- S3 Guideline Urticaria. Part 1: Classification and diagnosis of urticaria - German-language adaptation of the international S3 Guideline. [Journal Article]J Dtsch Dermatol Ges. 2023 01; 21(1):81-93.JD
- The lifetime prevalence of urticaria, a severe allergic disease, is almost 20%. It not only limits the quality of life of those affected, but also their general performance at work and in their daily activities. This publication is the first section of the Urticaria Guideline. It covers the classification and diagnosis of urticaria, taking into account the major advances in research into its caus…
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- A multidisciplinary approach to verify and de-label of drug allergic histories in a university hospital in Thailand: a retrospective descriptive study. [Journal Article]
- CONCLUSIONS: More than half of drug allergic histories were successfully confirmed or de-labeled by the multidisciplinary ADR team. The collaborative activities of various healthcare professionals, consisting of physicians, nurse, and pharmacists as presented in the study were effective in VD services and should be implemented in other healthcare settings.
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- Fatty-Acid-Based Membrane Lipidome Profile of Peanut Allergy Patients: An Exploratory Study of a Lifelong Health Condition. [Journal Article]
- Peanut allergy is a lifelong, increasingly prevalent, and potentially life-threatening disease burdening families and communities. Dietary, particularly polyunsaturated fatty acids (PUFAs), intakes can exert positive effects on immune and inflammatory responses, and the red blood cell (RBC) membrane lipidome contains stabilized metabolic and nutritional information connected with such responses. …
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- Alpha-Gal Syndrome in the Infectious Diseases Clinic: A Series of 5 Cases in Central North Carolina. [Journal Article]
- CONCLUSIONS: ID physicians should be aware of AGS as a cause of persistent, nonspecific symptoms following a tick exposure or tick-borne illness. Further research is needed to determine the prevalence of alpha-gal sensitization and AGS following tick-borne bites.
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- Cofactors, age at onset, allergic comorbidities and gender are different in patients sensitized to omega-5 gliadin and Pru p 3. [Journal Article]
- Aim of this study is to clarify the impact of cofactors on allergic reactions in patients sensitized to LTP and ω-5-gliadin. We retrospectively examined the charts of our outpatients from January 2015 to July 2019 and identified 157 patients seen for urticaria/angioedema or anaphylaxis after a meal, in presence or absence of cofactors and sensitized to LTPs (Pru p 3 and/or Tri a 14) and/or ω-5-gl…
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- Improving drug allergy label accuracy by supervised safety- and protocol-driven evaluation. [Journal Article]Ann Acad Med Singap. 2022 11; 51(11):677-685.AA
- CONCLUSIONS: Seventy-five percent of drug allergy labels are inaccurate. Risk-stratified, protocolised allergy evaluation is safe. Prolonged drug challenge increases the sensitivity of drug allergy evaluation and should therefore be performed when indicated.
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- A clinical pathway for the diagnosis of sesame allergy in children. [Journal Article]
- CONCLUSIONS: OFCs remain the gold standard for the diagnosis of Sesame Allergy and are indicated to define ST/SA status even in highly atopic patients with previous immediate allergic reactions to sesame. A decision-tree analysis based on clinical parameters easily available in every allergy clinic, can predict the outcome of sesame OFC in the vast majority of children, increasing the safety and availability of such diagnostic procedures.
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- A new classification option for NSAID hypersensitivity: Kalyoncu classification. [Journal Article]Allergol Immunopathol (Madr). 2022; 50(6):122-127.AI
- CONCLUSIONS: Our research revealed that the Kalyoncu classification is more descriptive of patients with NERD exhibiting urticaria/angioedema-type reactions. It also provides future risk assessment for development of NERD. For controversial cases, the Kalyoncu classification can be utilized as a new complimentary option alone or in conjunction with ENDA classification.
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- Allergic Reactions to COVID-19 Vaccination in High-Risk Allergic Patients: The Experience of Trieste University Hospital (North-Eastern Italy). [Journal Article]
- Background. Allergic patients may develop reactions following COVID-19 vaccination more frequently than non-allergic individuals. The aim of our study was to assess the risk of reactions in high-risk allergic patients vaccinated for COVID-19 at the University Health Agency Giuliano-Isontina (ASUGI) of Trieste (northeastern Italy). Methods. Patients were considered at high risk for allergic reacti…
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- Hypersensitivity to Ibuprofen: Real-Life Experience in Children with History of Suspected Immediate Reactions. [Journal Article]Int Arch Allergy Immunol. 2023; 184(1):33-42.IA
- CONCLUSIONS: DPTs should be performed to confirm or exclude ibuprofen allergy in children and to find safe alternative drugs. Male gender and older age are risk factors for ibuprofen allergy. NSAID-induced hypersensitivity reactions in the pediatric population cannot be well defined using the adult classification system.
