Cases reported "Conjunctivitis, Allergic"

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11/15. Allergy to ficus benjamina (weeping fig) in nonatopic subjects.

    Occupational allergy to ficus benjamina (Fb), or weeping fig, occurs in about one in four plant-keepers. Sensitization to this plant occurs in about 3-4% of persons with clear-cut atopy. I now report on four female nonatopic patients with rhinoconjunctivitis who were sensitized only to weeping fig. All four had a positive skin prick test and RAST test to Fb. The identification of a preventable respiratory allergen is of considerable importance for the patient. Inclusion of Fb in the standard prick test panel may therefore be considered. Furthermore, the findings suggest that it may be unwise to choose Fb as an ornamental indoor plant.
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12/15. Severe isolated allergy to ficus benjamina after bedroom exposure.

    Allergies to ficus benjamina (Fb, weeping fig) have been described first as an occupational disease in plant keepers and later in clearly atopic subjects with known sensitizations to other inhalant allergens. We report a case of a hitherto nonatopic man with allergic rhinoconjunctivitis, contact urticaria, and asthma caused by a Fb kept in his bedroom for 18 months. Rubbing and skin prick test with native fig leaves and sap, and RAST to Fb were clearly positive. No other sensitization could be detected. After eliminating his Fb, he became asymptomatic within a few months. This case shows that private close contact to Fb can also induce allergy even in hitherto nonatopic subjects. Therefore, Fb should not be kept in bedrooms.
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13/15. asthma caused by ficus benjamina latex: evidence of cross-reactivity with fig fruit and papain.

    BACKGROUND: ficus benjamina or weeping fig is a plant used increasingly for indoor decoration that can cause allergic rhinitis and asthma. OBJECTIVE: We report a clinical and immunologic study in a patient with perennial asthma caused by F. benjamina latex in whom several episodes of angioedema of the oropharyngeal tract and tongue followed ingestion of figs and kiwi. methods: hypersensitivity to latex from F. benjamina and from hevea brasiliensis, fig fruit, kiwi, papain, and bromelain was investigated by means of skin prick test, specific IgE determination by CAP, histamine release test, and bronchial provocation test to F. benjamina latex. CAP-inhibition assays were carried out to study possible cross-reactivity among these antigens. RESULTS: hypersensitivity to F. benjamina latex, fig, kiwi, and proteases was demonstrated by means of skin prick test, determination of specific IgE and histamine release test. Bronchial provocation test with F. benjamina latex resulted in a dual asthmatic reaction, confirming the etiologic role of this plant. A rise of eosinophil cationic protein in patient's serum was observed 21 hours after bronchial challenge, suggesting activation of eosinophils. Inhibition assays showed that F. benjamina latex as liquid-phase inhibited up to 95% the CAP to fig and up to 57% the CAP to papain. Neither sensitization nor cross-allergenicity with H. brasiliensis latex was found. CONCLUSIONS: hypersensitivity to F. benjamina latex may cause IgE-mediated respiratory allergy. The association with allergy to fig and papain is likely due to the existence of cross-reactive allergen structures.
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14/15. Limbal cell autograft transplantation for severe ocular surface disorders.

    BACKGROUND: Limbal cell transplantation may improve the visual outcome after chemical trauma and ocular surface diseases. methods: Nine eyes of nine consecutive patients (eight males and one female, age 9-60 years), underwent limbal autograft transplantation (LAUT). In five cases LAUT was done for severe chemical burns in the acute stage (group 1). In four patients with old chemical trauma LAUT was performed years after the trauma (group 2). Penetrating keratoplasty (PKP) was carried out within 6 months after LAUT in three patients of group 2. Preoperatively, the visual acuity in all the patients except one was counting fingers. Postoperatively, patients were treated with topical antibiotics, topical corticosteroids and oral steroids. Oral cyclosporin was used after penetrating keratoplasty. RESULTS: No complications were observed during the surgical procedure. Postoperatively, the epithelialization was complete between days 7 and 12. The inflammatory response subsided within 3 months and the stromal neovascularization decreased. visual acuity improved in all the nine cases, ranging from 6/6 to 6/30. The decreased visual acuity was due to corneal haze, scars and vascularization. Following PKP, the three grafts remained clear with intact epithelium. No complications were observed during the follow-up period from 7 to 60 months. CONCLUSIONS: Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity after severe chemical trauma.
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15/15. Rhinoconjunctivitis and asthma caused by vine pollen: a case report.

    BACKGROUND: The vine (vitis vinifera) is a cultivated plant that is found in some European and American countries. Its pollen gathers in small quantities during a short pollination period in the months of May and June. Allergy to vine pollen has not been previously documented. OBJECTIVE: We sought to describe a case report of allergy to vine pollen documented on the basis of anamnesis, cutaneous, provocation, and specific IgE determination tests. methods: An allergenic extract was obtained from collected V vinifera pollens by aqueous standard procedures. pollen counts and pollination periods of this and other common pollens in the area where the patient became symptomatic were studied. Cutaneous tests and the presence of specific IgE to the pollen extracts were performed by prick, CAP, and RAST techniques. Bronchial and conjunctival tests with the involved pollen extracts were also carried out to identify the sensitizing allergens. Five healthy subjects and 5 pollinic patients were used as control subjects and underwent the same tests. RESULTS: skin prick test responses with vine pollen at different concentrations were positive for the studied patient and negative for the control subjects. Patient serum revealed a total IgE titer of 334 IU/mL and a specific IgE value of 1.3 PRU/mL (RAST class 2) to vine pollen. Bronchial and conjunctival provocation test responses were also positive when the patient was challenged with V vinifera extract. CONCLUSION: Exposure to the pollen of the vineyard plants (V vinifera) can induce immunologic sensitization and rhinoconjunctivitis/asthma.
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