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    Potential Biomarkers for the Diagnosis of Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema.
    ORL J Otorhinolaryngol Relat Spec 2017 Feb 24;79(1-2):85-92. Epub 2017 Feb 24.
    Hals-, Nasen- und Ohrenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
    Background: Angiotensin-converting enzyme inhibitor-induced angioedema (ACEi-AE) is the most frequent drug-induced angioedema. The aim of this study was to evaluate potential biomarkers for the detection of the risk to develop an ACEi-AE.

    Methods: Adult patients who started antihypertensive treatment with ramipril were included and followed up for 4-6 weeks. Read More

    Natural evolution in patients with non-steroidal anti-inflammatory drugs -induced urticaria/angioedema.
    Allergy 2017 Feb 22. Epub 2017 Feb 22.
    Allergy Unit, Regional University Hospital of Malaga-IBIMA, Malaga, Spain.
    Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequent triggers of drug hypersensitivity with NSAIDs-induced urticaria/angioedema (NIUA) the most common phenotype. Loss of hypersensitivity has been reported for IgE-mediated reactions; however it has not been assessed in non-immunological reactions such as NIUA. We evaluated NSAID-hypersensitivity over time in NIUA patients. Read More

    Inhibiting Plasma Kallikrein for Hereditary Angioedema Prophylaxis.
    N Engl J Med 2017 02;376(8):717-728
    From the Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (A.B.), Dyax, Burlington (C. Soo, R.I., D.J.S., C.T., J.A.K., R.F., H.K., R.M., C. Stevens, J.C.B., Y.C., B.A.), and ICON Clinical Research, Marlborough (J.G.S.) - all in Massachusetts; the Division of Clinical Immunology and Allergy, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York (P.B.), and Winthrop University Hospital, Mineola (M.D.-L.) - both in New York; Triumpharma, Amman, Jordan (M.S., A.A.-G.); Asthma and Allergy Research Associates, Dallas (W.L.); the Division of Allergy and Immunology, Washington University School of Medicine, St. Louis (H.J.W.); Allergy and Asthma Medical Group, Walnut Creek (J.J.), and the Department of Rheumatology, Allergy, and Immunology, University of California, San Diego, San Diego (M.R.) - both in California; Baker Allergy, Asthma, and Dermatology, Lake Oswego, OR (J.B.); the Department of Internal Medicine-Allergy Section Cincinnati, University of Cincinnati College of Medicine, Cincinnati (J.A.B.); the Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa (R.L.); the Institute for Asthma and Allergy, Chevy Chase, MD (H.H.L.); the Department of Medicine and Pediatrics, Penn State Hershey Allergy, Asthma, and Immunology, Hershey, PA (T.C.); and the Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, and Luigi Sacco Hospital Milan, Milan (M.C.).
    Background Hereditary angioedema with C1 inhibitor deficiency is characterized by recurrent, unpredictable swelling episodes caused by uncontrolled plasma kallikrein generation and excessive bradykinin release resulting from cleavage of high-molecular-weight kininogen. Lanadelumab (DX-2930) is a new kallikrein inhibitor with the potential for prophylactic treatment of hereditary angioedema with C1 inhibitor deficiency. Methods We conducted a phase 1b, multicenter, double-blind, placebo-controlled, multiple-ascending-dose trial. Read More

    Recurrent Angioedema: Occurrence, Features, and Concomitant Diseases in an Italian Single-Center Study.
    Int Arch Allergy Immunol 2017 Feb 22;172(1):55-63. Epub 2017 Feb 22.
    Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
    Background: Angioedema (AE) is a potentially life-threatening condition with hereditary (HAE), acquired (AAE), or iatrogenic causes. A careful workup allows for the identification of the etiology of attacks and the appropriate management. In this cohort study, based on a clinical practice setting, we aimed at investigating clinical and laboratory findings concerning different features of patients with recurrent AE who were referred to a single, tertiary-level center for HAE. Read More

    Hereditary C1 inhibitor deficiency is associated with high spontaneous amidase activity.
    Mol Immunol 2017 Feb 18;85:120-122. Epub 2017 Feb 18.
    GREPI, UE7408 Université Grenoble Alpes, Grenoble, France; Centre de Référence des Angioedèmes (CREAK), CHU Grenoble Alpes, Grenoble, France. Electronic address:
    Background: Angioedema diagnosis classically targets the complement system (via C1 inhibitor (C1Inh) function and antigenic C4 level) and contact phase activation (via amidase activity). Bradykinin is responsible for angioedema attacks and is produced from contact phase activation secondary to failed C1Inh control.

