RESUMEN
Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma.
Asunto(s)
Asma , Encuestas Nutricionales , Rinitis Alérgica Estacional , Neoplasias Cutáneas , Humanos , Estudios Transversales , Masculino , Rinitis Alérgica Estacional/epidemiología , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/diagnóstico , Femenino , Adulto , Persona de Mediana Edad , Estados Unidos/epidemiología , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/diagnóstico , Prevalencia , Asma/epidemiología , Asma/inmunología , Asma/diagnóstico , Alérgenos/inmunología , Alérgenos/efectos adversos , Pruebas Cutáneas , Anciano , Adulto Joven , Polen/inmunología , Polen/efectos adversos , Factores de RiesgoAsunto(s)
Anafilaxia , Citrus sinensis , Hipersensibilidad a los Alimentos , Giberelinas , Humanos , Anafilaxia/diagnóstico , Anafilaxia/etiología , Anafilaxia/inmunología , Hipersensibilidad a los Alimentos/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Citrus sinensis/inmunología , Citrus sinensis/efectos adversos , Giberelinas/efectos adversos , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangre , Proteínas de Plantas/inmunología , Proteínas de Plantas/efectos adversos , Femenino , Masculino , Alérgenos/inmunología , Alérgenos/efectos adversos , Antígenos de Plantas/inmunología , Pruebas CutáneasAsunto(s)
Hipersensibilidad a las Drogas , beta-Lactamas , Humanos , Hipersensibilidad a las Drogas/diagnóstico , beta-Lactamas/efectos adversos , beta-Lactamas/administración & dosificación , beta-Lactamas/inmunología , Femenino , Administración Oral , Masculino , Adulto , Persona de Mediana Edad , Antibacterianos/efectos adversos , Antibacterianos/administración & dosificación , Alérgenos/inmunología , Alérgenos/administración & dosificación , Alérgenos/efectos adversos , Pruebas CutáneasRESUMEN
BACKGROUND: Skin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs. METHODS: We conducted a cost-consequence analysis from a hospital's perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital, whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision-based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty. RESULTS: The difference in average cost between the two alternatives from a hospital's perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs. CONCLUSION: Against the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study.
Asunto(s)
Pruebas Cutáneas , Humanos , Suiza , Pruebas Cutáneas/economía , Pruebas Cutáneas/métodos , Control de Costos/métodos , Diagnóstico por Computador/métodos , Diagnóstico por Computador/economía , Hipersensibilidad/diagnóstico , Hipersensibilidad/economía , Masculino , Hospitales Universitarios , Método de Montecarlo , FemeninoRESUMEN
OBJECTIVES: Exposure to bioaerosols in salmon processing workers is associated with occupational asthma. IgE-mediated allergy and other disease mechanisms may be involved in airway inflammation and obstruction. Knowledge about disease burden, mechanisms, phenotypes and occupational exposure is limited. METHODS: Salmon processing workers referred to our occupational medicine clinic from 2019 to 2024 were included in a patient register. They were investigated in line with current guidelines for the management of occupational asthma, categorised according to diagnostic certainty and characterised with a focus on symptoms, work tasks and clinical findings. RESULTS: A total of 36 patients were included, among whom 27 had typical symptoms of work-related asthma, and 21 were diagnosed with occupational asthma. Among those with occupational asthma, all worked in the filleting or slaughtering area at the time of symptom onset. Median latency from the start of exposure to symptom onset was 4 years. 14 (67%) of the patients with occupational asthma were sensitised to salmon. Three patients were sensitised to salmon skin but not salmon meat. CONCLUSIONS: Occupational asthma among salmon processing workers displays a heterogeneous clinical picture. IgE-mediated inhalation allergy towards various parts of the salmon seems to represent an important pathophysiological mechanism. However, some have occupational asthma with negative allergy tests. A comprehensive workup strategy including early initiation of serial peak expiratory flow and skin prick tests with various parts of the salmon should be considered. Although the incidence remains unknown, the substantial number of cases presented warrant increased efforts to reduce harmful exposure in the salmon processing industry.
