Cases reported "Urticaria"

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1/97. urticaria due to airborne permethrin exposure.

    Although naturally derived pyrethrins are well recognized sensitizers, there is currently some degree of controversy regarding the sensitizing potential of synthetic pyrethroids. The literature is briefly reviewed, and an outbreak of several cases of urticaria occurring in children from 1 household and associated with airborne exposure to permethrin is reported.
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2/97. Occupational IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria caused by Easter lily (lilium longiflorum) and tulip.

    BACKGROUND: We report on IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria to two liliaceae plants, tulip and Easter lily (lilium longiflorum), diagnosed in a floral shop worker. methods: Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. RESULTS: skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/I, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/I. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, contact urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. CONCLUSIONS: A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and contact urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two liliaceae plants.
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3/97. Galvanic urticaria.

    A variety of environmental stimuli, such as vibration, ultraviolet radiation, and exposure to water, are recognized as causes of "physical urticaria." A medical student, participating in a demonstration of a galvanic device used in the treatment of hyperhidrosis, demonstrated urticaria in response to this galvanic stimulation.
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4/97. Solar urticaria: A consideration of the mechanism of inhibition spectra.

    BACKGROUND: Solar urticaria is a rare disorder characterized by pruritus, erythema and wheal upon sunlight exposure. Inhibition spectra (IS), which prevent wheal formation, have been found mainly in Japanese patients and lie mostly in longer wavelengths than the action spectrum (AS). The exact mechanism of AS and IS has not been clarified. patients AND methods: To elucidate the mechanism of AS and IS, we conducted photobiological studies including in vitro irradiated serum injection tests and measurements of plasma histamine levels in 3 patients with IS. RESULTS: All patients had AS ranging between 400 and 490 nm and IS ranging between 520 and 610 nm. A wheal reaction appeared soon after the termination of IS irradiation. The patients developed no wheal or erythema upon intradermal injection of preirradiated serum. plasma histamine levels were not elevated during irradiation with slide projector light, but marked elevation of histamine was observed when wheals developed after the termination of inhibitory irradiation. CONCLUSION: These results suggest that the IS in our cases might inactivate photoallergens produced by AS and, additionally, stabilize mast cell degranulation.
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5/97. Persistent solar urticaria. A case report.

    Solar urticaria is an uncommon dermatological disease characterized by wheals developing within a few minutes after sun exposure and lasting a few hours. We describe a man in whom wheals developed on his trunk and arms more than 30 min after sun exposure and lasted more than 24 h. High doses of UVA reproduced lesions with histological features typical of urticaria. After 7 years, urticaria began to develop even in winter and without sun exposure. Our patient is unusual in that his wheals were delayed in onset and longlasting. The later association of idiopathic urticaria is an additional unusual feature.
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6/97. Localized heat urticaria.

    Localized heat urticaria is one of the rarest of the physical urticarias, characterized by well-defined urticarial lesions sharply confined to sites of heat exposure. We describe a case of localized heat urticaria in a 40-year-old woman. Because of the rarity of this disorder, much remains to be elucidated. The clinical features, pathogenesis and therapy are reviewed.
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7/97. Occupational allergic rhinitis and contact urticaria caused by bishop's weed (ammi majus).

    Bishop's weed (ammi majus) has been known to induce toxic phytophotodermatitis. We now describe IgE-mediated rhinitis and contact urticaria caused by exposure to bishop's weed in a 31-year-old atopic female florist. A skin prick-prick test with bishop's weed flowers gave an 8-mm wheal, and the bishop's weed-specific IgE level in the patient's serum was 9.7 PRU/ml (RAST class 3). In an immunoblotting experiment with the patient's serum, nine IgE-binding protein bands with the molecular weights 19, 34, 39-41 (doublet), 52-61 (doublet), and >67 (triplet) kDa were detected in bishop's weed extract. The patient became symptomless after she had ceased to work as a florist.
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8/97. in vitro released interferon-gamma in the diagnosis of drug-induced anaphylaxis.

    A 17-year-old Japanese male was referred with acute urticaria and anaphylaxis after the administration of PL (salicylamide, acetaminophen, anhydrous caffeine and promethazine methylene disalicylate) and Bufferin (aspirin and dialminate) for headache and a high grade fever. The results of prick test, patch test and drug-induced lymphocyte stimulation test with PL and Bufferin were all negative. The patient's peripheral blood mononuclear cells (PBMC) were cultured with or without PL for 72 hours, and the activity of interferon-gamma (IFN-gamma) in the culture supernatant was measured with EIA. A significantly high level of IFN-gamma was detected in PBMC from the patient, but very little in those from healthy control subjects with a history of exposure to PL. This finding may indicate the presence of drug-specific IFN-gamma producing T cells in patients with an anaphylactic shock reaction to medication. Assays that measure the drug-induced IFN-gamma production may thus be a useful diagnostic tool not only for identifying delayed-type hypersensitivity (DTH) to drugs, but also for predicting anaphylactic shock reaction to drugs.
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9/97. anaphylaxis to pine nuts and immunological cross-reactivity with pine pollen proteins.

    Despite the wide use of pine nuts, the fruit of pinus pinea, only a few reports of allergic reactions to them have been published. We present herein a case of food allergy to pine nuts in a patient who showed no clinical symptoms to pine pollen despite the presence in her serum of specific IgE antibodies. In order to verify whether the reaction against pine nuts was IgE mediated, specific IgE against pine nuts and pollen were evaluated by skin-prick test, prick by prick and RAST. immunoblotting and immunoblotting-inhibition were used to evaluate the allergenic components of both extracts and their cross-reactivity. Prick by prick with fresh pine nuts and RAST with pine nut and pine pollen extracts showed that the patient had high levels of specific IgE against both extracts. immunoblotting experiments showed the presence in serum of IgE antibodies against several components in pine nuts and pollen. immunoblotting-inhibition experiments demonstrated the presence of some cross-reacting components. These data confirm the existence of food allergy induced by pine nuts. This sensitization to pine nuts developed with no symptoms of pine pollinosis. Development of pollinosis may require a longer time of exposure to allergens. Based on the cross-reactivity between pine nut and pine pollen extracts, cosensitization to these two allergens could be possible.
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10/97. UVA rush hardening for the treatment of solar urticaria.

    Induction of tolerance by subsequent UV exposures is the most effective therapy for solar urticaria; however, it is time-consuming and takes a long time until protection is achieved. Three patients with solar urticaria were exposed to multiple UVA irradiations at 1-hour intervals per day. With this rush hardening regimen, protection was achieved within 3 days.
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