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- Disease activity of patients with chronic urticaria receiving COVID-19 vaccines. [Journal Article]Asian Pac J Allergy Immunol. 2022 Oct 18 [Online ahead of print]AP
- CONCLUSIONS: Approximately 15% of chronic urticaria patients reported exacerbation after receiving a COVID-19 vaccination. No serious events were observed. Chronic urticaria patients should be vaccinated against COVID-19 after a discussion of the risk of disease flare-up.
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- Real World Management of Anaphylaxis Versus the National Institute for Health and Clinical Excellence (NICE) Guidelines. [Journal Article]
- Objectives Anaphylaxis is an acute, life-threatening immediate allergic reaction caused by the sudden systemic release of mediators from mast cells. This study aims to assess the current practice of emergency management of children and adults diagnosed with anaphylaxis at the Royal Hospital, Muscat, Oman, in line with the National Institute for Health and Clinical Excellence (NICE) guidelines. Me…
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- Diagnostic management of patients reporting symptoms after wheat ingestion. [Review]
- Many patients report symptoms after wheat ingestion experiencing a wide spectrum of clinical manifestations. Three possible diagnoses have been recognized: celiac disease (CD), wheat allergy (WA), and non-celiac (gluten) wheat sensitivity (NCGS/NCWS). CD is a chronic immune-mediated disease of the small bowel caused by exposure to dietary gluten in genetically predisposed individuals, with a prev…
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- Treatment of hereditary angioedema-single or multiple pathways to the rescue. [Review]
- Hereditary angioedema (HAE) is a rare disease caused by mutations in the SERPING1 gene. This results in deficient or dysfunctional C1 esterase inhibitor (C1-INH) and affects multiple proteases involved in the complement, contact-system, coagulation, and fibrinolytic pathways. Current options for the treatment and prevention of HAE attacks include treating all affected pathways via direct C1-INH r…
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- [Angioedema and anaphylaxis, a family story]. [Journal Article]Rev Infirm. 2022 Jun-Jul; 71(282):27-29.RI
- Non-allergic angioedema has a worrying morbidity. Clinical examination is central, as C1-esterase inhibitor deficiency will not be documented in the acute phase. In the case of anaphylaxis that does not respond to adrenaline, an early diagnosis can optimise referral of the patient to a reference healthcare establishment for a specific therapeutic protocol (icatibant, C1 inhibitor) recently update…
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- Diagnostic value of a medical algorithm for investigation of perioperative hypersensitivity reactions. [Journal Article]Allergy. 2023 Jan; 78(1):225-232.A
- CONCLUSIONS: The published algorithm (of tryptase rise, two-organ involvement or new urticaria/angioedema) is highly sensitive, and appropriate as a screening tool to identify patients suitable for testing for IgE-mediated POH.
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- Mollusk allergy in shrimp-allergic patients: Still a complex diagnosis. An Italian real-life cross-sectional multicenter study. [Journal Article]
- CONCLUSIONS: The current diagnostic methods are inadequate to predict the cross-reactivity between crustaceans and mollusks. The detection of mollusks hypersensitivity should still rely on skin tests with fresh material. The exclusion of mollusks from shrimp allergic patients' diets should occur when clinical history, available diagnostic instruments, and/or tolerance tests support such a decision.
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- Acute Urticaria and Anaphylaxis: Differences and Similarities in Clinical Management. [Review]
- Acute urticaria is a common condition that presents with wheals and/or angioedema. However, these symptoms are also frequent in anaphylaxis, a life-threatening reaction that should be immediately diagnosed and treated. In both, mast cells play a central role in the physiopathology. Causes and triggers of acute urticaria and anaphylaxis are similar in general, but some peculiarities can be observe…
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- Intubating Special Populations. [Review]Emerg Med Clin North Am. 2022 Aug; 40(3):443-458.EM
- Emergency clinicians are tasked with managing a variety of patients with acute deformities. One of the most acute situations management of the patient who presents with an airway emergency. Patients present with various pathologies may result in anatomically challenging intubation scenarios. Deferral of intubation is often not an option in the emergency department. In some cases, challenging anat…
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- Anaphylaxis to Moringa oleifera in North Africa: A case report and review of the literature. [Case Reports]
- We describe here the third reported case of anaphylaxis after ingestion of some leavers of Moringa oleifera, causing a widespread angioedema, a respiratory distress, and an elevation of serum tryptase. M. oleifera leaves were confirmed as the causative allergen by prick testing with fresh leavers.
