Cases reported "Hypersensitivity"

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1/47. Occupational generalised urticaria and allergic airborne asthma due to anisakis simplex.

    anisakis simplex (AS), a fish and cephalopodes parasite, may cause allergic reactions in humans on eating and/or handling contaminated fish. We present a case of occupational hypersensitivity to AS in a woman employed in a frozen-fish factory. She showed both generalised urticarial rash and asthmatic symptoms after work place exposure. All these symptoms immediately disappeared after work place exposure was ceased. The presence of a positive skin prick test and high specific IgE values confirmed a hypersensitivity to anisakis. This is the first case reported of both occupational generalised urticaria and allergic airborne asthma due to AS in the same patient. We suggest that AS could be an important cause of occupational asthma and/or urticaria in the fish industry.
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2/47. Three cases of childhood nocturnal asthma due to buckwheat allergy.

    BACKGROUND: Buckwheat flour (BF) is known as a potent food allergen. Sensitization to it usually occurs by ingestion but also by inhalation in occupational or domestic exposure. Buckwheat chaff-stuffed pillows (BCP) can be contaminated with BF during the process of pilling, and many Korean children and adults use BCP for health reasons. methods AND RESULTS: We here present three cases of BF allergy in children using BCP, who had been treated as nonatopic asthmatics after undergoing the routine allergy skin tests and serologic tests. We took careful clinical histories, and performed skin prick tests (SPT), the radioimmunoassay (RIA) for specific IgE, the BCP-elimination test, the BF bronchial provocation test, and IgE Western blot. All three children showed positive skin reactions to BF, but none of them had positive reactions to house-dust mites. Nocturnal asthmatic symptoms were improved during 7 days of BCP elimination, and asthmatic responses were observed by bronchial provocation tests with homemade BF extract. serum BF-specific IgE antibodies and several IgE-binding proteins were detected by RIA and Western blot analysis, respectively. CONCLUSIONS: Thus, a small amount of BF attached to BCP can induce BF sensitization, and BCP should be considered a main cause of childhood nocturnal asthma in those asthmatics exposed to these pillows.
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3/47. 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.
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4/47. 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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5/47. platinum concentrations in sera of catalyst production workers are not predictive of platinum salt allergy.

    platinum (Pt) salts are potent occupational allergens in precious metal refineries and catalyst productions. The threshold limit value of 2000 ng soluble Pt/m3 enforced in many countries has been questioned because there is still a high incidence of Pt salt allergy. The objective of the present case series is to define the predictive value of biological monitoring by relating Pt in the serum of catalyst production workers and control subjects to sensitization to Pt salts as assessed by skin prick testing. A total of 38 Pt measurements were taken from sera of six workers investigated several times during a 5-year cohort study. Three subjects showed a conversion of skin prick test (SPT) with Pt salts from negative to positive during the cohort study (all considered highly exposed to Pt), and three did not show SPT conversion. Previous therapy with Pt-containing anti-cancer drugs and metallic dental alloys were considered as confounders. Only one of the three workers sensitized to Pt salt had clearly elevated serum Pt concentrations, but this elevation was not observed in each examination. Elevated Pt concentrations were also found in two subjects with low or no exposure to Pt. Both had metallic dental alloys. One control subject without metallic dental alloys showed low Pt concentrations in the serum in four examinations, but a single unexplained high concentration in his initial examination. In this small case series, serum Pt concentrations were neither sensitive nor specific for the prediction of Pt salt sensitization. Low specificity may be explained by Pt-containing metallic dental alloys, but additional unknown confounders may be of importance.
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6/47. A case of cold-dependent exercise-induced anaphylaxis.

    exercise-induced anaphylaxis (EIA) is a form of physical urticaria that is induced by exercise. A 16-year-old Japanese boy had a 4-year history of recurrent wealing and dyspnoea after physical exercise such as jogging, playing handball or riding a bicycle in winter. The episodes were not associated with ingestion of foods including wheat or soya bean. A provocation test, with 15 min of exercise and 2 min of cold stimulation immediately before or immediately after the exercise, elicited a weal that was localized to the test area. A challenge test with ingestion of boiled soya beans and exercise did not elicit a weal. Therefore, in this case, cold exposure, but not food ingestion, was essential for inducing EIA. Cold-dependent EIA is different from cold urticaria, food-dependent EIA, cholinergic urticaria and cold-induced cholinergic urticaria, and may be a distinct entity.
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7/47. 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.
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8/47. A one-year case study of farmers with storage mite allergy.

    Four farmers with a positive bronchial challenge test to either L. destructor or T. putrescentiae had bronchial histamine challenge every second month during a year. In the same year, monthly samples of house dust, grain, straw and hay were analyzed for their content of house dust mites and storage mites. The exposure to house dust mites and storage mites differed between farmers. Significant changes in histamine reactivity were found, but no association with time of year or mite counts was observed.
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9/47. Ladybug hypersensitivity: report of a case and review of literature.

    For years, allergists have known that inhalant allergens arise from insects such as flies, beetles, moths, cockroaches, and mites. Now, it is becoming evident that the Asian ladybeetle Harmonia axyridis possibly should be added to this list. Several cases have been reported recently in the literature describing patients suffering from allergic respiratory symptoms including rhinitis, conjunctivitis, and asthma related to exposure to ladybugs. These patients reveal positive skin-prick testing with ladybug extract and immunoglobulin e immunoblotting with the sera showing at least two distinct allergenic proteins. This species infests homes in very large numbers in the fall and winter months and stay there in a hibernation-like state until the warm weather arrives with early spring. We discuss avoidance measures, which are the key to successful treatment.
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10/47. Nonoccupationally induced allergy to monkey.

    BACKGROUND: A previous study described 2 patients with occupationally induced asthma caused by exposure to monkey. We describe a patient who developed asthma, rhinitis, and conjunctivitis owing to sensitivity to a pet monkey. The patient had a long history of upper and lower allergic airway disease. When 2 pet macaque monkeys were introduced into the home, the patient noticed increasing coughing, wheezing, and shortness of breath. During a particularly long exposure to the monkey in a car, the patient developed severe wheezing, rhinitis, and conjunctival edema. OBJECTIVE: To demonstrate that a nonoccupational exposure to monkey can lead to allergic sensitivity. methods: Commercially obtained macaque monkey hair was defatted in acetone and extracted. A total of 5 microg/mL of extract protein was adsorbed onto microtiter plates, and an alkaline phosphatase enzyme-linked immunosorbent assay was performed on serum samples from 4 individuals: 2 controls, 1 individual with suspected sensitivity, and the patient. A positive result was an optical density greater than twice that of the control. RESULTS: The patient's serum had an optical density greater than twice that of the control. The antibody levels of 2 control subjects-the patient's wife and one of the investigators-were elevated but not positive. The investigator had manifested asthma after exposure. CONCLUSIONS: This is the first report of sensitivity to monkey occurring in a nonoccupational setting.
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keywords = occupational exposure, exposure
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