Allergy to pine nuts

We report two cases of cryptococcosis in patients with Waldenstrom's macroglobulinaemia and chronic lymphocytic leukaemia that responded to prolonged therapy with systemic amphotericin and flucytosine. Cryptococcosis, although more common in those with impaired cell mediated immunity, should also be considered as a complication in patients with impaired antibody responses.     

Effects of birch pollen-specific immunotherapy on apple allergy in birch pollen-hypersensitive patients

Electrophysiological testing remains an important efficacy parameter in clinical neuropathy trials. The quality of nerve conduction studies in reported trials varies greatly, and may be responsible for negative results. We report the utilization of an expert core lab for electrophysiological testing. With the core lab, the variability of repeat testing is comparable to that of a single, excellent laboratory. Motor conduction velocities demonstrated a coefficient of variation of 3% and sensory conduction velocities 4% across 60 study sites. The distal motor evoked potential amplitudes varied by 13% at the ankle, and 10% at the wrist. The sensory potential amplitudes varied by 16% at the ankle, and 11% at the wrist in 60 sites. The overall monitoring rate in all submitted nerve conduction tracings was 36.6%. Our results show that an expert core lab can improve the electrophysiological quality of clinical trial data with the potential to show small changes in nerve conduction velocities and in both motor and sensory potential amplitudes.     

Reproducibility and seasonal dependence of specific intranasal provocation tests in birch pollen allergy patients

BACKGROUND: The intranasal allergen Provocation test (INT) is the standard procedure to verify the effect of an allergen when a nasal allergy is suspected. It may be especially useful if results from skin tests or in vitro tests conflict with those from the history. In the clinical and research setting, INT may be used to study the efficacy of different treatment modalities such as pharmacotherapy or immunotherapy. The technique of INT has not been well standardized in the past. Variations exist in planning the optimum time for testing, especially in seasonal allergies. METHODS: We examined influences of different test dates with regard to the pollen season on the result of INT. A total of 19 patients (eight females, 11 males, aged 26.1 +/- 4.8 years) with a history of at least two years of allergic rhinitis to birch pollen, positive skin prick test, and RAST (> or = CAP class II) to birch pollen. INT was performed during the winter-period after approximately six months without natural pollen exposition (V1), during the birch pollen season (V2) and six weeks after the birch pollen season (V3). Allergens were applied using a pump spray (0.1 ml) in concentrations of 10, 50, 100, 500, 1000, 5000, 10,000, 50,000, and 100,000 SQ units per ml (SQ/ml). RESULTS: The threshold concentrations were significantly lower at V2 (100 SQ/ml) and V3 (500 SQ/ml) if compared to V1 (1000 SQ/ ml). CONCLUSIONS: Seasonal influences should be taken into account when performing INT in birch pollen allergy.     

Specific V beta T cell subsets are associated with cat and birch pollen allergy in humans

Cognate interaction between TCRs and MHC class II molecules plays an important role in initiating the allergen-specific immune response. Therefore, we analyzed the TCR distribution of human PBLs of 56 atopic and nonatopic (NA) individuals, including 4 monozygotic twin pairs, from two extended and four nuclear families. The expression of 23 V beta and 3 V alpha elements was analyzed. The blood samples of symptomatic birch pollen-sensitized individuals that were taken < or = 6 wk after the birch pollen season (n = 8) showed a significantly higher frequency of V beta 16.1+ and V beta 20.1+ T cells compared with the blood samples of birch pollen-sensitized individuals that were obtained out of allergen season (n = 10) or from NA individuals (p < 0.0005 and p < 0.0001, respectively). Allergen-specific lymphocyte proliferation was detected in the allergic individuals, and the distribution of V beta 16.1+ and V beta 20.1+ T cells returned to normal levels after the pollen season. The frequency of these V beta-expressing T cells correlated with the levels of allergen-specific IgE Abs. In addition, cat-sensitized individuals (n = 8) showed a significantly higher frequency of V beta 17.1-expressing T cells than did NA individuals (p < 0.005). Our results indicate restricted TCR-V beta gene usage in cat and birch pollen allergies; we suggest that both genetic and environmental factors contribute to TCR-V beta gene expression and to the development of a specific T cell response.     

Allergy to latex condoms

This study delineates the prevalence of reactions to condoms among latex-allergic patients seen in allergy consultation services since 1987. Questionnaires were mailed to 374 patients previously found to have clinically significant allergy to latex. Of these, only 238 completed the questionnaire. The respondents were 89% female, aged 14-70 years; 49% were health care workers. The results of the survey reveal that the 79 (84%) reported local itching and swelling and 25% had cutaneous urticaria, angioedema, and/or respiratory symptoms. In light of this problem, this paper suggests that physicians should be aware of other contraceptive alternatives for latex-sensitive patients.     