    Objective: We aimed to compare the diagnostic performances of spontaneous amidase activity and antigenic C4 level in C1Inh hereditary angioedema (C1Inh-HAE) patients. Read More

    Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines.
    Actas Dermosifiliogr 2017 Feb 17. Epub 2017 Feb 17.
    Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
    Introduction: Chronic spontaneous urticaria is a prevalent and difficult-to-treat condition that has a very negative impact on patient quality of life.

    Objective: To describe the epidemiological and clinical characteristics of patients presenting with chronic spontaneous urticaria and the response to treatment administered according to the EAACI/GA(2)LEN/EDF/WAO consensus guideline.

    Material And Method: Descriptive cross-sectional study of all the patients with chronic spontaneous urticaria who consulted a skin allergy unit in the dermatology department of a tertiary hospital in Spain between July 2011 and July 2015. Read More

    D-Dimer Plasma Levels Parallel the Clinical Response to Omalizumab in Patients with Severe Chronic Spontaneous Urticaria.
    Int Arch Allergy Immunol 2017 Feb 21;172(1):40-44. Epub 2017 Feb 21.
    Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy.
    Omalizumab is very effective in the majority of patients with severe chronic spontaneous urticaria (CSU), but its mechanism of action is still unclear. In CSU the coagulation cascade is activated with an intensity that parallels the disease severity, and elevated plasma D-dimer levels are associated with a poor response to both antihistamines and cyclosporin. We measured D-dimer plasma levels before and after the first administration of omalizumab in 32 patients with severe CSU. Read More

    Quincke's disease.
    J Family Med Prim Care 2016 Jul-Sep;5(3):677-679
    Department of Emergency Medicine, Conemaugh Health System, Johnstown, Pennsylvania, USA.
    Marijuana smoke can cause thermal injury, and since legalization and increased use of marijuana in our society, differentiating, diagnosing, and managing this condition have become mandatory. A case of a 28-year-old male with Quincke's disease secondary to marijuana inhalation is presented. Read More

    Immediate Reactions to More Than 1 NSAID Must Not Be Considered Cross-Hypersensitivity Unless Tolerance to ASA Is Verified.
    J Investig Allergol Clin Immunol 2017 ;27(1):32-39
    Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.
    Background And Objectives: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Read More

    Recombinant Human C1-Esterase Inhibitor to Treat Acute Hereditary Angioedema Attacks in Adolescents.
    J Allergy Clin Immunol Pract 2017 Feb 12. Epub 2017 Feb 12.
    Department of Medicine, Division of Rheumatology, Allergy, & Immunology, University of California San Diego, San Diego, Calif.
    Background: Recombinant human C1-esterase inhibitor (rhC1-INH) is efficacious and well tolerated for managing hereditary angioedema (HAE) attacks in adults. However, there are insufficient data on its efficacy and safety in adolescents.

    Objective: To evaluate the efficacy and safety profiles of rhC1-INH for acute HAE attacks in adolescents. Read More

    Dipeptidyl peptidase-4 inhibitor induced angioedema - an overlooked and potentially lethal adverse drug reaction?
    Curr Diabetes Rev 2017 Feb 14. Epub 2017 Feb 14.
    Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Denmark.
    Introduction Angioedema is a potentially fatal adverse drug reaction of some medications, as swellings of the upper airways can cause death by asphyxiation. Angiotensin converting enzyme-inhibitors are widely known to cause angioedema but less is known about the association between dipeptidyl peptidase-4 inhibitors (gliptins) and angioedema. Dipeptidyl peptidase-4 inhibitors are anti-diabetic drugs used to improve glycaemic control. Read More