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- StatPearls: Angioedema [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Angioedema is defined as " subcutaneous tissues and/or submucosal tissues circumscribed non-pitting edema affecting lips, face, neck, and extremities oral cavity, larynx, and gut." It becomes life-threatening when it involves the larynx, while intestinal angioedema is painful and mimics acute abdomen.[1][2] Angioedema was first described in 1882 by Quincke, then by Osler in 1888 (hereditary angio…
- Correlation between skin test results and historical manifestations in patients with suspected lidocaine hypersensitivity. [Journal Article]
- CONCLUSIONS: Negative skin test and subcutaneous challenge with a history of generalized cutaneous symptoms and/or systemic symptoms during the reaction to LA can be attributed to many causes, such as an IgE-mediated reaction against a component other than lidocaine (e.g., latex), medication side effects (adrenaline in combined preparations), and/or symptoms of primary disease (chronic spontaneous urticaria/angioedema).
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- First allergy conference in Qatar: Let's explore allergy with a new lens. [Journal Article]
- Allergic diseases are common medical conditions that now show an increasing trend globally and contributes to poor quality of life of the affected individual. Allergies can be fatal in a few instances such as anaphylaxis, severe asthma, and hereditary angioedema if the symptoms are not recognized and treated correctly. (1, 2) The first Allergy Conference in Qatar aimed to highlight the burden of …
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- Adrenaline autoinjector is under-prescribed in typical cold urticaria patients living in tropical climate countries. [Journal Article]
- Background: The diagnosis of typical cold urticaria (ColdU) relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). Till date, it is largely unclear how often patients with ColdU receive adrenaline treatment and are provided with an adrenaline autoinjector (AAI). Methods: An international, cross-sectional study, COLD-CE (…
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- Incidence of immediate allergic reactions to mRNA COVID-19 vaccines in adults with drug allergies and other allergic disorders. [Journal Article]
- Concerns have been raised about allergic reactions to messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccines. A history of allergic reactions, including anaphylaxis to drugs, has been frequently reported in individuals with anaphylaxis to mRNA vaccines. To estimate the rate of immediate allergic reactions in patients with a history of drug allergy or other allergic disorde…
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- Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS). [Review]
- The α-Gal syndrome (AGS) is a pathognomonic immunoglobulin E (IgE)-mediated delayed anaphylaxis in foods containing the oligosaccharide galactose-α-1,3-galactose (α-Gal) such as mammalian meat or dairy products. Clinical presentation of AGS can also comprise immediate hypersensitivity due to anticancer therapy, gelatin-containing vaccines or mammalian serum-based antivenom. The IgE initial sensit…
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- Use of clindamycin as an alternative antibiotic prophylaxis. [Journal Article]
- CONCLUSIONS: Clindamycin was largely administered in patients with non-severe HSRs, low-risk history or unknown reactions to PCN or cephalosporin, whom cefazolin could have been administered safely. Obtaining a detailed history of antibiotic allergy, allergy testing and/or direct oral challenge can de-label unsubstantiated PCN or cephalosporin allergy and ultimately reduce the incidence of SSIs by optimizing the rate of more effective antibiotic administration.
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- Elicitors and phenotypes of adult patients with proven IgE-mediated food allergy and non-immune-mediated food hypersensitivity to food additives. [Journal Article]
- CONCLUSIONS: The importance of oral food challenges for the diagnosis of food hypersensitivity is confirmed. IgE-dependent food allergy is more frequently proven, reaching a positivity rate of one-third and only about 20% for non-immune-mediated hypersensitivity. Future studies should elaborate on the mechanisms of non-immune-mediated food hypersensitivity and the clinical impact of cofactors in this setting.
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- StatPearls: Type I Hypersensitivity Reaction [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- The immune system plays a crucial role in maintaining health and protecting the human body against microbial invasions. However, this same system can lead to exaggerated immune and inflammatory responses that result in adverse outcomes known as hypersensitivity reactions. There are four traditional classifications for hypersensitivity reactions, and these include Type I, Type II, Type III, and Ty…