Cases reported "Hypersensitivity"

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1/9. Demonstration of reactivity to airborne and food allergens in cutaneous vasculitis by variations in fibrinopeptide a and other blood coagulation, fibrinolysis and complement parameters.

    In a 32-year-old woman and a 40-year-old man with cutaneous vasculitis, etiological allergic responses to foods and airborne allergens were found. During provocation tests, observations were made on blood levels of fibrinopeptide a(FPA) and coagulation factors, fibrinogen degradation products (FDP) and serum complement components. Skin biopsies were taken for microscopic and immunofluorescence analysis. In case 1, anaphylactoid allergy to milk and reaginic and anaphylactoid hypersensitivity to grass pollens were found. Dermal provocations with grass pollens gave arthralgia, hematomas, serum C3 fluctuation, factor vii reduction and fibrinolysis. During peroral milk challenge, transient increases in FPA and FDP levels were observed before symptoms appeared. In case 2, anaphylactoid hypersensitivity responses to bacteria, animal danders, foods and pollens were found. Two inhalations with sheep-wool extract resulted in a typical skin eruption. The first also gave an early reduction of C3 and then FPA liberation. Nasal birch-pollen test gave an increase of FPA in the latent period and then typical nodules. At least no low molecular weight FDP were detected during provocations. In patients with vasculitis reactions to exogenous allergens, FPA and FDP estimations after provocations may discriminate harmful from innocuous allergens and reveal individual response patterns in coagulation and fibrinolysis systems.
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ranking = 1
keywords = animal
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2/9. Immunological and in-vivo neurological studies on a benzoic acid-specific T cell-derived antigen-binding molecule from the serum of a toluene-sensitive patient.

    T-cell-derived antigen-binding molecules (TABMs) specific for benzoic acid were isolated from the serum of a toluene-sensitive patient. The resulting purified TABMs (BA-TABMs) did not contain immunoglobulin g and were associated with the cytokine transforming growth factor-beta (TGF-beta). BA-TABMs bound to benzoic acid conjugated to human serum albumin (BA-HSA), as well as to other chemicals conjugated to human serum albumin-including dinitrophenol and oxazolone. The binding of BA-TABMs to the conjugated chemicals increased the level of detectable TGF-beta, and a similar effect was observed with the unconjugated chemicals, benzoic acid and 2,4-dinitrophenol glycine. The increase in TGF-beta was critically dependent on the ratio between BA-TABMs and the conjugated or unconjugated chemicals; the increase was optimum at intermediate concentrations and absent at low and high concentrations. The authors used an established animal model in vivo and demonstrated that TGF-beta enhanced the inflammatory response induced by the release of neuropeptides from sensory nerves; this enhancement occurred in a dose-dependent manner. The BA-TABMs also enhanced this neurogenic inflammatory response in a dose-dependent manner, and this effect was blocked by anti-TGF-beta antibody. When the authors added either BA-HSA or benzoic acid, the effect of BA-TABMs on neurogenic inflammation was further enhanced at intermediate concentrations of antigen and was unaltered or reduced at higher concentrations. TABMs specific to particular chemicals, as a result of their association with cytokines (e.g., TGF-beta), may be implicated in symptom production in chemically sensitive patients.
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ranking = 1
keywords = animal
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3/9. Allergic contact urticaria and rhinitis to roe deer (Capreolus capreolus) in a hunter.

    Roe deer (Capreolus capreolus) is one of the most common game mammals in Europe, where hundreds of thousands people are exposed to this animal. Despite this fact, we are aware of only two cases of allergy to roe deer published until recently, one case of allergic rhinoconjunctivitis and asthma and the second of contact urticaria. We describe another case with co-existing allergic contact urticaria and rhinitis in a 55-year old male professional hunter. The symptoms were provoked only by exposure to roe deer, and there were no other past or present allergic diseases. Specific IgE was found to following animal allergens: cow dander (CAP class 5), goat epithelium and horse dander (each CAP class 4), dog epithelium, dog dander and swine epithelium (each CAP class 2). Skin prick tests have shown positive reaction only to cow epithelium ( ). Because of lack of deer dander allergen for specific IgE and skin tests, we have confirmed the causal relationship between exposure to roe deer and allergy using the rub test with roe deer's fur. There was a clearly positive urticarial reaction on the patient's skin accompanied by nasal itch, sneezing and rhinorrhea. No reaction was seen in a control person. We surmise that the positive tests with cow epithelium seen in this patient may result from a cross-reactivity to deer allergens. We conclude that although occupational allergies to roe deer seem to be rare, such possibility should be always considered among people having contact with these animals.
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ranking = 3
keywords = animal
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4/9. A novel inhalation allergen present in the working environment of beekeepers.

