RESUMEN
Drug-induced SLE and idiopathic SLE differ in a number of important aspects, for example the male/female ratio and the age of the patients. There are also differences in incidence in different populations. The mechanism of drug-induced SLE is still largely unknown. It is generally assumed to be an allergic reaction to the drug. The database of the Netherlands Pharmacovigilance Centre Lareb contains 31 reports of SLE in relation to the use of 24 different drugs. In 3 of these cases, there was aggravation of pre-existent SLE. Infliximab and terbinafine are the most frequently reported in association with drug-induced SLE. Furthermore, the database contains a small number of reports of SLE associated with the use of antibiotics. It is difficult to determine whether all of the reported cases involve true drug-induced SLE, but a number of factors suggest that this is often the case, such as the presence or absence of skin involvement and the number of patients that recover after withdrawal of the drug. During the diagnosis of SLE, healthcare professionals should be aware of the use of drugs that might be associated with the induction of SLE.
Asunto(s)
Antibacterianos/efectos adversos , Anticuerpos Monoclonales/efectos adversos , Lupus Eritematoso Sistémico/inducido químicamente , Naftalenos/efectos adversos , Adulto , Antibacterianos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Notificación de Enfermedades , Femenino , Humanos , Infliximab , Masculino , Persona de Mediana Edad , Naftalenos/uso terapéutico , TerbinafinaRESUMEN
An otherwise healthy 31-year-old woman with allergic rhinoconjunctivitis developed considerable swelling of the floor of her mouth after sublingual allergen-specific immunotherapy with the hyposensitization product 'Slit One grass pollen'. After discontinuation, complaints disappeared and she was successfully put on a regimen of subcutaneous immunotherapy. Despite a lack of reports of serious adverse reactions in clinical trials, the Inspectorate of Health Care and The Netherlands Pharmacovigilance Centre Lareb received several reports of sometimes serious localized reactions to oral and sublingual allergen-specific immunotherapy. Under-reporting is likely since local reactions are more or less expected. Caution should be exercised with allergen treatment, even in the case of non-invasive administration.
Asunto(s)
Desensibilización Inmunológica/efectos adversos , Edema/etiología , Enfermedades de la Boca/etiología , Administración Sublingual , Adulto , Conjuntivitis Alérgica/terapia , Femenino , Humanos , Inyecciones Subcutáneas , Suelo de la Boca/patología , Rinitis Alérgica Estacional/terapiaRESUMEN
BACKGROUND: The combination of genetic susceptibility and environmental factors induce allergic sensitization and subsequently local inflammation, resulting in atopic manifestations. OBJECTIVE: To examine whether immunological features reflecting sensitization (total and specific IgE levels, allergen-induced proliferative responses and skin tests) and markers of inflammation (plasma sE-selectin and blood eosinophils) are related to the clinical expression of atopy and whether they precede atopic disease in children up to 2 years of age. METHODS: The development of these markers during the first 2 years of life was studied prospectively in 133 newborns at high risk to develop atopic disease. RESULTS: The prevalence of atopic disease increased from 25% at 12 months to 32% at 24 months of age. The children with food allergy at 12 months, who all had atopic dermatitis (AD), turned out to have asthma-like disease in 40% and AD in 100% at the age of 24 months. Total IgE levels increased with time and from 12 months onward levels started to differ markedly between atopics and nonatopics. Food-specific IgE antibodies were significantly associated with AD (relative risk [RR] = 2.39), food (RR = 1.32) and upper-airway allergy (RR = 1.20), and house dust mite-specific IgE antibodies with upper-airway allergy (RR = 5.00). A positive skin test was significantly associated with AD (RR = 2.90) and food allergy (RR = 1.36). The inflammation markers investigated, were not related to the clinical expression or preceded atopic disease at 2 years of age in high-risk children. CONCLUSION: Positive skin tests and specific IgE to food or inhalant allergens were related to the clinical expression of different atopic diseases. The combination of AD and food allergy at 12 months reflected the strongest risk factor in this high risk cohort for the development of asthma-like disease at 24 months of age.
Asunto(s)
Asma/sangre , Dermatitis Atópica/sangre , Selectina E/sangre , Eosinófilos/inmunología , Hipersensibilidad a los Alimentos/sangre , Hipersensibilidad Respiratoria/sangre , Alérgenos/efectos adversos , Asma/epidemiología , Asma/etiología , Biomarcadores/sangre , Preescolar , Dermatitis Atópica/epidemiología , Dermatitis Atópica/etiología , Hipersensibilidad a los Alimentos/epidemiología , Hipersensibilidad a los Alimentos/etiología , Humanos , Inmunización , Inmunoglobulina E/sangre , Recién Nacido , Recuento de Leucocitos , Activación de Linfocitos , Países Bajos/epidemiología , Prevalencia , Estudios Prospectivos , Hipersensibilidad Respiratoria/epidemiología , Hipersensibilidad Respiratoria/etiología , Factores de Riesgo , Pruebas Cutáneas , Factores de TiempoRESUMEN
OBJECTIVE: To determine the prevalence of IgE-mediated latex allergy in workers in an operation room (OR) complex. DESIGN: Descriptive. METHOD: Regular OR staff members of Rotterdam University Hospital were tested in May-July 1998 for latex allergy and cross-reacting allergens. Questionnaires, serologic testing and skin prick tests with different extracts were used. RESULTS: The study group comprised 163 persons (response: 70%), 30 men and 133 women, with a mean age of 38 years (range: 18-60). Twenty-three persons (14.1%) had specific IgE antibodies against latex. Persons with an atopic constitution ran an increased risk of latex sensitization (odds ratio: 4.3; 95% confidence interval: 1.6-11.4). Of these 23 persons, 16 showed symptoms of urticaria, angio-oedema, rhinoconjunctivitis and/or dyspnoea. CONCLUSION: IgE-mediated allergy to natural rubber latex was prevalent in 23/163 (14.1%) of the OR personnel.
Asunto(s)
Hipersensibilidad Inmediata/epidemiología , Hipersensibilidad al Látex/epidemiología , Tamizaje Masivo/métodos , Quirófanos , Adulto , Femenino , Humanos , Hipersensibilidad Inmediata/diagnóstico , Hipersensibilidad Inmediata/inmunología , Inmunoglobulina E/sangre , Incidencia , Hipersensibilidad al Látex/diagnóstico , Hipersensibilidad al Látex/inmunología , Masculino , Países Bajos/epidemiología , Oportunidad Relativa , Factores de Riesgo , Estudios Seroepidemiológicos , Recursos HumanosRESUMEN
BACKGROUND: Anaphylactic reactions to cotrimoxazole are often ascribed to the sulphamethoxazole component of this antibacterial drug. OBJECTIVE: To determine whether the trimethoprim component can be the cause of an anaphylactic reaction. METHODS: An analysis was made of reports on anaphylaxis attributed to trimethoprim, as notified to the Drug Safety Unit of the Dutch Inspectorate for Health Care. RESULTS: In the period between September 1981 and November 1995, 13 such reports were received. Nine were classified as probable anaphylaxis. Of these, the causal relationship between exposure to trimethoprim and anaphylaxis was classified as definite in three reports, and as probable in the other six. The remaining four reports were classified as possible anaphylaxis. In one of these, the causal relationship was classified as definite, and in three as probable. CONCLUSION: Although anaphylaxis due to trimethoprim seems to be rare, it may be more common than previously thought. Apparently, anaphylaxis to cotrimoxazole is not always caused by sulphamethoxazole.