Asunto(s)
Antibacterianos/efectos adversos , Carbapenémicos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Adulto , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/patología , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/patología , Eccema/inducido químicamente , Eccema/diagnóstico , Eccema/patología , Femenino , Humanos , Enfermeras y Enfermeros , Exposición ProfesionalRESUMEN
The multiple drug intolerance syndrome is a clinical entity characterized by adverse drug reactions to at least three drugs, chemically, pharmacologically and immunogenically unrelated, manifested upon three different occasions, and with negative allergy testing. Symptoms referred by the patients are often subjective, of neurovegetative origin. The aim of the study is to characterize patients suffering from the multiple drug intolerance syndrome from a psychological point of view, and to compare them to healthy subjects. We studied 30 women suffering from the multiple drug intolerance syndrome. All subjects underwent the following psychodiagnostic tests: (1) the State Trait Anxiety Inventory-Form Y, (2) the Zung Self-rating Anxiety Scale, (3) the Zung Self-rating Depression Scale, (4) the Quality of life enjoyment and satisfaction questionnaire, (5) the Minnesota Multiphasic Inventory-2, (6) the Toronto Alexithymia Scale. The study group was compared to 30 healthy women. When compared with the control group, our patients showed: a higher anxiety, a higher grade of depression, this difference was statistically significant (p < 0.01); a high difference (p < 0.01) between the two groups as regards somatic symptoms; a higher grade of alexithymia (p < 0.01); and a worse quality of life, in all the analyzed ambits. These findings clearly demonstrate the importance of psychological symptoms in patients with the multiple drug intolerance syndrome, and show that a complex allergy and psychological work-up is mandatory in the management of these patients.
Asunto(s)
Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/psicología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Estudios de Casos y Controles , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Hipersensibilidad a las Drogas/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Análisis Multivariante , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Psicología , Valores de Referencia , Medición de Riesgo , Síndrome , Adulto JovenAsunto(s)
Antiinflamatorios/efectos adversos , Hipersensibilidad a las Drogas/etiología , Inmunidad Celular , Inmunoglobulina E/inmunología , Serina Endopeptidasas/efectos adversos , Angioedema/inducido químicamente , Dermatosis Facial/inducido químicamente , Femenino , Humanos , Persona de Mediana EdadRESUMEN
OBJECTIVE: We present the case of a woman with 'empty sella syndrome' who experienced generalized urticaria after the administration of sodium succinate hydrocortisone in two episodes. METHODS: The patient underwent an allergological evaluation (prick, intradermal, and patch tests) with hydrocortisone sodium succinate, hydrocortisone acetate, hydrocortisone, hydrocortisone sodium phosphate, methylprednisolone hemisuccinate, methylprednisolone, and preservatives held in the formulation of sodium succinate hydrocortisone (sodium phosphate and methyl-p-oxybenzoate). The basophil activation test (BAT) was also performed with hydrocortisone. The single-blind i.m. challenge test was performed with hydrocortisone sodium phosphate in 4 days. RESULTS: Skin test with hydrocortisone sodium succinate and methylprednisolone hemisuccinate was positive. On the contrary, allergological tests performed with other formulations of the same steroids and preservatives were negative. These results showed an immediate-type allergy to succinate ester. BAT was not helpful to improve our diagnostic work-up because our patient was a 'nonresponder.' Therefore, the patient underwent successfully to a challenge test with hydrocortisone sodium phosphate. CONCLUSIONS: Patients with succinate ester allergy can tolerate alternative corticosteroids without ester.
Asunto(s)
Erupciones por Medicamentos/diagnóstico , Síndrome de Silla Turca Vacía/tratamiento farmacológico , Hidrocortisona/análogos & derivados , Hipersensibilidad Inmediata/diagnóstico , Urticaria/inducido químicamente , Antialérgicos/uso terapéutico , Betametasona/uso terapéutico , Erupciones por Medicamentos/complicaciones , Erupciones por Medicamentos/tratamiento farmacológico , Tratamiento de Urgencia/métodos , Síndrome de Silla Turca Vacía/complicaciones , Femenino , Humanos , Hidrocortisona/administración & dosificación , Hidrocortisona/efectos adversos , Hidrocortisona/inmunología , Hipersensibilidad Inmediata/inducido químicamente , Hipersensibilidad Inmediata/complicaciones , Hipersensibilidad Inmediata/tratamiento farmacológico , Infusiones Intravenosas , Persona de Mediana Edad , Pruebas Cutáneas , Urticaria/tratamiento farmacológicoAsunto(s)
Anorexia/diagnóstico , Budesonida/uso terapéutico , Diarrea/etiología , Enteritis/tratamiento farmacológico , Eosinofilia/tratamiento farmacológico , Gastritis/tratamiento farmacológico , Leche , Pérdida de Peso , Adulto , Animales , Anorexia/etiología , Femenino , Glucocorticoides/uso terapéutico , HumanosAsunto(s)
Alérgenos/uso terapéutico , Desensibilización Inmunológica/métodos , Hipersensibilidad al Látex/terapia , Goma/uso terapéutico , Administración Sublingual , Alérgenos/inmunología , Niño , Estudios de Seguimiento , Humanos , Inmunoglobulina E/sangre , Hipersensibilidad al Látex/sangre , Hipersensibilidad al Látex/inmunología , Masculino , Pruebas Cutáneas , Resultado del TratamientoAsunto(s)
Adenocarcinoma Bronquioloalveolar/complicaciones , Anticoagulantes/efectos adversos , Neoplasias de la Mama/complicaciones , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad Tardía/diagnóstico , Neoplasias Pulmonares/complicaciones , Polisacáridos/efectos adversos , Vena Cava Superior , Trombosis de la Vena/tratamiento farmacológico , Corticoesteroides/uso terapéutico , Anticoagulantes/uso terapéutico , Hipersensibilidad a las Drogas/tratamiento farmacológico , Hipersensibilidad a las Drogas/etiología , Enoxaparina/efectos adversos , Enoxaparina/uso terapéutico , Femenino , Fondaparinux , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Hipersensibilidad Tardía/tratamiento farmacológico , Hipersensibilidad Tardía/etiología , Persona de Mediana Edad , Nadroparina/efectos adversos , Nadroparina/uso terapéutico , Pruebas del Parche , Polisacáridos/uso terapéutico , Resultado del Tratamiento , Trombosis de la Vena/etiologíaRESUMEN
Food allergy is a matter of concern because it affects about 0.5-3.8% of the paediatric population and 0.1-1% of adults, and as well may cause life-threatening reactions. Skin prick testing with food extracts and with fresh foods, the measurement of food-specific IgE, elimination diets and a double-blind, placebo-controlled food challenge are the main diagnostic procedures; many non-validated procedures are available, creating confusion among patients and physicians. The treatment of food allergy is still a matter of debate. Antihistamines, corticosteroids and, if necessary (in case of anaphylaxis), epinephrine, are the drugs of choice for the treatment of symptoms of food allergy. Sodium cromolyn may be used prophylactically even though there are no controlled studies certifying its efficacy. The only etiologic treatment of food allergy is specific desensitization. Sublingual-oral-specific desensitization has been used by our group for the treatment of food-allergic patients with a high percentage of success.