Asunto(s)
Asma Ocupacional , Industria de Procesamiento de Alimentos , Exposición Profesional , Salmón , Humanos , Asma Ocupacional/etiología , Adulto , Masculino , Femenino , Persona de Mediana Edad , Animales , Exposición Profesional/efectos adversos , Inmunoglobulina E/sangre , Pruebas Cutáneas/métodos , Enfermedades Profesionales/etiologíaRESUMEN
BACKGROUND: A novel skin test-called Diaskintest (DT)-containing specific M. tuberculosis antigens is in clinical use in the Russian Federation (RF). This test may improve diagnosis of tuberculosis (TB) infection. The use and performance of the DT was described and compared to the tuberculin skin test (TST). METHODS: Data on children <18 years referred to a TB reference centre (Jan/2018- Dec/2019) with ≥1 DT and TST result available were analysed. An immune correlate of TB infection was defined as a positive TST (≥10 mm induration) or a positive DT (any induration). RESULTS: Of 2710 included cases, the median age was 9.0 (IQR 5.7-13.1) years and 97.5% were BCG immunised. Overall, 1976 (79.9%) were TB uninfected, 724 (26.7%) had an immune correlate of TB infection and 10 (0.4%) TB disease. Reasons for referral were: positive or increasing skin test results in routine screening (992, 36.6%), screening before admission to a health care institution (501, 18.5%) and TB contact (457, 16.9%). DT was positive in 11.7% (308/2625) and TST in 63.1% (467/740) (Kappa 0.08, 95% CI:0.013-0.14). A positive DT was associated with older age (OR 1.16 (95% CI: 1.13-1.19) per year). Among TB contacts DT positivity was associated with contagiousness: highest proportion of positivity of 12.0% was observed when the index case was smear positive. CONCLUSION: In a setting with universal BCG vaccination and regular screening with TST, DT was used to rule out TB infection as TST was commonly positive. We found an association of DT positivity and contagiousness of the index case in children contacts. These observations may suggest improved specificity and sensitivity of DT compared to TST.
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Prueba de Tuberculina , Tuberculosis , Humanos , Niño , Prueba de Tuberculina/métodos , Masculino , Femenino , Preescolar , Adolescente , Tuberculosis/diagnóstico , Mycobacterium tuberculosis/inmunología , Pruebas Cutáneas/métodos , Vacuna BCG/inmunología , Lactante , Antígenos Bacterianos/inmunología , Antígenos Bacterianos/análisisRESUMEN
PURPOSE OF REVIEW: Cephalosporins are one of the most prescribed antibiotics worldwide and are implicated in a wide range of hypersensitivity reactions (HSR). This review summarizes recent updates in cephalosporin hypersensitivity with a focus on diagnostic testing. RECENT FINDINGS: Reported testing strategies to evaluate different immediate and delayed cephalosporin HSR have included skin testing, in vitro testing, and diagnostic drug challenges. However, the diagnostic performance of in vivo and in vitro tests remains unclear across different hypersensitivity endotypes; adequately powered studies investigating the true positive and negative predictive value of these diagnostic modalities are needed using the reference standard of drug challenges to define cephalosporin hypersensitivity. Refinement of diagnostic testing should be guided by growth in our understanding of cephalosporin antigenic determinants. This growth will be crucial in driving further clarification of cross-reactivity between cephalosporins, and potentially delineating streamlined evaluation processes resulting in reduced unnecessary antibiotic avoidance.