    BACKGROUND: inhalation allergies, caused by allergens from various kinds of pollen, house dust mites, animal epithelium, and mould fungi, are strongly increasing in frequency. In 2.6% of the cases the allergen source remains unidentified. The present paper describes a so far unknown inhalation allergy which was observed in the case of a patient working with hives. methods AND RESULTS: The allergen was characterized by immunoblotting, enzyme-linked immunosorbent assay inhibition, and isoelectrofocusing, using the serum of the patient. It is present in both the bee bodies and the larvae, has a molecular mass of 13 kDa, and an isoelectric point of 5.85. It is thermolabile and does not cross-react with allergens from birch, mugwort and timothy grass pollen, mould fungi, or bee venom. The N-terminal amino acid sequence of allergen from larvae was determined to be (2)QIEELKTRLHT(12). A similar allergen of 13 kDa was also found in Varroa mite accompanying bee populations. CONCLUSION: honey bees (including the larva stadium) and Varroa mite contain a 13-kDa protein causing an allergic reaction. Presently, there is no evidence whether the case described is a singular phenomenon or whether this allergen is a more common inducer of allergies among subjects exposed to honey bees. However, a bee and Varroa mite allergy has to be considered for beekeepers after exclusion of known inhalation allergies.
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ranking = 1
keywords = animal
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5/9. Exotic pets are new allergenic sources: allergy to iguana.

    Although furry animals are known sources of respiratory allergy, scaly animals are assumed not to be allergenic. Exotic animals such as iguanas are becoming increasingly common pets. Nevertheless, these animals are not suspected to be allergenic. We present the case of a 42-year-old woman suffering from allergic rhinoconjunctivitis and asthma caused by a pet iguana. Clear IgE-sensitization and respiratory allergy to iguana scales is demonstrated, suggesting that scaly pets should be taken into account as possible allergenic sources.
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ranking = 4
keywords = animal
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6/9. Severe persistent biphasic local (immediate and late) skin reactions to insulin.

    A patient with adult-onset insulin-requirging diabetes mellitus had persistent severe local reactions to all available insulins of animal origin. Skin reactions were biphasic in nature with both immediate and late characteristics. An extensive immunologic investigation of this problem was undertaken, revealing evidence of reaginic antibody involvement in the reactions. Routine histologic studies suggested the possibility that Arthus-type mechanisms played a part, although this impression was not confirmed by immunofluorescent microscopy. A program of medical management provided some relief of symptoms.
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ranking = 1
keywords = animal
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7/9. hypersensitivity to rat saliva.

    A patient who rapidly developed impressive local edema around a rat bite site is described. An interesting differential diagnosis was presented since the offending rat was experiencing an opiate withdrawal syndrome. A discussion of the possibilities of animal product allergy, local infection, and edema produced by opiate histamine releasers was considered.
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ranking = 1
keywords = animal
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8/9. Hyposensitization therapy with alum-precipitated pyridine extracts in animal dander sensitive patients.

    Hyposensitization therapy with APP extracts was found to be effective in 80% of 185 patients allergic to animals (96 to cats, 84 to dogs and 5 to horses) with a minimum of reactions (2.5 local and 0.2% constitutional). Lower respiratory symptoms were the most common complaints, followed by nasal, ocular and respiratory, singly or in combination.
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ranking = 5
keywords = animal
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9/9. Occupational asthma caused by orangutan in a zoo animal handler.

    A zoo animal handler developed bronchial asthma for the first time from handling orangutans (pongo pygmaes). He had prior allergic reactions (rhinoconjunctivitis and urticarial rash), but no asthma, to deer and other hoofed animals in the zoo. In a worksite challenge, immediate and late onset of asthmatic symptoms and airflow obstruction were provoked by carrying a baby orangutan for about 20 minutes.
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ranking = 6
keywords = animal
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