Practical guidelines for diagnosing hypersensitivity reactions to nonsteroidal anti-inflammatory drugs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs most frequently involved in hypersensitivity reactions. These reactions include various clinical entities with different mechanisms leading to the release of inflammatory mediators. Characterization of patients based on clinical manifestations and suspected underlying mechanisms is critical for implementation of adequate diagnostic procedures and patient management.

Alternating Polistes-Vespula venom immunotherapy: a therapeutic strategy to resolve a diagnostic deficiency.

Background: In Mediterranean regions, double sensitization to Polistes and Vespula species is frequent in patients reacting to an unidentified wasp sting. Since both genera are present, it is often difficult to determine which insect is responsible and, consequently, select venom for immunotherapy. When a specific diagnosis cannot be made, a new therapeutic strategy should be undertaken.

Allergenic profile of nasal polyposis.

Background: Nasal polyposis is highly prevalent in the general population. Its exact origin is unknown, although several factors are involved in the etiology and development of this condition. Clinical patterns, a history of atopy, environmental exposure, eosinophil-mediated inflammation, the presence of inflammatory mediators, and sensitization to some allergens indicate that nasal polyposis is associated with allergic phenomena.

Fungal sensitization in nasal polyposis.

Background: There are indications that polyposis is somehow related to allergic phenomena. Fungal sensitization in substantial proportions of patients has been cited as a trigger of inflammatory mechanisms involving either an immunoglobulin (Ig) E-mediated reaction to fungal colonization or fungal invasion of tissues.

Objective: To confirm whether fungi were involved in the development of polyposis by examining sensitivity to fungal allergens and potential local contamination by fungal species.

Efficacy and quality of life with once-daily sublingual immunotherapy with grasses plus olive pollen extract without updosing.

Objective: The purpose of this randomized, double-blind, placebo-controlled study was to evaluate the clinical efficacy and tolerance of once-daily sublingual immunotherapy without updosing. Reduction in symptoms and medication use was the primary endpoint.

Methods: One hundred five patients with rhinitis and/or asthma due to grass and olive sensitization were randomized to be treated with placebo or active sublingual immunotherapy with the SLITone grass mix plus olive pollen extract for 6 months before the 2005 pollen season.

Predicting patients at high-risk of systemic reactions to cluster allergen immunotherapy: a pilot prospective observational study.

Objective: The purpose of this study was to identify factors associated with increased risk of adverse systemic reactions to cluster allergen immunotherapy and to create a preliminary predictive clinical model.

Methods: In a prospective observational study, the tolerance of 611 patients with seasonal respiratory diseases who were receiving cluster immunotherapy was monitored and all systemic reactions were recorded. Associations between potential prognostic factors (sex, age, respiratory disease, severity, duration of disease, previous immunotherapy, nonseasonal symptoms, skin prick test, total immunoglobulin (Ig) E, specific IgE, treatment schedule, allergenic composition, batch, date of treatment, habitat, place of residence) and systemic reactions were estimated.

Tolerance of a cluster schedule on the treatment of seasonal allergic respiratory disease with pollen extracts quantified in mass units.

In order to evaluate the tolerance of a cluster schedule on specific immunotherapy (SIT), 306 patients were included in a multicenter study. The patients were suffering from rhinoconjunctivitis with/without asthma, caused by sensitization to olive and/or grass pollen. SIT was administered subcutaneously according to a cluster schedule in which the maintenance dose is reached after four visits (3 weeks).