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Antibacterianos , Cefalosporinas , Hipersensibilidad a las Drogas , Pruebas Cutáneas , Humanos , Cefalosporinas/efectos adversos , Cefalosporinas/inmunología , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/inmunología , Antibacterianos/efectos adversos , Antibacterianos/inmunología , Reacciones Cruzadas/inmunología , Pruebas Diagnósticas de RutinaRESUMEN
BACKGROUND: Intense physical exercise in athletes increases the risk to develop exercise-induced bronchocontriction (EIB). We aimed to study EIB prevalence and explore methods for effective EIB screening. METHODS: Three hundred twenty-seven adolescent athletes (12-18 years) performing at least 12 h of sports a week were included. The evaluation consisted of spirometry, eucapnic voluntary hyperpnoea test (EVH) to evaluate for EIB, FeNO, skin prick testing, blood sampling (serum markers of epithelial damage and mast cell activation), and questionnaires (AQUA©, ACT, ACQ, and exposure and symptom-related questions). RESULTS: Of all athletes, 22% tested positive for EIB (n = 72), 14% reported a previous asthma diagnosis and 40% were atopic. Eighty percent of EIB+ athletes did not use any inhalation therapy. EIB+ athletes were significantly younger, had decreased FEV1/FVC (%), and increased post-EVH-reversibility (%) post-salbutamol compared with EIB- athletes. Furthermore, EIB was significantly associated with previous asthma diagnosis and atopy. The best predictors for a positive EVH test were AQUA© score ≥ 6 (sensitivity of 78%, p = .0171) and wheezing during exercise (specificity of 82%, p = .0002). FeNO negatively and significantly correlated with maximal fall in FEV1 post-EVH test in atopic athletes (r = -.2735, p = .0056). Maximal fall in FEV1 was also associated with prior PM10 exposure (p = .036). Serum markers of epithelial damage were significantly associated with training type, training intensity, EIB severity, and prior air pollution exposure. CONCLUSION: Our findings support the effectiveness of a systematic respiratory screening approach, including baseline questionnaires, lung function tests, and FeNO measurement, to improve EIB detection in adolescent athletes in whom respiratory response to EVH testing is associated with prior exposure to air pollution.
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Asma Inducida por Ejercicio , Atletas , Humanos , Adolescente , Masculino , Femenino , Asma Inducida por Ejercicio/diagnóstico , Asma Inducida por Ejercicio/epidemiología , Niño , Encuestas y Cuestionarios , Prevalencia , Broncoconstricción , Pruebas Cutáneas/métodos , Tamizaje Masivo/métodos , Espirometría/métodos , Ejercicio Físico/fisiologíaRESUMEN
PURPOSE OF REVIEW: Buckwheat (BW) allergy is a significant issue in Asia. This review delves into three types of BW allergy: immediate food allergy; food-dependent, exercise-induced anaphylaxis (FDEIA) as a subset of immediate food allergy; and food protein-induced enterocolitis syndrome (FPIES); by comparing data from Asian and non-Asian countries. RECENT FINDINGS: Most studies on BW have been published in Japan and Korea, and only a few studies on the topic have been done outside Asia. To date, seven components of common BW (Fagopyrum esculentum) and four components of Tartary BW (Fagopyrum tartaricum) have been implicated in BW allergy. Although BW-sIgE has limited utility for evaluating immediate BW allergy, Fag e 3-specific IgE, one of the components of common BW, and the skin prick test are diagnostically useful. The present review aims to shed light on the current state of knowledge, highlight research gaps, and suggest future directions in the management and understanding of BW allergy.
Asunto(s)
Fagopyrum , Hipersensibilidad a los Alimentos , Humanos , Fagopyrum/inmunología , Fagopyrum/efectos adversos , Hipersensibilidad a los Alimentos/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Asia/epidemiología , Inmunoglobulina E/inmunología , Anafilaxia/inmunología , Anafilaxia/diagnóstico , Anafilaxia/etiología , Anafilaxia/epidemiología , Alérgenos/inmunología , Pruebas Cutáneas , Enterocolitis/inmunología , Enterocolitis/diagnóstico , Enterocolitis/etiologíaRESUMEN
BACKGROUND: The beneficial off-target effects of Bacille Calmette-Guérin (BCG) vaccination potentially include protection against allergy. OBJECTIVE: In the MIS BAIR trial, we aimed to determine whether neonatal BCG vaccination reduces atopic sensitisation and clinical food allergy in infants. METHODS: In this randomised controlled trial, 1272 neonates were allocated to BCG-Denmark vaccine (0.05 mL intradermal dose) or no BCG at birth. Randomisation was stratified by recruitment site, mode of delivery and plurality of birth. The primary outcome was the incidence of atopic sensitisation determined by skin prick test at 1 year of age. Food allergy was determined by 3-monthly online questionnaires and oral food challenges. Data were analysed by intention-to-treat using binary regression. CLINICALTRIALS: gov (NCT01906853). RESULTS: Atopic sensitisation during the first year of life was 22.9% among infants in the BCG group and 18.9% in the control group (adjusted risk difference (aRD) 3.8% (95% CI -1.5 to 9.1) after multiple imputation). Clinical food allergy was similar between infants in the BCG and control groups (9.8% vs. 9.6%; aRD 0.2, 95% CI -3.4 to 3.8). An interaction was observed between the primary outcome and maternal history of BCG vaccination. No interaction was observed for the additional prespecified potential effect modifiers tested (sex, delivery mode, family history of any allergy, season of birth, hepatitis B vaccination at randomisation, BCG scar and age at BCG administration). CONCLUSIONS AND CLINICAL RELEVANCE: Neonatal BCG-Denmark vaccination does not protect against atopic sensitisation or clinical food allergy in the first year of life.
