Drug allergy and pollinosis. A short report.

2 series of patients with pollinosis and drug allergy studied 10 years apart and comprising 115 cases are presented. In both series grass pollens and parietaria are as usual the most common cause of pollinosis but Parietaria was more common in the first series. Beta-lactams were the major cause of drug allergy in the first group, supersed by NSAID in the second group.

Drug allergy and asthma.

The prevalence of drug induced asthma in a series of 347 patients with drug induced adverse effects has been evaluated corresponding to 10% of drug adverse effects always due to NSAIDS.

"In vivo" and "in vitro" tests in the diagnosis of Beta-lactams allergy.

The results of "in vivo" and "in vitro" diagnostic tests in 114 patients reporting an allergic reaction to Beta-lactams are presented. Skin test gave an overall positivity of 85% and determination of specific IgE of 42%. Skin tests have a greater sensitivity but "in vitro" tests are an useful associated diagnostic method.

Alpha-1-antitrypsin deficiency asthma and allergy.

The biochemistry, genetics and pathology of alpha-1-anti-trypsin deficiency are reviewed. The geographical distribution in Europe of more current phenotypes M, SZ is discussed. Two cases of alpha-1- anti-trypsin are presented one homozygotic ZZ non-smoker without any respiratory pathology and one heterozygotic SZ heavy smoker with a severe chronic obstructive pulmonary disease and reversibility to Beta-2-mimetics suggesting asthma.

Clinical efficacy and safety of preseasonal sublingual immunotherapy with grass pollen carbamylated allergoid in rhinitic patients. A double-blind, placebo-controlled study.

Background: The aim of this study was to confirm the clinical efficacy and safety of a preseasonal sublingual immunotherapy (SLIT) in a group of allergic patients with seasonal rhinoconjunctivitis with or without mild intermittent or mild persistent asthma. The immunotherapy was administered through the oral mucosa with a monomeric carbamylated allergoid (allergoid SLIT) for grass pollens. A secondary endpoint was to evaluate the effect of the allergoid SLIT on nasal reactivity.

Prevalence of drug allergy in an out-patient population.

The prevalence of drug allergy in an out-patient population has been studied, 448 cases were diagnosed mainly to NSAIDS and beta-lactams and local anesthetics, sulfa drugs, quinolones and others. Clinical history and skin tests are sufficient to diagnose most cases of drug allergy.

Skin tests in NSAIDS hypersensitivity.

Prick tests are more specific but less sensitive than ID which can give false positive results. 3 NSAIDS groups can be considered: Aspirin, diclofenac and metamizol with a higher percentage of positivity. For others NSAIDS including the newer coxibs positivity around 50%.

Trichophyton allergy: review of 89 cases.

A serie of 89 cases (55 men 34 women) of Tricophyton allergy is presented. All the patients had a clinical history and in 86 out of 89 lesions of dermatophytosis urticaria/angioedema was present in 57, eczema in 8, rhinitis in 12, conjunctivitis in 1 and asthma in 12. Skin prick tests to Tricophyton were positive in 53 (59,6%) of the patients and intradermal test in all.

Effect of immunotherapy on fungal allergy: a case report.

Candida is presented. Systemic immunotherapy with a Tricophyton/Candida vaccin was completely cleared the urticaria/angioedema and decreased specific IgE from more than 100 KUA/I to 7.6 to Tricophyton and from 4.

Monoid sublingual immunotherapy.

Sublingual monoid immunotherapy with monomeric allergoids has been largely used in Europe in the last few years. An open trial of allergoid in tablets has been done in rhinitic patients allergic to house dust mites, grass pollens and Parietaria with clear improvement in clinics and drug consumption scores. In a second phase a double blind placebo controlled trial of grass pollens allergoids have been done in hay fever patients with significant decrease on the scores of rhinorrea, sneezing and conjunctivitis nasal steroid consumption and clinical score after serial nasal challenges.

Immunoblot studies in allergic patients to hymenoptera venom before and during immunotherapy.

Background: Hymenoptera venom immunotherapy (VIT) is immunologically effective in patients with systemic allergic reactions after hymenoptera stings.

Objective: To evaluate the effect of VIT on specific IgE and IgG4 immunoblotting bands in VIT-treated patients.

Material And Methods: Specific IgE and IgG4 immunoblotting bands for hymenoptera venom were performed with ALABLOT in sera of 17 patients (8 allergic to honeybee venom, 8 to wasp and 1 to polistes venom) before and during successful VIT (1 and 3 years).

Allergy to sunflower seeds.

A case of oral syndrome after eating sunflower seeds is reported. Sensitization has been probably through inhalant route when using these seeds to feed birds. Skin prick tests with a fresh macerate of sunflower seeds has been clearly positive (greater than histamine control) but commercial extracts have given borderline positivity and specific IgE to sunflower was strongly positive.

"Minor" hemoglobinopathies: a risk factor for asthma.