    Structure-Guided Design of Novel, Potent, and Selective Macrocyclic Plasma Kallikrein Inhibitors.
    ACS Med Chem Lett 2017 Feb 6;8(2):185-190. Epub 2016 Dec 6.
    Pharmaron Xi'an Co. , Xi'an, Shaanxi 710018, China.
    A series of macrocyclic analogues were designed and synthesized based on the cocrystal structure of small molecule plasma kallikrein (pKal) inhibitor, 2, with the pKal protease domain. This led to the discovery of a potent macrocyclic pKal inhibitor 29, with an IC50 of 2 nM for one olefinic isomer and 42.3 nM for the other olefinic isomer. Read More

    Mutational spectrum of the SERPING1 gene in Swiss patients with Hereditary Angioedema.
    Clin Exp Immunol 2017 Feb 14. Epub 2017 Feb 14.
    Division of Hematology and Central Hematology Laboratory, Department of Internal Medicine, Kantonsspital Lucerne, and University of Berne, Switzerland.
    Hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease caused by mutations in the C1 inhibitor gene SERPING1. Phenotype and clinical features of the disease are very heterogeneous, varying even in the same family. Compared to HAE cohorts in other countries the genetic background of the Swiss HAE patients has not been elucidated yet. Read More

    Aspirin Desensitization in Patients With Coronary Artery Disease: Results of the Multicenter ADAPTED Registry (Aspirin Desensitization in Patients With Coronary Artery Disease).
    Circ Cardiovasc Interv 2017 Feb;10(2)
    From the Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo, Italy (R.R., A.I., G.M., M.S.); Division of Cardiology, A.O.U San Luigi Gonzaga, Orbassano, Torino, Italy (R.P., M.B.); IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy (S.L.); Divisione di Cardiologia, Ospedale Carlo Poma, Mantova, Italy (C.L.); Cardiologia 1 Emodinamica, Dipartimento Cardiovascolare, ASST Niguarda Grande Ospedale Metropolitano, Milano, Italy (I.B., P.C.); U.O. Emodinamica, Ospedale Sandro Pertini, Roma, Italy (S.R.); Università degli Studi di Pavia, Italy (C.D.); Unità operativa di Cardiologia, Humanitas Mater Domini, Castellanza (Varese), Italy (A.A.); Cardio-Thoracic-Vascular Department, Ferrarotto Hospital, University of Catania, Italy (D.C.); and Division of Cardiology, University of Florida College of Medicine, Jacksonville (D.J.A.).
    Background: There are limited data on aspirin (ASA) desensitization for patients with coronary artery disease. The aim of the present study was to assess the safety and efficacy of a standard rapid desensitization protocol in patients with ASA sensitivity undergoing coronary angiography.

    Methods And Results: This is a prospective, multicenter, observational study including 7 Italian centers including patients with a history of ASA sensitivity undergoing coronary angiography with intent to undergo percutaneous coronary intervention. Read More

    When Nothing Else Works: Fresh Frozen Plasma in the Treatment of Progressive, Refractory Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema.
    Cureus 2017 Jan 11;9(1):e972. Epub 2017 Jan 11.
    Internal Medicine, University of Central Florida College of Medicine.
    Angioedema is a severe form of an allergic reaction characterized by the localized edematous swelling of the dermis and subcutaneous tissues. Angiotensin-converting enzyme inhibitor-induced angioedema (ACEI-IA) is an allergic reaction that can be severe in some cases requiring advanced management measures. Fresh frozen plasma has been used off-labeled in some case reports to improve and to prevent worsening of the angioedema in a few cases of ACEI-IA. Read More

    Donkey's milk allergy.
    Br J Dermatol 2017 Feb 11. Epub 2017 Feb 11.
    Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
    A 25 years-old woman, with a history of personal atopic dermatitis, allergic asthma and hay fever, experienced a facial angioedema 5 minutes after consuming fresh donkey's milk for the first time (Fig. 1). She developed dyspnea and collapsed after a few minutes. Read More