Asunto(s)
Vacuna BCG , Vacunación , Humanos , Vacuna BCG/administración & dosificación , Vacuna BCG/inmunología , Masculino , Femenino , Recién Nacido , Lactante , Hipersensibilidad a los Alimentos/prevención & control , Hipersensibilidad a los Alimentos/inmunología , Pruebas Cutáneas , Hipersensibilidad/prevención & control , Hipersensibilidad/inmunologíaRESUMEN
BACKGROUND: The skin prick test (SPT) is a standard procedure in allergy/immunology clinics, crucial for evaluating conditions like allergic rhinitis and food allergies. As a cornerstone in investigating immunoglobulin E-mediated allergy, it plays a vital role in diagnosing allergies, including those triggered by common dust mites like Dermatophagoides pteronyssinus, Dermatophagoides farinae, Euroglyphus maynei, and Blomia tropicalis. Despite its widespread use, adverse reactions to SPT are uncommon (15 per 100,000 patients), though the procedure is not entirely risk-free. This article presents a clinical case involving a 17-year-old female who experienced a moderately delayed allergic reaction 120 minutes post-SPT, managed effectively with subsequent symptom resolution. METHODS: The patient, with a history of persistent rhinorrhea, itchy nose, eyes, and postnasal drip, sought consultation due to worsening symptoms. Diagnostic measures, including patient-reported outcomes and SPT with a standard aeroallergen panel, revealed sensitization to various allergens. RESULTS: Post-test, the patient reported ocular pruritus, left eyelid swelling, and moderate rhinorrhea, persisting for about 24 hours. On the subsequent medical visit, the patient received rupatadine and deflazacort, leading to symptom resolution within 3 hours. CONCLUSION: This article delves into a systemic allergic reaction post-SPT, emphasizing the 2 main stages of type I hypersensitivity reactions. While the acute phase involves mast cell-driven mediators within 15 minutes, the delayed phase (4-8 hours) includes de novo cytokine release. Vigilance regarding symptom onset and differentiation between mild and severe reactions is crucial. Notably, the absence of specific waiting time guidelines post-SPT underscores the need for reporting to enhance understanding and subsequent management. Performing these procedures in specialized centers with qualified professionals is essential for effectively managing potential anaphylactic reactions. Addressing these knowledge gaps will contribute to enhanced patient safety during diagnostic procedures.
