Showing papers on "Hypersensitivity reaction published in 1993"
TL;DR: It is hypothesized that a lymphocyte-mediated hypersensitivity phenomenon may account for the generalized pathophysiologic changes observed in clinical radiation pneumonitis observed in 17 women referred for immediate post-operative radiotherapy for breast cancer.
Abstract: Objective: To determine if unilateral thoracic irradiation results in a lymphoid alveolitis in both irradiated and unirradiated lung fields. Design: A prospective, nonrandomized study. Patients: Wo...
187 citations
TL;DR: The acute hypersensitivity reaction could be completely blocked in all but in 1 of 14 patients, and this pretreatment schedule had an important prophylactic effect on edema formation.
131 citations
TL;DR: Anticonvulsants can cause a characteristic hypersensitivity reaction that presents as fever, mucocutaneous eruptions, lymphadenopathy and hepatitis.
Abstract: Anticonvulsants can cause a characteristic hypersensitivity reaction. This multisystem reaction typically presents as fever, mucocutaneous eruptions, lymphadenopathy and hepatitis. There is cross-reactivity between different anticonvulsants, which complicates subsequent therapy. We report three cases to illustrate both the typical features, and less common complications, of this under-recognized and life-threatening syndrome.
64 citations
TL;DR: The clinical and histologic findings of a case in which a patient developed an acute hypersensitivity reaction to an aluminum zirconium complex are presented.
Abstract: Zirconium compounds have been associated with the development of hypersensitivity granulomas. However, aluminum zirconium complexes have not previously been shown to induce sensitization. We present the clinical and histologic findings of a case in which a patient developed an acute hypersensitivity reaction to an aluminum zirconium complex.
51 citations
TL;DR: A nonsmoking ceramic tile worker 25 yr of age who developed a worsening dry cough and dyspnea after 3.5 yr as a sorter and glazer of tiles demonstrates that zirconium can also cause an acute and fulminant allergic alveolitislike hypersensitivity reaction.
Abstract: We describe a nonsmoking ceramic tile worker 25 yr of age who developed a worsening dry cough and dyspnea after 3.5 yr as a sorter and glazer of tiles. Open lung biopsy revealed an intense granulomatous interstitial pneumonia with mild fibrosis, compatible with hypersensitivity pneumonitis, and numerous very small birefringent crystals around the terminal airways and occasionally in granulomas. Pulmonary particle analysis revealed an inhaled dust burden nearly 100-fold the normal background level, mainly consisting of clay minerals and zirconium silicate. The patient had no history or clinical or laboratory findings suggesting any organic etiologic agent. A sarcoid granulomatosis type of chronic pulmonary hypersensitivity reaction is known after long-term exposure to zirconium, but this case demonstrates that zirconium can also cause an acute and fulminant allergic alveolitislike hypersensitivity reaction.
36 citations
TL;DR: It is proposed that acquired resistance, in conjunction with low-level persistence of Candida in the model, mimics the carrier state in sensitized humans.
Abstract: In our experimental model of oral candidiasis in the CD1 mouse, the primary infection showed reproducible Candida overgrowth kinetics with a peak level on day 5 of the infection. After day 7, the population stabilized at about 300 colony-forming units per excised mucosal tissue. The primary infection triggered an inflammatory response that resolved in under 8 days. At this point, the histological pattern of the mucosa reached a new equilibrium between recruited and resident mononuclear cells. The primary infection also rapidly stimulated cellular immunity, as measured from day 4 by a delayed-type hypersensitivity footpad reaction. Following a second topical challenge with Candida 30 days after the primary infection, the infection was barely detectable and a typical local delayed-type hypersensitivity reaction occurred between 24-72 h. It is proposed that acquired resistance, in conjunction with low-level persistence of Candida in our model, mimics the carrier state in sensitized humans.
29 citations
TL;DR: Of 17 children with spina bifida undergoing transurethral electrical bladder stimulation, 5 with latex allergy 3 to 9 years old were identified, all 5 patients were noted to manifest sneezing or a cough several minutes before the development of a generalized hypersensitivity reaction, which in several patients progressed to bronchospasm.
20 citations
TL;DR: It is presented further evidence that this is mediated via a delayed‐type hypersensitivity reaction and protein binding of hydrocortisone or a degradation product may be important in the development of corticosteroid allergy.
Abstract: Hypersensitivity to topical hydrocortisone is becoming increasingly recognized. We present further evidence that this is mediated via a delayed-type hypersensitivity reaction. A hydrocortisone: albumin complex was able to induce a proliferative response in the peripheral blood mononuclear cells of patients allergic to hydrocortisone. Protein binding of hydrocortisone or a degradation product may be important in the development of corticosteroid allergy.