    Screening for hereditary angioedema (HAE) at 13 emergency centers in Osaka, Japan: A prospective observational study.
    Medicine (Baltimore) 2017 Feb;96(6):e6109
    aDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine bEmergency and Critical Care Medical Center, Osaka Police Hospital cSenri Critical Care Medical Center, Osaka Saiseikai Senri Hospital dEmergency and Critical Care Medicine, Kishiwada Tokushukai Hospital eSenshu Trauma and Critical Care Center, Rinku General Medical Center fEmergency Division, Osaka Red Cross Hospital gDepartment of Emergency Medicine, Osaka General Medical Center hOsaka Prefectural Nakakawachi Medical Center of Acute Medicine iTraumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital jEmergency and Critical Care Medical Center, Osaka City General Hospital kOsaka Mishima Emergency Critical Care Center lDepartment of Critical Care Medical Center, Kinki University School of Medicine mDepartment of Trauma and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka nDepartment of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan.
    Hereditary angioedema (HAE) with deficiency of C1 inhibitor (C1-INH) is an autosomal-dominant disease characterized by recurrent episodes of potentially life-threatening angioedema. The objective is to study the incidence of HAE among patients who visit the emergency department.This was a 3-year prospective observational screening study involving 13 urban tertiary emergency centers in Osaka prefecture, Japan. Read More

    A Report of Two Cases of Solid Facial Edema in Acne.
    Dermatol Ther (Heidelb) 2017 Feb 6. Epub 2017 Feb 6.
    Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
    Introduction: Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published.

    Methods: We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids. Read More

    H1-antihistamine-refractory chronic spontaneous urticaria: It's worse than we thought - first results of the multicenter real-life AWARE study.
    Clin Exp Allergy 2017 Feb 4. Epub 2017 Feb 4.
    Novartis Pharma GmbH, Nürnberg, Germany.
    Background: Most data on chronic spontaneous urticaria (CSU) originate from highly selected patient populations treated at specialized centers. Little is known about CSU patient characteristics and the burden of CSU in routine clinical practice. AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is an ongoing global study designed to assess chronic urticaria in the real-life setting. Read More

    Hereditary Angioedema: Implications of Management.
    South Med J 2017 Feb;110(2):101-106
    From the Department of Internal Medicine, University of Florida, Gainesville, and Wake Baptist Hospital, Salisbury, North Carolina.
    Hereditary angioedema (HAE) is a genetic condition that is characterized by frequent episodes of localized angioedema. It is a rare disorder that a primary care provider, otolaryngologist, dermatologist, or rheumatologist may encounter only occasionally. This disease is being reviewed because of the significant advances in further understanding the genetics, biology, and therapeutic management surrounding the condition. Read More

    [Angioedema and the role of bradykinins: new treatments and implications in patients with heart failure].
    G Ital Cardiol (Rome) 2016 Dec;17(12):966-972
    Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Università degli Studi, Ospedale Luigi Sacco, Milano.
    The definition of angioedema is an edema of subcutaneous and submucosal tissues due to increased vascular permeability and fluid extravasation. It can affect different areas, including extremities, genitals, upper airways and intestinal mucosa. The symptoms are disabling and this condition can be fatal if it involves the larynx. Read More

    The Journal of Allergy and Clinical Immunology: In Practice - 2016 Year in Review.
    J Allergy Clin Immunol Pract 2017 Jan 28. Epub 2017 Jan 28.
    Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif.
    As editors, we concluded that it would be helpful to our readers to write a Year in Review article that highlights the Review, Original, and Clinical Communication articles published in 2016 in The Journal of Allergy and Clinical Immunology: In Practice. We summarized articles on the topics of asthma, rhinitis/rhinosinusitis, food allergy, anaphylaxis, drug allergy, urticarial/angioedema, eosinophilic disorders, and immunodeficiency. Within each topic, epidemiologic findings are presented, relevant aspects of prevention are described, and diagnostic and therapeutic advances are enumerated. Read More