Asunto(s)
Pruebas Cutáneas , Humanos , Femenino , Adolescente , Pruebas Cutáneas/métodos , Instituciones de Atención Ambulatoria , Hipersensibilidad/diagnósticoAsunto(s)
Conservadores de la Densidad Ósea , Difosfonatos , Pamidronato , Ácido Zoledrónico , Humanos , Ácido Zoledrónico/efectos adversos , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/efectos adversos , Pamidronato/efectos adversos , Femenino , Pruebas Cutáneas , Imidazoles/efectos adversos , Reacciones Cruzadas , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Anciano , Persona de Mediana EdadRESUMEN
Cutaneous adverse drug reactions collectively are delayed drug reactions such as morbilliform drug eruption and severe cutaneous adverse reactions (SCARs). Morbilliform drug eruption may wane over time, be the result of drug viral interactions, and be amenable to slow reintroduction or rechallenge, whereas SCARs are HLA class I restricted, T-cell-mediated reactions that demonstrate durable immunity and warrant lifelong avoidance. SCARs such as drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome and toxic epidermal necrolysis, acute generalized exanthematous pustulosis, and generalized bullous fixed drug eruption often occur in the setting of multiple drugs dosed together. Collectively, they lead to significant morbidity, mortality, and drug safety concerns that could severely limit future treatment options. Currently, no single or combination of diagnostic tests for SCARs such as ex vivo or in vitro testing, in vivo (skin) testing, or other adjunctive tests such as HLA typing have 100% negative predictive value. In this "Controversies in Allergy Review" article, we review the current literature on delayed skin testing (patch and delayed prick/intradermal test) and critically assess the evidence base of its utility across different drugs and clinical phenotypes of delayed hypersensitivity reactions.
Asunto(s)
Pruebas Cutáneas , Humanos , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/inmunología , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad Tardía/diagnósticoRESUMEN
PURPOSE OF REVIEW: To provide an update on the diagnosis of non-specific Lipid Transfer Protein (nsLTP) allergy. RECENT FINDINGS: More publications report the presence of nsLTP allergy in Northern European countries and nsLTP sensitisation in children. Individuals are more likely to have severe reactions if there is recognition of increasing numbers of LTP components. Diagnosis is problematic; not all those with nsLTP allergy will have a positive test to a peach extract containing Pru p 3, the peach nsLTP. Sensitisation to nsLTP is being reported in more countries, including to the nsLTP in Cannabis Sativa in North America. Meals containing multiple nsLTP foods are more likely to be involved in co-factor reactions. Component-resolved diagnostics are superior to skin prick tests, to determine sensitisation to the individual nsLTP allergens causing symptoms and, in the future, the Basophil Activation test may best discriminate between sensitization and clinical allergy.
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Antígenos de Plantas , Proteínas Portadoras , Hipersensibilidad a los Alimentos , Pruebas Cutáneas , Humanos , Proteínas Portadoras/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Hipersensibilidad a los Alimentos/inmunología , Antígenos de Plantas/inmunología , Alérgenos/inmunología , Proteínas de Plantas/inmunología , Niño , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangreRESUMEN
Allergies play a pivotal role in the daily practice of ENT specialists. Allergic symptoms induced by inhalant allergens are widespread in the population and can manifest through a wide range of symptoms, including rhinorrhea, sneezing, conjunctival redness, cough and dyspnea. Inconsistent diagnosis and treatment of allergic conditions can lead to reduced quality of life, decreased work performance, and socioeconomically significant secondary diseases. In addition to the medical history, the skin prick test and serological IgE diagnostics are the most important diagnostic procedure for detecting type-I allergies. To clarify clinical relevance, molecular diagnostics and nasal provocation testing may be employed. The key to effective treatment lies in a comprehensive allergological diagnosis coupled with a detailed patient history. General treatment recommendations such as allergen avoidance and nasal irrigation should complement pharmacological therapy. In the treatment of allergic rhinitis topical steroids are first line treatment options. The primary goal of treatment is symptom control, and if control is insufficient, causal therapy through specific allergen immunotherapy is recommended. Challenges in the ENT clinic involve selecting the necessary diagnostics and appropriate, effective treatments. Hence, using diagnostic and treatment algorithms, as well as standardized patient history questionnaires, can serve as invaluable tools in daily patient interactions, especially considering limited time availability.
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Inmunoglobulina E , Humanos , Inmunoglobulina E/sangre , Pruebas Cutáneas , Desensibilización Inmunológica/métodos , Derivación y Consulta , Hipersensibilidad/diagnóstico , Hipersensibilidad/terapia , Hipersensibilidad/inmunologíaRESUMEN
Objective: To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia. Methods: From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method. Results: Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated (R=0.7671, P<0.001). Conclusion: Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.