20 citations
16 citations
TL;DR: Hypersensitivity reactions to TPN can be managed by withholding the TPN and treating with antihistamines if needed until the reaction resolves, and identification, possibly by epicutaneous allergy testing, and removal of the offending agent(s) from theTPN is necessary if TPN therapy must be restarted.
Abstract: ObjectiveTo report a case of a hypersensitivity reaction to total parenteral nutrition (TPN) and to review the available literature on this rare adverse effectCase SummaryThe reaction occurred in a 52-year-old woman with pancreatic carcinoma who received intravenous metronidazole, tobramycin, vancomycin, ranitidine, morphine, TPN, and lipid emulsion postoperatively Within 30 minutes of starting the TPN and lipid emulsion, the patient complained of dyspnea and pruritus She began hyperventilating and was hypoxic The reaction resolved after discontinuation of the TPN and lipid emulsion The reaction recurred when lipid-free TPN was initiated on two subsequent occasions, and resolved spontaneously following the discontinuation of the lipid-free TPN The antibiotics, ranitidine, and morphine therapy were continued with no further adverse effects and the patient was discharged on postoperative day 17DiscussionCase reports in the literature on TPN-related hypersensitivity reactions were reviewed It was spe
14 citations
Journal Article•
TL;DR: A generalized hypersensitivity reaction including as fever and skin rash to a porcine- and bovine-derived heparin preparation was observed in a hemodialysis patient due to the nephrotic syndrome.
Abstract: Hypersensitivity reactions to heparin are very rare. A generalized hypersensitivity reaction including as fever and skin rash to a porcine- and bovine-derived heparin preparation was observed in a hemodialysis patient due to the nephrotic syndrome. The patient revealed peripheral eosinophilia and normal serum IgE. The results of a drug lymphocyte stimulating test on heparin were positive. Following prednisolone administration and infusion of nafamostat mesilate as anticoagulant therapy during hemodialysis, the high fever and generalized urticaria disappeared. Caution is required when conducting heparin therapy on hemodialysis patients.
Journal Article•
TL;DR: The immunologic mechanisms responsible for allergic reactions are well studied and are among the best defined of any immunopathologic disorder.
Abstract: The immunologic mechanisms responsible for allergic reactions are well studied and are among the best defined of any immunopathologic disorder. New knowledge is expanding rapidly, and the type I Gell and Coombs immediate hypersensitivity reaction, which is the basis of the IgE-mediated allergic disease, is more accessible to accurate diagnosis and specific therapy than ever before. The mechanisms of the immediate, late-phase, and dual reactions are discussed. The role of the cyclic nucleotide system, nonimmune mast cell degranulation, and participation of cytokines in atopic allergy are investigated. The principles and pitfalls of specific immunotherapy are reviewed briefly.
TL;DR: Two children who developed hypersensitivity reactions of varying severity following barium meal examination, the more severe of which was associated with documented severe food allergy, are reported.
Abstract: We report two children who developed hypersensitivity reactions of varying severity following barium meal examination, the more severe of which was associated with documented severe food allergy For children with this risk factor, contrast studies should be performed only where facilities and personnel are available for immediate resuscitation of all sizes of child For children such as these, consideration should be given to the use of pure barium sulphate
Journal Article•
TL;DR: The results suggest the reaction was a type I hypersensitivity reaction to ethylenediamine, but a nonimmune mechanism could not be excluded.
Abstract: We present a patient who experienced an immediate adverse reaction following intravenous administration of aminophylline. Skin prick, intradermal, and patch tests, RAST and indirect ELISA assays with aminophylline, theophylline and ethylenediamine were negative. A positive histamine release test was found only with ethylenediamine. Single-blind placebo-controlled challenges were positive with aminophylline and negative with theophylline. Our results suggest the reaction was a type I hypersensitivity reaction to ethylenediamine, but a nonimmune mechanism could not be excluded.
01 Jan 1993
TL;DR: There is now a significant body of evidence suggesting that asthma should be viewed as a chronic inflammatory disease, and dysfunction in T cell regulation may result from a loss of local suppressor mechanisms mediated by a subset of lung macrophages.
Abstract: There is now a significant body of evidence suggesting that asthma should be viewed as a chronic inflammatory disease. The chronic inflammation (present even in stable asthmatics) exhibits the characteristics of a T-cell-mediated delayed-type hypersensitivity reaction. Within this reaction, activation of TH2-like T cell clones producing an excess of IL4 and IL5 may promote an over stimulation of IgE and link the T cell aberration to the immediate hypersensitivity reaction that causes the acute episodes of bronchospasm and eosinophil accumulation. This dysfunction in T cell regulation may result from a loss of local suppressor mechanisms mediated by a subset of lung macrophages. This hypothesis is represented schematically in Fig 4.