    Small Bowel Angioedema Secondary to Angiotensin-Converting Enzyme Inhibitors.
    Cureus 2016 Dec 26;8(12):e943. Epub 2016 Dec 26.
    Division of Gastroenterology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
    Small bowel angioedema induced by angiotensin-converting enzyme (ACE) inhibitors is a rare clinicopathologic entity. It frequently poses a diagnostic challenge and is often not recognized before surgical exploration. The present study illustrates that clinical awareness for this condition and adequate use of radiologic investigations can help make the correct diagnosis of ACE inhibitor-associated angioedema, thus avoiding the cost and morbidity associated with unnecessary interventions. Read More

    Plasma kallikrein mediates brain hemorrhage and edema caused by tissue plasminogen activator therapy in mice after stroke.
    Blood 2017 Jan 27. Epub 2017 Jan 27.
    Research Division, Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
    Thrombolytic therapy using tissue plasminogen activator (tPA) in acute stroke is associated with increased risks of cerebral hemorrhagic transformation and angioedema. While plasma kallikrein (PKal) has been implicated in contributing to both hematoma expansion and thrombosis in stroke, its role in the complications associated with the therapeutic use of tPA in stroke is not yet available. We investigated the effects of tPA on plasma prekallikrein (PPK) activation and the role of PKal on cerebral outcomes in a murine thrombotic stroke model treated with tPA. Read More

    ACE Inhibitor-Induced Angioedema of the Small Bowel.
    J Pharm Pract 2017 Jan 1:897190017690641. Epub 2017 Jan 1.
    5 Department of Pharmacy Practice, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH, USA.
    Angiotensin-converting enzyme (ACE) inhibitors are known to cause angioedema. Most ACE inhibitor-induced angioedema cases describe swelling in the periorbital region, tongue, and pharynx. We describe a case of a 62-year-old female with presumed angioedema of the small bowel after more than a 2-year history of lisinopril use (with no recent changes in her dose of 40 mg orally twice daily). Read More

    Omalizumab for treating chronic spontaneous urticaria: an expert review on efficacy and safety.
    Expert Opin Biol Ther 2017 Mar 9;17(3):375-385. Epub 2017 Feb 9.
    a Dermatology Department, Hospital del Mar IMIM , Universitat Autònoma and Universitat Pompeu Fabra , Barcelona , Spain.
    Introduction: Chronic spontaneous urticaria (CSU) is characterized by the recurrence of itchy hives and/or angioedema for greater than six weeks, with no known external trigger. Omalizumab, a humanized, recombinant, monoclonal anti-IgE antibody, is the only approved add-on therapy for H1-antihistamine refractory CSU patients. Areas covered: The objective of this article is to discuss the mechanism of action, pharmacokinetics and pharmacodynamics of omalizumab for the treatment of CSU. Read More

    Sulfasalazine-Related Hypersensitivity Reactions in Patients With Rheumatic Diseases.
    J Clin Rheumatol 2017 Mar;23(2):77-79
    From the Department of Immunology-Allergy, Adnan Menderes University, Aydin, Turkey.
    Background: Sulfasalazine (SSZ), which has an arylamine sulfonamide structure, is an anti-inflammatory drug used in the treatment of many rheumatic diseases. Various adverse effects have been reported related to SSZ. In the present study, we aimed to define the frequency of SSZ-related hypersensitivity reaction in patients with rheumatoid arthritis and ankylosing spondylitis. Read More

    Hereditary angioedema: health-related quality of life in Canadian patients as measured by the SF-36.
    Allergy Asthma Clin Immunol 2017 19;13. Epub 2017 Jan 19.
    grid.415502.7Division of Clinical Immunology and Allergy, St. Michael's Hospital, Bond Street, 4 CC Specialty Clinics, Toronto, ON M5B 1W8 Canada.
    Background: Hereditary angioedema (HAE) is a rare but serious condition characterized by recurrent spontaneous attacks of angioedema affecting superficial tissues of upper respiratory and gastrointestinal tracts. The potentially fatal and disfiguring nature of HAE impacts the health-related quality of life (HRQoL) of patients with this condition.