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Artemisia , Polen , Rinitis Alérgica , Población Rural , Pruebas Cutáneas , Población Urbana , Humanos , Polen/inmunología , China/epidemiología , Prevalencia , Rinitis Alérgica/epidemiología , Encuestas y Cuestionarios , Alérgenos , Rinitis Alérgica Estacional/epidemiología , Masculino , Femenino , Adulto , Adulto JovenRESUMEN
BACKGROUND: Complete avoidance of milk is the usual management for IgE-mediated cow's milk protein allergy (CMPA). A baked milk ladder is a method of dietary advancement therapy in IgE-mediated CMPA in Ireland, while in Spain, avoidance of milk awaiting natural tolerance acquisition through an oral food challenge (OFC) is employed. The aim of this study was to evaluate the use of dietary advancement therapy using a milk ladder compared with complete avoidance of milk for managing IgE-mediated CMPA. METHODS: This is a retrospective chart review of 371 pediatric patients from the population who have been treated for IgE-mediated CMPA between 2011 and 2020, with the milk ladder (Ireland) or complete avoidance followed by an OFC (Spain). The main outcome was the introduction of cow's milk. RESULTS: Milk ladder patients were 3.67 times more likely to succeed in comparison with milk avoidance (p < .001). Anaphylaxis during the treatment period occurred in 34 patients in the milk avoidance groups, while three patients in the milk ladder group experienced anaphylaxis due to accidental exposure to milk (p < .001). Failure to complete treatment was associated with a higher skin prick test in the milk avoidance group and a raised specific IgE in the milk ladder group. CONCLUSION: This is the first study that compares outcomes of dietary advancement therapy to complete avoidance for CMPA management, demonstrating that cow's milk can be successfully and safely reintroduced using dietary advancement therapy using a milk ladder.
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Inmunoglobulina E , Hipersensibilidad a la Leche , Proteínas de la Leche , Humanos , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/terapia , Estudios Retrospectivos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Femenino , Masculino , Preescolar , Animales , Proteínas de la Leche/inmunología , Niño , Lactante , España , Leche/inmunología , Irlanda , Anafilaxia/prevención & control , Anafilaxia/inmunología , Anafilaxia/etiología , Pruebas Cutáneas , Tolerancia Inmunológica , Bovinos , Alérgenos/inmunología , Alérgenos/administración & dosificación , Resultado del TratamientoRESUMEN
Background: Fruit allergy usually presents with mild-to-moderate symptoms but serious systemic reactions, e.g., anaphylaxis, may also occur. Objective: This study aimed to examine the clinical and laboratory characteristics of patients with fruit allergy and fruit-induced anaphylaxis. Methods: Patients diagnosed with fruit allergy at Diskapi Hematology and Oncology Hospital and Bilkent City Hospital between January 2017 and January 2023 were included in the study. The diagnosis of anaphylaxis was made according to the European Allergy and Clinical Immunology Anaphylaxis Guideline. Results: During the study period, skin-prick tests with food allergens were performed on 9432 patients in our clinic, and fruit allergy was detected in 78 patients (0.82%). Five patients with inaccessible medical records were excluded from the study. 40 (54.8%) were boys. The median (interquartile range) age at the onset of symptoms was 72 months (12.5-144 months). Sixty-eight of the patients (93.2%) had a concomitant allergic disease, the most common of which was allergic rhinitis (n = 48 [65.8%]). The 73 patients had a history of reaction to 126 fruits. Twenty-five patients (19.8%) were allergic to multiple fruits. The most common fruit allergen was banana (22/126 [17.4%]), followed by peach (18/126 [14.2%]) and kiwi (17/126 [13.5%]). Mucocutaneous findings were observed most frequently after fruit consumption (120/126 [95.2%]). Anaphylaxis occurred in 17 patients (23.2%) with 21 fruits.The fruits most commonly associated with anaphylaxis were banana (6/21 [28.6%]) and kiwi (6/21 [28.6%]). Conclusion: Fruit allergy generally presents with mild symptoms, e.g., oral allergy syndrome, but severe systemic symptoms, e.g., anaphylaxis, can also be observed. Kiwi and banana are the fruits that most commonly cause anaphylaxis. Although more comprehensive studies are needed to comment on the development of tolerance, especially in patients with anaphylaxis, responsible fruit avoidance is still the most important strategy.