Background: Thalassemia, sickle cell disease and other hemoglobinopathies are not rare in Portugal and European Mediterranean area. Homozygotic patients present major hematological disease but heterozygotic minor assymptomatic forms are frequent, mainly thalassemia minor and sickle cell trait. In these cases mycrocytosis with decrease or red cell volume and mean corpuscular volume or abnormal rigid erythrocytes are found and can lead to hemorheologic disturbances.

Chronic urticaria and thyroid auto-immunity.

Purpose was to evaluate thyroid auto-immunity and thyroid function in chronic urticaria (CU). Evaluation of antibodies Ab to thyroglobulin (TG) thyroid peroxidase (TPO) and of TSH, FT3, FT4, and of intra-dermal self test with patients own serum in 56 patients presenting chronic idiopathic urticaria and in a matched control group of 56 subjects without CU. Ab to TG positive in 13 (22.

Efficacy and safety of specific immunotherapy with a modified mite extract.

Background: In specific immunotherapy (SIT), modified extracts have been used to allow safe administration of higher allergen doses. Schedules reaching maintenance doses in approximately 1 month, which may have greater efficacy, have even been proposed.

Aims: To assess the safety and efficacy of SIT with modified (depigmented and polymerized) Dermatophagoides pteronyssinus extract in the treatment of allergic rhinitis.

Solar urticaria and porphyrias.

The importance of disturbances of porphyrin metabolism in solar urticaria is discussed. 15 cases of porphyrias with sun sensitivity are presented comprising 5 cases of erythropoietic protoporhyria, 8 cases of coproporphyria hereditaria and 2 cases of porphyria variegata, 9 out of these 10 patients presented neuroabdominal symptoms and in 4 cases contraceptive pills have triggered the disease. Due to the risk of severe forms of disease sometimes drugs induced porphyrias must be considered in all cases of solar urticaria and a correct laboratory study done in the suspected cases.

Latex and chickpea (Cicer arietinum) allergy: first description of a new association.

In this paper we describe the existence of cross-reactivity between allergens from latex and chickpea, a food from the Leguminosae family, which is common in the Mediterranean diet. We present the case report of a spina bifida boy with a clinical relevant food allergy to chickpea (oral syndrome + dysphonia), developing after the appearance of latex allergy symptoms (lip angioedema + intraoperative anaphylaxis). Specific IgE to latex and chickpea was demonstrated by skin prick tests, measurement of patient's serum specific IgE and IgE-immunoblotting.

Candida and human disease.

A general review on candida and human disease emphasizing Candida Species, clinical manifestations, immune response NK failure and immunotherapy.

Lung function in asthma: relation to clinics, challenge tests and immunotherapy.

Background: In the last few years the consensus on asthma, guidelines and GINA have introduced a classification based on clinical criteria, PFR or FEV1 values and reversibility. However the relation of clinical classification with the functional data is not well defined.

Purpose: To correlate the clinical evaluation of asthma with the most usual parameters of larger and smaller airways bronchial obstruction, PFR and FEV1.

Correlation between clinical classification, PEF and FEV1: guidelines and reality.

The currently proposed guidelines and consensus for asthma include Peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1) as two criteria to classify asthma severity. The report between these functional data and clinical classification degrees has been evaluated in 153 asthmatic patients. Concordance between functional evaluation and clinical degree has been found only for moderate persistent asthma but not for intermittent or mild persistent asthma.

Peritoneal fluid concentrations of interleukin-8 in patients with endometriosis depend on the severity of the disorder and are higher in the luteal phase.

Background: Previous evaluations of the relationship between the concentrations of interleukin-8 (IL-8) in the peritoneal fluid and endometriosis led to non-consistent results. Our purpose was to investigate the correlation of the concentrations of IL-8 in the peritoneal fluid with the stage of endometriosis, the presence of red lesions and the phase of the menstrual cycle.

Methods: Ninety-two patients with infertility (n = 87) or undergoing sterilization (n = 5) had peritoneal fluid samples collected at laparoscopy.

Soluble intercellular adhesion molecule 1 in the peritoneal fluid of patients with endometriosis correlates with the extension of peritoneal implants.

Objective: To investigate the correlation of the concentrations of soluble intercellular adhesion molecule 1 (sICAM-1) in the peritoneal fluid (PF) with the extent of peritoneal endometriotic lesions and with the presence of red lesions (RLs).

Study Design: Sixty-seven patients with endometriosis and 19 controls with normal pelvis had PF samples collected during laparoscopy.

Results: The concentrations of sICAM-1 in the PF of patients and controls were not different.

Candida and allergy.

The role of Candida species in allergic diseases is briefly reviewed pointing out the more common forms of cutaneous and respiratory allergy where Candida can be implied, the current laboratory diagnostic methods and the possible effectiveness of Candida immunotherapy in selected patients.

Correlation between clinical classification, PEF and FEV1: guidelines and reality.

The currently proposed guidelines and consensus for asthma include Peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1) as two criteria to classify asthma severity. The report between these functional data and clinical classification degrees has been evaluated in 153 asthmatic patients. Concordance between functional evaluation and clinical degree has been found only for moderate persistent asthma but not for intermittent or mild persistent asthma.