    Objectives: To assess the health-related quality of life of Canadian patients with HAE using the 36-item Short-Form Health Survey (SF-36v2). Read More

    Emergency Department Airway Management of Severe Angioedema: A Video Review of 45 Intubations.
    Ann Emerg Med 2017 Jan 19. Epub 2017 Jan 19.
    Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.
    Study Objective: Angioedema is an uncommon but important cause of airway obstruction. Emergency airway management of angioedema is difficult. We seek to describe the course and outcomes of emergency airway management for severe angioedema in our institution. Read More

    [A case report: Nursing interventions on a patient with anaphylactic shock in ICU].
    Enferm Intensiva 2017 Jan 16. Epub 2017 Jan 16.
    Hospital de Figueres, Figueres, España.
    Introduction And Objectives: The care plan of a 42-year-old woman with anaphylactic shock, secondary to ingestion of amoxicillin/clavulanic acid, with upper airway involvement due to laryngeal angioedema, is presented. Previously she had had two episodes of angioedema of unknown origin. The incidence of this phenomenon is between 3. Read More

    Health-related quality of life with hereditary angioedema following prophylaxis with subcutaneous C1-inhibitor with recombinant hyaluronidase.
    Allergy Asthma Proc 2017 Mar 16;38(2):143-151. Epub 2017 Jan 16.
    Background: To estimate health-related quality-of-life changes in patients with hereditary angioedema due to C1-inhibitor (C1-INH) deficiency who received subcutaneous C1-INH with recombinant hyaluronidase (rHuPH20) for attack prophylaxis in a randomized, double-blind, dose-ranging, cross-over study.

    Methods: Patients with type I/II hereditary angioedema received 1000 U of C1-INH with 24,000 U of rHuPH20 or 2000 U of C1-INH with 48,000 U of rHuPH20 every 3-4 days for 8 weeks and then crossed over for another 8-week period. The study was terminated early as a precaution related to non-neutralizing antibodies to rHuPH20. Read More

    Therapeutic complement inhibition: a promising approach for treatment of neuroimmunological diseases.
    Expert Rev Neurother 2017 Jan 17. Epub 2017 Jan 17.
    d Consultant neurologist , Gloucestershire Hospitals NHS Foundation Trust Ringgold standard institution , Great Western Road, Gloucester , United Kingdom of Great Britain and Northern Ireland.
    Introduction: Autoimmunity is an important cause of disease both in the central and peripheral nervous systems. Aetiologies and clinical manifestations are complex and heterogeneous. Inappropriate control of complement activation at inappropriate sites has been recognized as a major determinant in several neurological conditions, including Guillain-Barré syndrome and neuromyelitis optica. Read More

    A Case of Miller Fisher Syndrome, Thromboembolic Disease, and Angioedema: Association or Coincidence?
    Am J Case Rep 2017 Jan 16;18:52-59. Epub 2017 Jan 16.
    Department of Medicine, Riverside University Health System, Moreno Valley, CA, USA.
    BACKGROUND Miller Fisher Syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered to be a variant of Guillain-Barre Syndrome. Miller Fisher Syndrome is observed in approximately 1-5% of all Guillain-Barre cases in Western countries. Patients with Miller Fisher Syndrome usually have good recovery without residual deficits. Read More

    Current and future therapies for the treatment of histamine-induced angioedema.
    Expert Opin Pharmacother 2017 Feb 25;18(3):253-262. Epub 2017 Jan 25.
    a Department of Internal Medicine, Division of Immunology, Rheumatology, and Allergy , University of Cincinnati College of Medicine , Cincinnati , Ohio , USA.
    Introduction: Angioedema, a sudden, self-limited swelling of localized areas of any part of the body that may or may not be associated with urticaria, is thought to be the result of a mast-cell mediated process versus a bradykinin etiology. Understanding the mechanism is key in determining the proper treatment. Areas Covered: Clinical presentation of varying angioedema types may be similar; however, the appropriate treatment algorithm is dependent upon clinicians' knowledge of the underlying pathophysiology and classification of angioedema. Read More

