Cases reported "Drug Hypersensitivity"

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1/14. Cutaneous hypersensitivity reaction to injectable hyaluronic acid gel.

    BACKGROUND: Injectable hyaluronic acid gel is a non-animal biomaterial used for soft tissue augmentation. OBJECTIVE: The dermal implantation of this naturally occurring polysaccharide is reported to be well tolerated by patients, with a longer duration in tissue than bovine collagen without any major local or systemic side effects. We report a case of an acute hypersensitivity reaction in a woman after her third injection for improvement of melolabial fold wrinkles. methods: An adverse granulomatous-like response to the intradermal injection of a modified hyaluronic acid gel is described. RESULTS: The patient developed indurated and erythematous papulocystic nodules in the melolabial folds bilaterally at the sites of injection. CONCLUSION: Injectable hyaluronic acid gel can be associated with severe allergic reactions and patients should be warned of this possible treatment side effect.
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keywords = animal
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2/14. Management of heparin allergy in pregnancy.

    Thromboembolic disease during pregnancy has traditionally been treated with heparin. If heparin cannot be used, then treatment options remain limited. Despite the recent availability of new anticoagulation agents, data relating to their use during pregnancy is lacking. Hirudin, a relatively new anti-thrombotic agent, through animal models has been shown to have a very low transplacental transfer, thus making it a candidate drug to be used during pregnancy in case of heparin allergy. This report describes a case of heparin allergy in a pregnant patient with recurrent DVT that was successfully managed with hirudin and coumadin.
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keywords = animal
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3/14. angioedema acute hypersensitivity reaction to injectable hyaluronic acid.

    BACKGROUND: Injectable hyaluronic acid was introduced to European markets in 1996 and has demonstrated a high safety profile. We describe the first reported case of angioedema-type hypersensitivity following injection of the upper lip with non-animal-stabilized hyaluronic acid (NASHA) gel. OBJECTIVE: To report a case and discuss a potential mechanism for and treatment of angioedema-type hypersensitivity following injection with NASHA gel into the upper lip. methods AND MATERIALS: Not applicable. RESULTS: Not applicable. CONCLUSION: Although injectable hyaluronic acid has a high safety profile, this reaction is dramatic. Treatments and potential mechanisms are discussed.
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keywords = animal
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4/14. hypersensitivity reaction to nonanimal stabilized hyaluronic acid.

    Soft tissue augmentation has become a cornerstone of facial rejuvenation. The bovine collagens were historically considered the "gold standard" as they had an extensive safety history and were effective. However, because of their brief duration and the approximate 1.0% to 3.0% incidence of hypersensitivity, alternatives were sought. A new class of agents, the hyaluronans, was recently granted approval by the food and Drug Administration. The hyaluronans are indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (eg, the nasolabial folds). The hyaluronans have two derivations: nonanimal stabilized hyaluronic acid (NASHA) and an additional formulation of avian origin. Both are considered major advancements as they are not species specific and therefore theoretically do not elicit humoral or cell-mediated immune reactions. To date there have been a few reports of allergic reactions to the NASHA hyaluronans, primarily to Restylane. We report what to our knowledge is the first hypersensitivity reaction to the second brand of NASHA, Captique.
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ranking = 5
keywords = animal
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5/14. gold sodium thiomalate (GTM) induces hypersensitivity to thiomalate, the thiol carrier of GTM.

