after the insertion of a spinal cord stimulator in a patient with complex regional pain syndrome type 1. SETTING: The patient was being followed in an office-based pain management practice. PATIENT: The patient is a 41-year-old woman with complex regional pain syndrome type 1, posttrauma. Intervention: Insertion of a cervical and lumbar spinal cord stimulator. OUTCOME MEASURES: The outcome measures were a numerical scale of pain intensity and the ability to perform the activities of daily living. RESULTS: Adequate pain control complicated by allergic reaction. CONCLUSIONS: There exists a possibility that a patient may experience an allergic reaction to spinal cord stimulator components. Recognition of such contact sensitivity is important for physicians implanting such devices. patients may be misdiagnosed as having infections, which can delay appropriate management; definitive diagnosis can be confirmed with a patch test. Treatment consists of removal of such devices.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
4/26. silver-coated prosthetic heart valve: a double-bladed weapon.A St. Jude Medical Silzone was implanted in a 72-year-old female, suffering from mitral valve disease. Four months later, the patient had acute cardiac failure due to partial detachment of the prosthetic valve. The mitral annulus was ulcerated and there were multiple erosions in the myocardial tissue in contact with the prosthetic valve. Histological examination revealed chronic inflammation with hemosiderine deposits and giant cells. No allergy to silver ions was found. The silver-coated sewing cuff had caused a chronic inflammatory reaction due to a toxic reaction to silver. The Silzone valve was withdrawn from the market on January 2000.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
5/26. Are high-dose toxic exposures always associated with reactive airways dysfunction syndrome (RADS)?Bottling plant workers were evaluated for respiratory symptoms following an accidental exposure to a chlorine dioxide aerosol. Six exposed employees underwent medical and occupational histories, skin testing to common allergens, spirometry before and after use of bronchodilators, and methacholine challenge. The reported exposure to chlorine dioxide ranged from 30 min to 12 hr. Physical examinations were all normal. Four workers had positive prick skin tests to common aeroallergens. None of the workers demonstrated significant changes in forced expiratory volume in 1 sec following use of bronchodilators, and none experienced methacholine hyperresponsiveness. These cases suggest that the occurrence of reactive airways dysfunction syndrome is unpredictable and may not always occur in heavily exposed individuals.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
6/26. Pacemaker component allergy: case report and review of the literature.Pacemaker component allergy is a relatively uncommon cause of erythema and pain at the site of an implanted pacemaker. Allergies to multiple pacemaker components have been well described. We present a case in which 2 component allergies were documented on separate occasions. Although attempts were made to protect the patient by "coating" the pacemaker, the protective coating was incomplete and the patient again had a clinical reaction. More complete coating corrected the problem. diagnosis of a pacemaker component allergy first requires awareness of the problem and then thorough allergy testing with appropriate components.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
7/26. Preoperative identification of a bone-cement allergy in a patient undergoing total knee arthroplasty.Allergy to polymethyl methacrylate bone-cement or its components is unusual. Because of the potential for an inflammatory response in an allergic patient and the possibility of pain and loosening if a cemented implant is used, it is imperative to identify patients with this allergy to modify their treatment. We report the case of an otherwise healthy 60-year-old woman who needed a total knee arthroplasty and who had an allergy to methyl methacrylate bone-cement identified preoperatively. The appropriate evaluation for a patient who is suspected to have an allergy to bone-cement or its components is reviewed.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
8/26. Allergy to ficus benjamina.The clinical history of 16 patients found to have specific IgE antibodies against ficus benjamina was analyzed in terms of allergic symptoms, clinical and biological cross-sensitisation to other allergens and compared to the data found in the literature. Two different groups of patients were studied. Group A consisted of 13 patients who became sensitised through contact with ficus plants and experienced symptoms upon exposure. Their main symptoms where conjunctivitis, rhinitis, asthma, eyelid oedema or urticaria. Of these patients 11 had other atopic manifestations. Two persons had no other allergy. 10 patients experienced symptoms at home, 2 at the working place and 1 while being in a restaurant. One patient had a crossreactive food allergy to figs. Group B consisted of 3 highly atopic patients who had also a sensitization both to latex (hevea brasiliensis) and to ficus benjamina. They had no clinical history of allergic reactions provoked by ficus plants.- - - - - - - - - - ranking = 2keywords = plant (Clic here for more details about this article) |
9/26. Metal fragment in the temporomandibular joint: a case report.A 56-year-old woman was referred for severe pain and restricted jaw movements with a duration of more than 10 years.In the early 1990s a discectomy on the left side had been performed where the disc was extirpated and replaced with a polymeric implant. Due to infection and pain the implant was removed about 2 months later. In the 10-year period thereafter she suffered pain from the joint, pain from the left ear, tinnitus and restricted mouth opening.A computer tomography scan revealed a foreign body, approximately 4mm in size, situated in the medial part of the glenoid fossa. The metallic foreign body was surgically removed. The pain from her left temporomandibular joint decreased and the mouth opening capacity increased. Patch-testing showed that the patient had a potential for contact allergy to nickel, chromium and cobalt. The foreign body was most probably a fractured tip of a surgical awl. Energy dispersive X-ray analysis revealed that the fragment consisted of iron and chromium. The instrument fragment could have caused the symptoms either by an allergic reaction or a direct mechanical effect.- - - - - - - - - - ranking = 2keywords = plant (Clic here for more details about this article) |
10/26. A case of a long-time survivor with chronic active Epstein-Barr virus infection.Epstein-Barr virus (EBV) is associated with hypersensitivity to mosquito bites (HMB) and fatal EBV-associated hemophagocytic syndrome (HPS). The prognosis of patients with chronic active EBV infection (CAEBV) is very poor. We report a rare case of an adult woman patient with a 28-yr history of HMB, who developed EBV-HPS. EBV genome was detected in the serum and peripheral blood lymphocytes. Clonal proliferation of EBV was demonstrated by Southern blot analysis using an EBV genome terminal-repeat probe. This is a very rare case of a long-term survivor with CAEBV. The patient was initially treated with immunochemotherapy and achieved complete remission. However, the patient immediately relapsed and underwent allogeneic bone marrow transplantation (BMT) from her HLA-matched brother. Peripheral blood cell recovered well, and EBV genome disappeared from the peripheral blood. Allogeneic BMT may be effective in eradicating EBV-HPS. Unfortunately, the patient died of graft vs. host disease on the 92nd day after BMT.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
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