    Recurrent angioedema associated with pharmacological inhibition of dipeptidyl peptidase IV.
    BMJ Case Rep 2017 Jan 10;2017. Epub 2017 Jan 10.
    Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
    Angioedema (AE) of the upper airways is a severe and potentially life-threatening condition. The incidence has been increasing in the past two decades, primarily due to increased use of medications inhibiting the degradation of vasoactive peptides. Acquired angioedema related to angiotensin-converting enzyme inhibitors (ACEI-AAE) is well known, but other pharmaceutical agents also affect the degradation of bradykinin and substance P. Read More

    Glucocorticoid receptor gene polymorphisms in hereditary angioedema with C1-inhibitor deficiency.
    Orphanet J Rare Dis 2017 Jan 10;12(1). Epub 2017 Jan 10.
    Hungarian Angioedema Center, 3rd Department of Internal Medicine, Semmelweis University, Kútvölgyi street 4, H-1125, Budapest, Hungary.
    Background: Hereditary angioedema caused by C1-inhibitor deficiency (C1-INH-HAE) is a rare, autosomal dominant disorder. C1-INH-HAE is characterized by edema-formation, which may occur in response to stress. The individual's response to stress stimuli is partly genetically determined. Read More

    Anaphylaxis in Children: Experience of 485 Episodes in 1,272,482 Patient Attendances at a Tertiary Paediatric Emergency Department from 2007 to 2014.
    Ann Acad Med Singapore 2016 Dec;45(12):542-548
    Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.
    Introduction: Anaphylaxis is a predominantly childhood disease. Most of the literature on anaphylaxis has emerged from Western countries. This study aimed to describe the incidence, triggers and clinical presentation of anaphylaxis among children in Singapore, look for predictors for anaphylaxis with severe outcomes, and study the incidence of biphasic reactions. Read More

    The safety of sacubitril-valsartan for the treatment of chronic heart failure.
    Expert Opin Drug Saf 2017 Feb;16(2):257-263
    a School of Medicine , University of California San Francisco , San Francisco , CA , USA.
    Introduction: Sacubitril-valsartan is a combination drug that contains the neprilysin inhibitor sacubitril and angiotensin II receptor blocker valsartan. In 2015, the US Food and Drug Administration approved sacubitril-valsartan for treatment of heart failure patients with reduced ejection fraction and New York Heart Association class II-IV symptoms following a large, Phase III clinical trial (PARADIGM-HF) that demonstrated a 20% reduction in the combined primary end-point of death from cardiovascular cause or hospitalization for heart failure compared to enalapril. Areas covered: This review discusses the clinical efficacy and safety of angiotensin receptor neprilysin inhibitor sacubitril-valsartan in heart failure with reduced ejection fraction. Read More

    Multicenter Study of Adverse Events After Intravenous Tissue-Type Plasminogen Activator Treatment of Acute Ischemic Stroke.
    J Neurosci Nurs 2017 Feb;49(1):31-36
    Questions or comments about this article may be directed to Hannah Fernandez-Gotico, MS RN-BC CPHQ at She is a Quality Director of Clinical Services, Kaiser Permanente, South San Francisco, CA. Tiffany Lightfoot, MS RN CPPS, is Healthcare Consultant, The Rosenberger Group, Los Angeles, CA. Melissa Meighan, MS RN CNRN, is Regional Stroke Coordinator, Kaiser Northern California, Oakland, CA.
    Background And Purpose: The approved treatment by the Food and Drug Administration for acute ischemic stroke is intravenous tissue-type plasminogen activator (IV tPA). After IV tPA administration, patients are monitored for adverse events using an American Heart Association/American Stroke Association guideline instituted in 1996. There is limited evidence describing the safest and most efficient method to monitor patients during the first 24 hours after tPA administration. Read More