    A case of the gold sodium thiomalate (GTM)-induced eruptions with thiomalate (TM) hypersensitivity was reported. A 61-year-old Japanese woman developed lichenoid and seborrheic dermatitis (SD)-like eruptions with alopetia, when the total dosage of GTM administered for rheumatoid arthritis became 110 mg. The eruptions slowly disappeared with pigmentation after discontinuance of the GTM therapy, and the resumption resulted in the development of similar eruptions. She showed a positive reaction to GTM in an intradermal test. She also showed a positive response to TM, which is the thiol carrier of GTM, in the patch test, but a negative one to metallic gold. After administration of auranofin (AF), she also developed the SD-like eruptions with hypersensitivity to metallic gold as well as AF on patch testing, but did not develop the lichenoid ones. Our animal experiments revealed an almost complete cross reaction between GTM and TM, but only a partial one between GTM and aurothioglucose, which have dissmilar structures in the carrier part for gold. Probable roles of hypersensitivity to TM and metallic gold, which are metabolites of GTM, were discussed, respectively, in the genesis of the GTM-induced lichenoid eruptions and the AF-induced SD-like eruptions.
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ranking = 1
keywords = animal
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6/14. Resistance and allergy to recombinant human insulin.

    Insulin allergy and antibody-mediated resistance may complicate therapy with animal insulins. We describe a 53-year-old man manifesting both resistance and persistent systemic allergy despite treatment with recombinant human insulin. insulin resistance and symptoms of allergy appeared in this patient several months after initiating therapy with mixed beef-pork insulin, as is often the case. Symptoms initially improved, but persisted, and then worsened again, despite continuous human insulin therapy. Total insulin-binding capacity by Scatchard analysis, high plasma insulin-binding capacity, and specific anti-insulin antibody levels were consistent with an immunologic form of insulin resistance. Glucocorticoid therapy was required both to reduce allergic findings and to restore glycemic control. Although recently available human insulins may be less immunogenic than animal forms, immune responses to exogenous human insulin still may pose significant clinical problems.
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ranking = 2
keywords = animal
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7/14. Insulin allergy in clinical practice.

    Insulin allergy, either localized or systemic, is a clinical problem that may be encountered by nurse practitioners. Studies have shown that 10 to 37 percent of patients started on animal-source insulin developed an allergic reaction to the agent. With the advent of purified animal-source insulins and of human insulin, this number has decreased, but the problem is unlikely to be completely eradicated. This article presents information about the diagnosis, treatment and management of patients presenting with localized or systemic insulin allergy. A brief discussion of the antigenicity of insulin and the basic immune processes operating in insulin allergy will be included. It is hoped that by acquainting nurse practitioners with the manifestations of insulin allergy and the treatment involved, earlier recognition and intervention will occur. This will help remove an extra burden from a patient who is already trying to adjust to the necessity of daily insulin injections.
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ranking = 2
keywords = animal
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8/14. IgA nephropathy associated with dental nickel alloy sensitization.

    We report a patient with documented IgA nephropathy in whom microscopic hematuria, proteinuria, and hypertension first occurred after placement of nickel alloy base dental crowns. Progressive proteinuria culminating in nephrotic-range proteinuria occurred parallel to increased nickel placement and dramatically resolved following nickel alloy removal. That immunologic alterations occur as a result of nickel exposure has already been suggested by the common occurrence of nickel contact dermatitis, often exacerbated by intraoral nickel placement, increased carcinogenesis in nickel refinery workers, and animal models of nickel-associated carcinogenesis. Our patient may represent an example of nickel-induced sensitization and associated IgA glomerulopathy. Further study of patients with immune-mediated glomerulopathy with attention to dental nickel exposure appears indicated.
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ranking = 1
keywords = animal
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9/14. Cutaneous allergy to human (recombinant dna) insulin.

    p6 report two cases of cutaneous allergy to human (recombinant dna) insulin. Each patient had a history of systemic allergic reactions to porcine insulin and was at least as reactive to human as to porcine insulin by end-point cutaneous titration. Both patients' insulin allergy was managed with animal insulins and both have done well. Our experience with these two patients indicates that human insulin (rDNA) should not be expected to be efficacious in all patients with systemic allergy to insulin.
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keywords = animal
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10/14. Conventional and human insulin: complications of insulin therapy in children.

    The management of complications of insulin therapy, such as lipoatrophy, allergic reactions, insulin resistance, and insulin edema, is outlined. Human and animal insulin preparations currently available in the united states are discussed, highlighting the comparative costs and indications for use.
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