TL;DR: The results suggest that this procedure may be a useful tool for evaluating delayed type hypersensitivity induction during the early development of novel antibiotics, since not only can sensitization be induced with protein-unconjugated antibiotic, but also because assessment can be made using a small amount of sample.
Abstract: This study was designed to determine whether delayed type hypersensitivity could be evoked by protein-unconjugated beta-lactam antibiotics emulsified with Freund's complete adjuvant (FCA) in mice. The method providing the strongest sensitization was assessed by measuring footpad swelling induced by several biweekly intervals of subcutaneous injections of 0.8 mg/mouse cephalothin with FCA, followed by intradermal challenge with 1.0 mg/site cephalothin into the footpad in four different strains of female mice. A total of three and four injections, once every two weeks, in BDF1 and DBA/2 mice, respectively, produced the greatest potential for swelling. This swelling could be reinduced by the local passive transfer of cephalothin-primed splenocytes into the footpad of naive recipient mice. Moreover, the reaction was diminished by the addition of anti-Thy-1.2 monoclonal antibody with low-toxicity rabbit complement to cephalothin-primed splenocytes. Swelling in the footpad was therefore induced via the delayed type hypersensitivity reaction, indicating T-lymphocyte dependence. When the potential for beta-lactam antibiotics to elicit delayed type hypersensitivity was investigated in BDF1 mice, eight of the nine agents employed showed a 10-90% positive incidence. This result had a significant correlation (r = 0.76) with the data for skin reaction in guinea pigs, the method generally used for estimating allergenicity. These results suggest that this procedure may be a useful tool for evaluating delayed type hypersensitivity induction during the early development of novel antibiotics, since not only can sensitization be induced with protein-unconjugated antibiotic, but also because assessment can be made using a small amount of sample.
30 Jun 1993
TL;DR: The results suggest that NZ-107 has anti-allergic action including inhibition of eosinophil accumulation in an antigen-challenged airway lesion in rats and guinea-pigs.
Abstract: The effects of 4-bromo-5-(3-ethoxy-4-methoxybenzylamino)-3(2H)-pyridazinone (NZ-107) on immediate type hypersensitivity reactions in rats and guinea-pigs were studied. 1. When NZ-107, at a dose of 50 mg/kg (i.p.) or 100 mg/kg (orally), was administered to rats, 48-h homologous passive cutaneous anaphylaxis (PCA) reaction and histamine-, leukotriene C4 (LTC4)- and leukotriene D4 (LTD4)-induced skin reactions were suppressed by the agent. 2. NZ-107 (10(-6) g/ml) inhibited both LTC4- and LTD4-induced contractions of isolated rat stomach smooth muscle. 3. NZ-107 inhibited antigen-induced histamine release from rat peritoneal mast cells by 26% at a concentration of 10(-4) g/ml. 4. NZ-107, at doses of 25 and 50 mg/kg (orally), significantly inhibited guinea-pig 3-h heterologous PCA reaction. 5. NZ-107 inhibited antigen-induced histamine release from guinea-pig lung tissue by 17% and 48% at concentrations of 5 x 10(-5) and 10(-4) g/ml, respectively. 6. NZ-107, at doses of 25 and 50 mg/kg (i.p.), inhibited antigen-induced bronchoconstriction and eosinophil accumulation in the bronchoalveolar lavage fluid (BALF) of guinea-pigs. These results suggest that NZ-107 has anti-allergic action including inhibition of eosinophil accumulation in an antigen-challenged airway lesion in rats and guinea-pigs. The anti-allergic action of this agent is thought to be due to its action as a histamine and LT antagonist and its consequent inhibition of antigen-induced histamine release.
Journal Article•
TL;DR: The immunoperturbed state that exists for a period of time after bone marrow transplantation, especially in the presence of immunomodulation caused by combined therapy with recombinant human interferon alpha and interleukin-2, with exposure to potentially reaginic agents may have contributed to the development of the hypersensitivity reaction in this patient.
Abstract: Typical cutaneous hypersensitivity reaction to co-trimoxazole was seen in a woman after autologous bone marrow transplantation and immunotherapy. She had developed no such reaction during chemotherapy prior to the transplant or immediately after the transplant. The immunoperturbed state that exists for a period of time after bone marrow transplantation, especially in the presence of immunomodulation caused by combined therapy with recombinant human interferon alpha and interleukin-2, with exposure to potentially reaginic agents may have contributed to the development of the hypersensitivity reaction in this patient.
TL;DR: A unique patient with true asymmetrical hypersensitivity to bovine collagen is reported with the development of an inflammatory response at a treatment site after a negative skin test.
Abstract: We report a unique patient with true asymmetrical hypersensitivity to bovine collagen. Hypersensitivity is the development of an inflammatory response at a treatment site after a negative skin test. She developed an inflammatory response in only one of two simultaneously injected sites. About 1.5% of patients with a negative skin test have a hypersensitivity reaction consisting of firmness, erythema, and swelling. The signs and symptoms generally resolve spontaneously in a few months.