    Diagnosis and treatment of upper airway oedema caused by acute angio-oedema in the emergency department: a French consensus statement.
    Eur J Emerg Med 2017 Jan 4. Epub 2017 Jan 4.
    aDepartment of Anaesthesiology and Intensive care, Edouard Herriot University Hospital bDepartment of Clinical Research and Innovation, Hospices Civils de Lyon, Lyon cEmergency Department, Louis Mourier University Hospital, Paris 7 University dDepartment of Internal Medicine, Saint Antoine University Hospital, Paris 6 University, Assistance Publique-Hôpitaux de Paris, Paris eDepartment of Internal Medicine, Grenoble University Hospital, Grenoble-Alpes University, Grenoble fDepartment of Dermatology, Gabriel-Montpied University Hospital, Clermont-Ferrand gDepartment of Internal Medicine, Niort Hospital, Niort hDepartment of Internal Medicine, Archet 1 University Hospital, Nice Sophia-Antipolis University, Nice iDepartment of Medicine, Saint Louis University Hospital, Saint Pierre, Réunion jDepartment of Internal Medicine, Caen University Hospital, Caen kDepartment of Dermatology and Allergology, Grenoble University Hospital, Grenoble lDepartment of Internal Medicine, Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille mDepartment of Dermatology, Saint Eloi University Hospital, Montpellier nDepartment of Dermatology, Besançon University Hospital, Franche-Comté University, INSERM UMR 1098, Besançon oDepartment of Internal Medicine Toulouse University Hospital, Toulouse University, Toulouse pDepartment of Internal Medicine, Lille University Hospital, Lille University, INSERM U995 Lille, Lille, France.
    Angio-oedema is a transitory, localized, noninflammatory oedema of subcutaneous tissue or mucous. When the oedema affects the mouth, lips, tongue or larynx, it can result in fatal asphyxiation in the absence of specific treatment. Oedema secondary to plasma extravasation is usually mediated by either histamine or bradykinin. Read More

    Pulmonary localization of Mansonella perstans in a 16 months-old male patient in a tertiary care hospital in Bukavu, Democratic Republic of Congo.
    Germs 2016 Dec 2;6(4):151-154. Epub 2016 Dec 2.
    MD, Université Catholique de Bukavu, Bukvau, Democratic Republic of Congo, Université de Kinshasa, Kinshasa, Democratic Republic of Congo.
    Introduction: Mansonella perstans is a human filarial parasite transmitted by biting midges (Diptera: Ceratopogonidae) belonging to the genus Culicoides and it is widely spread in sub-Saharan Africa. While most cases are asymptomatic, mansonelliasis can be associated with angioedema, arthralgia, swellings, pain in the scrotum or in serous cavities such as the pleura, the peritoneum, the pericardium, etc. Mansonelliasis can be really hard to treat, but it has been shown that an intensive treatment using albendazole can clear the parasite. Read More

    Computational Modeling of Tracheal Angioedema due to Swelling of the Submucous Tissue Layer.
    Int J Numer Method Biomed Eng 2017 Jan 4. Epub 2017 Jan 4.
    Department of Mechanical Engineering, Michigan State University, East Lansing, Michigan, The United States.
    Angioedema is a tissue swelling pathology due to rapid change in soft tissue fluid content. Its occurrence in the trachea is predominantly localized to the soft mucous tissue that forms the innermost tracheal layer. The biomechanical consequences, such as airway constriction, are dependent upon the ensuing mechanical interactions between all of the various tissues that comprise the tracheal tube. Read More

    Novel usage of fresh frozen plasma in hereditary angioedema.
    Clin Ter 2016 Nov-Dec;167(6):182-184
    Department of Emergency and Trauma, Hospital Ampang.
    Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Read More

    Ofloxacin Induced Angioedema: A Rare Adverse Drug Reaction.
    J Clin Diagn Res 2016 Nov 1;10(11):FD03-FD04. Epub 2016 Nov 1.
    Clinical Associate, Critical Care, Max Super Specialty Hospital , Vaishali, Ghaziabad, Uttar Pradesh, India .
    The Adverse Drug Reaction (ADR) to a commonly prescribed anti-microbial can pose a major public health problem. The authors report a rare case of 24-year-old young lady who presented with angioedema of lips after ingestion of Ofloxacin, prescribed to her for treatment of loose motions. Fluoroquinolones are widely prescribed antibiotics for various disease conditions. Read More

    Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation.
    Int Arch Allergy Immunol 2016 4;171(3-4):269-275. Epub 2017 Jan 4.
    Immunoallergology Department, Centro Hospitalar do Porto EPE, Porto, Portugal.
    Background: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Read More

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