Cases reported "hypersensitivity"

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11/382. asthma induced by allergy to trichophyton rubrum.

    The worldwide incidence of asthma and of allergic respiratory diseases is increasing (Akiyama K. 'Environmental allergens and allergic diseases.' Rinsho Byori 1997;45(1):13. D'Amato G, Liccardi G, D'Amato M. environment and development of respiratory allergy. II. Indoors. Monaldi Arch Chest Dis 1994;49(5):412. Weeke AR. epidemiology of allergic diseases in children. Rhinol Suppl 1992;13:5. Ulrik CS, Backer V, Hesse B, Dirksen A. risk factors for development of asthma in children and adolescents: findings from a longitudinal population study. Respir Med 1996;90(10):623.) This has been attributed to several factors, including lifestyle changes and an expanding variety of potential causative allergens. Management of asthma entails preventive and acute medications, immunologic therapies, and removal of the identified allergen(s) from the patient's environment. Without the latter, patients may not experience full symptomatic relief. This case report describes a patient who developed bronchial asthma subsequent to an infection of tinea pedis and pedal onychomycosis; antifungal management resulted in full resolution of his tinea pedis, onychomycosis and asthma. ( info)

12/382. thalidomide-induced toxic epidermal necrolysis.

    Toxic epidermal necrolysis (TEN) is a severe dermatologic disorder associated with mortality of up to 30%. Withdrawal of the causative agent is crucial in its management. Although thalidomide-induced dermatologic disorders rarely were reported before thalidomide was administered to patients positive for the human immunodeficiency virus, hypersensitivity reactions including rash are the agent's major dose-limiting toxicities in this population. As it is prescribed for other immunosuppressed patients, such as those with malignancies, the frequency of dermatologic reactions (including TEN) may increase. A 62-year-old woman developed TEN after approximately 5 weeks of thalidomide therapy for the treatment of a glioblastoma. ( info)

13/382. starch granulomatous peritonitis.

    An unusual case of recurrent starch granulomatous peritonitis that presented as a long-standing paralytic ileus is described and the literature pertaining to this unusual entity is reviewed. The roentgenographic finding of severe prolonged paralytic ileus usually developing late in the post-operative period should suggest the possibility of this disease. ( info)

14/382. Transient eosinophilia by hiv infection.

    We describe a case of early human immunodeficiency virus infection characterized by transient eosinophilia without an elevated immunoglobulin e concentration, allergic symptoms, or atopic dermatitis. Possible mechanisms of the eosinophilia are discussed. ( info)

15/382. What does anisakis simplex parasitism in gastro-allergic anisakiasis teach us about interpreting specific and total IgE values?

    BACKGROUND: gastro-allergic anisakiasis is a mostly transitory clinical entity caused by anisakis simplex (A. simplex) and can be suspected by history and confirmed by fiberoptic gastroscopy and specific IgE. OBJECTIVE: we report a case of gastro-allergic anisakiasis, in which the parasite induces a high specific and total IgE response, and want to follow the specific and total IgE values by a serologic follow up over 10 months. methods: an analysis of total IgE and specific IgE against. A. simplex was performed within 24 hours, after 1, 4, 6 and 10 months. At month 4 and month 10 specific IgE against ascaris lumbricoides and echinococcus granulosus was determined in order to value cross-reactivity. RESULTS: there is an important raise in specific IgE against anisakis simplex (up to 903 kU/l) after 6 months and total IgE (up to 15,258 kU/l) after one month. Cross-reactive specific IgE against ascaris lumbricoides and echinococcus granulosus can be detected. CONCLUSIONS: we consider a raise of total and specific IgE as a typical feature of helminth infestation and learn that specific and total IgE values are highly variable in the months following the allergic and parasite-specific reaction. The amount of specific IgE against other cross reactive parasites depends directly on the total IgE values. ( info)

16/382. Aluminium allergy in a patient with occupational contact dermatitis.

    Case of a 57-year-old hospital attendant with hand eczema. patch tests were read at 2 and 3 days using the 1 to 3 scoring system recommended by the Contact dermatitis research Group. ( info)

17/382. An adult patient with hypersensitivity to mosquito bites developing mantle cell lymphoma.

    hypersensitivity to mosquito bites (HMB) has been known to occur exclusively in the first 2 decades of life and is frequently associated with Epstein-Barr virus (EBV) infection and lymphoproliferative diseases. We report here the first adult patient with HMB, a 61-year-old Japanese man who developed mantle cell lymphoma. EBV was detected in the lymph node by polymerase chain reaction and by in situ hybridization. serum levels of interleukin (IL)-4, IL-6, and IL-10 were markedly increased, and the T-helper cell (Th)1/Th2 balance determined by intracellular cytokine levels was polarized to Th2. These findings suggest that the Th1/Th2 imbalance could partly be involved in the pathogenesis of HMB. ( info)

18/382. Gastroallergic anisakiasis: findings in 22 patients.

    BACKGROUND AND AIMS: Ingestion of Anisakidae larvae in raw seafood may cause anisakiasis. However, despite the high level of consumption of seafood in spain, only a few cases of anisakiasis have been reported until now. anisakis simplex can cause allergic reactions in sensitized patients as a result of its parasitism in the gastrointestinal tract. The purpose of this study was to analyse the clinical findings in 22 patients with gastroallergic anisakiasis. methods: patients with allergic and/or gastric symptoms after seafood ingestion were evaluated in the emergency room of the La Paz General University Hospital. skin testing for anisakis simplex and tests on the implicated seafood were performed and amounts of serum-specific immunoglobulin e were assessed. A gastroscopy was performed in those patients with severe allergic or/and persistent gastric symptoms after ingestion of raw or undercooked seafood. RESULTS: Twenty-two patients were diagnosed with gastroallergic anisakiasis in 1 year. Most patients presented to the emergency room of our hospital with allergic symptoms. Gastric symptoms were usually moderate. gastroscopy revealed local mucosal oedema and gastric erosion at the point of fixation. Two or more worms were detected in three patients. The mean time of latency of allergic symptoms was 5 h, while the mean time for gastric symptoms was 3 h. CONCLUSION: anisakis simplex parasitism was the causative agent of allergic and gastric symptoms. Gastroallergic anisakiasis appears to be a relatively common disease, that may have been underdiagnosed. ( info)

19/382. 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. ( info)

20/382. The "Peter Pan" syndrome and allergy practice: facilitating adherence through the use of social support.

    The complexity of care of some patients in an allergy-immunology practice may be increased by behavioral abnormalities of the patients. Facilitating adherence through the use of social support may be the most effective treatment strategy for some of the most difficult of these patients. We report three patients whose medical management problems were alleviated largely because of the participation of their support system. All three patients were stabilized because of the acceptance of responsibility and support of the physician by the designated member of the patient's support system. The range of social support used to manage nonadherent patients ranged from directly providing instructions to a family member to the consistent presence of a spouse or companion at multiple clinical visits. In all cases, the success in management was attributed largely to the presence of a support system. ( info)
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