RESUMEN
Fish oil supplements are popular alternative medicines. Many manufacturers label their products with the warning "avoid this product if you are allergic to fish." The objective of this study was to determine if finned fish (FF)-allergic patients could safely tolerate fish oil supplements. Six FF-sensitive subjects as determined by history and skin testing were selected. They were skin tested with two different fish oil supplements and given an oral challenge of each supplement 1 hour apart. Vital signs were measured at baseline and at 20-minute intervals after each challenge. Spirometry was measured at baseline and 1 hour after each challenge. Six of six patients with positive skin tests to at least one FF had negative skin tests to both fish oil supplements. All six subjects then had negative oral challenges to both supplements. In this pilot study, FF-sensitive patients tolerated fish oil supplements.
Asunto(s)
Suplementos Dietéticos/efectos adversos , Ácidos Grasos Omega-3/efectos adversos , Aceites de Pescado/efectos adversos , Hipersensibilidad a los Alimentos/inmunología , Adulto , Ácidos Grasos Omega-3/administración & dosificación , Femenino , Aceites de Pescado/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Pruebas CutáneasRESUMEN
BACKGROUND: Recent surveys have indicated that the misconception that seafood allergy confers a disproportionately increased risk of adverse reactions to radiocontrast media remains pervasive among physicians and patients. One possible explanation for the persistence of this notion is that physicians responsible for radiocontrast administration are inadvertently contributing to its propagation. METHODS: An anonymous survey was sent to 231 faculty radiologist and interventional cardiologists at 6 Midwest academic medical centers. Two questions dealt directly with seafood allergy related to radiocontrast media administration, and 6 questions served as distracters. RESULTS: Sixty-nine percent of responders indicated that they inquire about a history of seafood allergy before radiocontrast media administration. Some 37.2% of responders replied that they would withhold radiocontrast media or recommend premedication on the basis of a history of seafood allergy. CONCLUSION: Even among faculty physicians at university medical centers, the notion of seafood allergy as a significant risk factor for adverse radiocontrast media reactions remains pervasive. Even if no action is taken on the basis of the answer, it seems probable that the act of inquiring about seafood allergy before radiocontrast media administration could lead patients and trainees to presume an inherent risk in patients who are seafood allergic, thus propagating the notion. Physician education with respect to seafood allergy and radiocontrast media administration is vital to halting the persistence of this misconception.
Asunto(s)
Medios de Contraste/efectos adversos , Conocimientos, Actitudes y Práctica en Salud , Hipersensibilidad/etiología , Alimentos Marinos/efectos adversos , Cardiología/estadística & datos numéricos , Encuestas de Atención de la Salud , Humanos , Medio Oeste de Estados Unidos , Radiología/estadística & datos numéricos , Factores de RiesgoRESUMEN
Familial hemophagocytic lymphohistiocytosis (FHLH) is an autosomal recessive disorder of cytotoxic cell function that results in abnormal proliferation of benign lymphocytes and histiocytes in response to infectious stimuli. FHLH generally occurs in very young children, and typically presents with fever, cytopenias, coagulopathy, lymphadenopathy, and hepatosplenomegaly. Central nervous system involvement occurs frequently and may precede the development of systemic symptoms by months to years. We report a case of an 18-year-old male with a 2-year history of symptoms attributed to a demyelinating disorder, who succumbed to rapidly progressive hemophagocyte lymphohistiocytosis. Post-mortem, two distinct perforin mutations were identified. We discuss the central nervous system and genetic findings in this unusual presentation of familial hemophagocytic lymphohistiocytosis.