Asunto(s)
Alérgenos , Anafilaxia , Hipersensibilidad a los Alimentos , Frutas , Pruebas Cutáneas , Humanos , Anafilaxia/diagnóstico , Anafilaxia/etiología , Anafilaxia/epidemiología , Masculino , Femenino , Niño , Hipersensibilidad a los Alimentos/diagnóstico , Hipersensibilidad a los Alimentos/complicaciones , Hipersensibilidad a los Alimentos/epidemiología , Frutas/efectos adversos , Frutas/inmunología , Preescolar , Alérgenos/inmunología , Lactante , AdolescenteRESUMEN
Background: ß-Lactams are the most widely used antibiotic family in the world. Nevertheless, they also stand out as the primary culprits for inducing drug hypersensitivity reactions (HSR). Methods: Between May 2018 and March 2023, patients with suspected HSRs to ß-lactams, who underwent skin tests (ST), were retrospectively screened. The determinants of allergenic penicillin (DAP) tests, which include penicillin minor and major determinants, clavulanic acid, and amoxicillin, along with ampicillin, sulbactam, the identified culprit drugs, and alternative cephalosporins, which include cefuroxime, ceftriaxone prick and/or intradermal tests, were administered. The analysis focused on identifying positive ST results and determining the true HSRs rates in this patient cohort. Results: Of the 147 patients, 78.9% (n = 116) were women and the median (minimum-maximum) age was 41 years (18-71 years). Mild HSRs (grades 1-2) were observed in 72.78% (n = 107), whereas 24.4% (n = 36) had severe reactions (grades 3-4) and 2.7% (n = 4) had an unknown grade. Of the patients, 64% (n = 94) experienced HSRs within the first hour after the last dose of the identified culprit drug. The overall positivity rate for all STs was 26.5% (n = 39). ST positivity rates were notably higher in individuals who had experienced HSRs within the past 6 months (p = 0.02) and those with severe anaphylaxis (p < 0.001). Conclusion: ß-Lactam ST positivity is higher, especially in those with grades 3-4 reactions and consulted a physician within the first 6 months after their HSRs.
Asunto(s)
Antibacterianos , Hipersensibilidad a las Drogas , Pruebas Cutáneas , beta-Lactamas , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Hipersensibilidad a las Drogas/diagnóstico , beta-Lactamas/efectos adversos , beta-Lactamas/inmunología , Adolescente , Anciano , Adulto Joven , Estudios Retrospectivos , Antibacterianos/efectos adversos , Índice de Severidad de la Enfermedad , Alérgenos/inmunologíaRESUMEN
BACKGROUND: Allergy to peanuts and tree nuts is a common cause of food allergy in Spain, with lipid transfer proteins (LTP) being the most frequently recognized panallergen. LTP sensitization often leads to multiple food group sensitivities, resulting in overly restrictive diets that hinder patient's quality of life. This study aimed to assess the tolerance of peanuts and tree nuts (hazelnuts and walnuts) in children sensitized to LTP, potentially mitigating the need for such diets. METHODS: This prospective study enrolled individuals diagnosed with allergy to peanuts, hazelnuts, or walnuts. Data were collected from medical records, including demographics and clinical history. Allergological assessment comprised skin prick tests using commercial extracts and the nuts in question, alongside measurements of total and specific IgE to nuts and their primary molecular components. Participants showing positive LTP sensitization without sensitization to seed storage proteins underwent open oral nut challenges. RESULTS: A total of 75 individuals labeled as allergic to peanuts, 44 to hazelnuts, and 51 to walnuts were included. All of them underwent an open oral provocation test with the incriminated nut, showing a high tolerance rate. Peanut was tolerated by 98.6% of patients, 97.72% tolerated hazelnut, and 84.3% tolerated walnut. CONCLUSION: The findings suggest that the majority of patients allergic to peanuts, hazelnuts, or walnuts, due to LTP sensitization and lacking IgE reactivity to seed storage proteins, can tolerate these nuts. This supports the need for personalized nut tolerance assessments to avoid unnecessary dietary restrictions.