Allergy to tartrazine in alprazolam

Allergy to tartrazine-containing psychotropic medication (especially antidepressants) had been reported. 20 patients of apparent allergy to tartrazine-containing alprazolam brands in 480 patients exposed to the dye are described. Rechallenge with non tartrazine-containing alprazolam brands did not produce the similar allergic reactions.     

Allergy and infection

The majority of infectious asthma in children is of viral etiology. The respiratory syncytial and parainfluenza viruses are the etiologic agents in most young children, whereas rhinovirus primarily initiates asthmatic episodes in older children. Short-term or alternate day maintenance corticosteroid therapy probably does not significantly increase the asthmatic child's susceptibility to infection.     

Toxicity and allergy to local anesthesia

Considering the amount of local anesthetic administered on a daily basis, dental professionals must be familiar with the factors that influence the dose and type of local anesthetic that induces a toxic or allergic reaction. In addition to the route and rate of administration, the patient's physical condition and health may also influence the dose of local anesthetic that could be safely administered. This article reviews the different causes of local anesthesia toxicity and allergy. With prevention and early recognition of the warning signs, poor prognosis can be avoided.     

Contact allergy to cosmetics

This article gives the results of contact allergic reactions to cosmetics seen between 1985 and 1990 (462 patients investigated) and between 1991 and 1996 (486 patients investigated). Perfume components remain the most frequently occurring allergens in cosmetics. They are followed by preservative agents, a class within which important shifts have occurred over time (e.g. as with the isothiazolinone mixture). Excipients and certainly emulsifiers (e.g. cocamidopropylbetaine) are potentially not only irritants but also allergens. Among the "active" or category-specific ingredients, oxidative hair dyes, based on paraphenylenediamine and derivatives, and nail care products, based on (meth)acrylates are particularly apt to cause professional dermatoses. Finally, the share of sunscreens as cosmetic allergens remains limited, which may well be because a contact or photocontactallergy is often not recognized since the differential diagnosis with a primary sun intolerance is not always obvious.     

Contact allergy to corticosteroids

This article describes a rare case of granuloma of the lacrimal sac, which was treated with dacryocistorhinostomy and glabellar flap. In addition, the possible etiologic factors, the differential diagnosis and reconstructive techniques indicated in such cases are described.     

Response latency of gerbils and hamsters to nuts flavoured with bitter-tasting substances

The unconditioned reactions of Mongolian gerbils to peanuts rolled in sucrose octa-acetate (SOA) or denatomium benzoate (Bitrex) were studied in Experiment 1. Although SOA evokes as high a bitterness rating among humans as quinine salts, the gerbils' latency to ingest a nut flavoured with the former was similar to that to an unflavoured nut. Their oral latency to a nut that was flavoured with Bitrex was longer than to either an unflavoured one or one flavoured with SOA. However, the fact that they ingested a nut flavoured with the "most bitter substance known to man" within 70 sec after contact is surprising. Experiment 2 dealt with the effects of a peanut that was either unflavoured or flavoured with SOA or quinine and then paired with a LiCl injection. The oral latency of these gerbils to a nut conveying such flavours was assessed for six days after this conditioning. A nut flavoured with quinine acquired aversive properties but not ones that were flavoured with SOA or were unflavoured. Similar results were observed in Experiment 3, when hamsters were tested under comparable conditions. The theoretical implications of these results are discussed.     

Contact allergy to cocamidopropyl betaine

Cocamidopropyl betaine is an amphoteric surfactant used increasingly in cosmetic products. We describe 20 cases of cosmetic allergy to cocamidopropyl betaine; all were caused by shampoo or shower gel. 8 patients were hairdressers, who had occupational allergic contact dermatitis from shampoos. We recommend patch testing cocamidopropyl betaine 1% aq. routinely in hairdressers with dermatitis of the hands, and in all patients suspected of suffering from cosmetic allergy.     

Approaches to otolaryngic allergy emergencies

The otolaryngic allergist should take every measure possible to prevent reactions during testing and treatment of the allergic patient. Because the risk of this rare complication cannot be completely eliminated, however, it is essential to be prepared for prompt recognition and proper treatment of an anaphylactic emergency. An emergency set, including airway management tools, oxygen, intravenous materials, and proper medication, is essential. The entire office staff should be educated to cope with the emergency. Finally, a medication history must be repeated at intervals to detect patients who are receiving beta blockers to either remove them from the patients' treatment regimen or to prepare for the special treatment of the patients on beta blockers.     

Severe allergy to sorbolene cream

One of the principles of primary health care is intersectoral co-ordination. A cross sectional study done at the primary health center revealed existence of unsatisfactory co-ordination between health and education department.