Journal Article•
TL;DR: The authors give a survey of the different allergic reactions and discuss the different components of the IgE mediated hypersensitivity which is the most important type of hypersensitivity in the upper airways.
Abstract: The tissue changes and symptoms that occur during an allergic reaction in the upper respiratory tract are due to inflammatory reactions. The authors give a survey of the different allergic reactions and discuss the different components of the IgE mediated hypersensitivity which is the most important type of hypersensitivity in the upper airways. The production of IgE, the immunoglobulin of the immediate hypersensitivity reaction, is modulated by T-cells through the activity of cytokines. Antigen presenting cells, including Langerhans cells, play an important role in the sensitisation phase. Mast cells and basophils degranulate as a result of a complex enzymatic pathway, in which phosphatidylinositol plays an important role. The mediators released by these cells include vasoactive substances, chemotactic agents and inflammatory proteases; these mediators and those liberated by secondary recruited cells, such as eosinophils and basophils will be responsible for the early and late symptoms.
Journal Article•
TL;DR: A case of a 7-year-old boy with myelodysplasia who developed a local acute hypersensitivity reaction after exposure to latex gloves during electromyography is presented in this paper.
Abstract: A case of a 7-year-old boy with myelodysplasia who developed a local acute hypersensitivity reaction after exposure to latex gloves during electromyography is presented. Anaphylaxis from latex gloves has been recently reported, especially in patients with myelodysplasia. Allergens from rubber gloves can be introduced under the skin during EMG and could cause local or systemic acute hypersensitivity reactions. Electromyographers should elicit a history to rule out rubber allergy and use vinyl gloves if suspicion of allergy exists.
TL;DR: Kerions, which are seen in inflammatory tinea capitis, are believed to result from a hypersensitivity reaction, although pus formation in kerions is not well known.
Abstract: Kerions, which are seen in inflammatory tinea capitis, are believed to result from a hypersensitivity reaction. Although pus formation in kerions is
TL;DR: H I antagonists are among the most widely prescribed and rccommcndcd mcdications in America for a numbcr of indications including common cold, nasal allergies, insomnia, itching, druginduced cxtrapyramidal rcactions, prctrcatmcnt for blood transfusions and trcatmcnt of hypcrscnsitivity reactions.
Abstract: liistaminc H I antagonists arc among thc most widely prescribed and rccommcndcd mcdications in America.' Thcy arc frcqucntly uscd for a numbcr of indications including thc common cold, nasal allergies, insomnia, itching, druginduced cxtrapyramidal rcactions, prctrcatmcnt for^ blood transfusions, i n d trcatmcnt of hypcrscnsitivity reactions. Whilc thcsc agcnts havc a rclativcly rvidc thcrapcutic indcx, thcy d o carry an incidcncc of advcrsc cffccts that has bccn rcportcd to bc as high as 50%' Many of thc advcrsc cffccts of histamine HI antagonists arc mild and rcsolve on discontinuation of thc offcnding agcnt. Bccausc histamine H I antagonists arc used so commonly to trcat hypcrscnsitivity rcactions, thcir potcntial to clicit hypcrscnsitivity rcacLions often goes unapprcciatcd.
TL;DR: Hcnytoin sodium (PS), rclcascd in P 1937, has bccn widcly uscd as an anticonvulsant and antiarrhythmic agcnt for the initial thcrapy of gcncralizcd tonic-clonic, complcx partial, and simplc partial scizurcs.
Abstract: hcnytoin sodium (PS), rclcascd in P 1937, has bccn widcly uscd as an anticonvulsant and antiarrhythmic agcnt. PS is uscful for the initial thcrapy of gcncralizcd tonic-clonic, complcx partial, and simplc partial scizurcs. PS is also uscd prophylactically to prcvcnt scizurcs in paticn’ts aftcr scvcrc hcad injury. Early scizurcs arc infrequent immcdiatcly aftcr a skull fracturc, yct convulsions can intcnsify brain insult by incrcasing intracranial prcssurc, causing rcspiratory distrcss, or incrcasing ccrcbral metabolism.’ Thus, PS is usually administcrcd early aftcr trauma. In most paknts, PS is considcrcd safc and is wcll-tolcratcd. Sincc 1930, morc than 100 cascs of phcnytoin hypcrscnsitivity syndromc (PHS) havc bccn rcportcd in thc litcraturc. This is a multisystcm disordcr that is oftcn associatcd with hcpatic dysfunction. Thc following case dcscribcs a paticnt with a dcprcsscd skull fracturc who rcccivcd PS prophylactically and dcvclopcd a lifc-thrcatcning advcrsc rcaction due to PHS.