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    Anaphylactoid Reactions to Intravenous N-Acetylcysteine during Treatment for Acetaminophen Poisoning.
    J Med Toxicol 2018 Feb 8. Epub 2018 Feb 8.
    Department of Pediatrics, University of Colorado School of Medicine, Denver, CO, USA.
    Background: Anaphylactoid reactions to intravenous (IV) N-acetylcysteine (NAC) are well-recognized adverse events during treatment for acetaminophen (APAP) poisoning. Uncertainty exists regarding their incidence, severity, risk factors, and management. We sought to determine the incidence, risk factors, and treatment of anaphylactoid reactions to IV NAC in a large, national cohort of patients admitted to hospital for acetaminophen overdose. Read More

    Vaccine-associated hypersensitivity.
    J Allergy Clin Immunol 2018 Feb;141(2):463-472
    Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Ga.
    Vaccine-associated hypersensitivity reactions are not infrequent; however, serious acute-onset, presumably IgE-mediated or IgG and complement-mediated anaphylactic or serious delayed-onset T cell-mediated systemic reactions are considered extremely rare. Hypersensitivity can occur because of either the active vaccine component (antigen) or one of the other components. Postvaccination acute-onset hypersensitivity reactions include self-limited localized adverse events and, rarely, systemic reactions ranging from urticaria/angioedema to full-blown anaphylaxis with multisystem involvement. Read More

    Hypocomplementemic Urticarial Vasculitis Syndrome With Crescentic Glomerulonephritis.
    Am J Med Sci 2018 Feb 8;355(2):195-200. Epub 2017 Apr 8.
    Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
    Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare autoimmune disease characterized by multiple organ system involvement, including renal disease, with low complement levels. We report the case of a 31-year-old woman who presented with nonspecific symptoms including fatigue, diarrhea, macular rash and abdominal pain with acute renal failure leading to end-stage kidney disease. Laboratory results showed hematuria, nephrotic range proteinuria, worsening creatinine and low C1q levels. Read More

    Establishing a Safe Administration of ASA in Cardiovascular Patients with Nonsteroidal Anti-Inflammatory Drug Hypersensitivity with Skin and/or Respiratory Involvement.
    Int Arch Allergy Immunol 2018 Jan 26. Epub 2018 Jan 26.
    Sabah Al Ahmed Cardiac Center, Ministry of Health, Kuwait City, Kuwait.
    Background: A history of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with cross-intolerance to several drugs is common in some patients with coronary artery disease. We present a series of patients with acute coronary syndrome undergoing ASA desensitization prior to a possible stent to evaluate the short- and long-term efficacy and safety. The aim was to evaluate the outcomes of an ASA desensitization protocol developed by our center based on the guidelines proposed by the EAACI drug allergy expert recommendations. Read More

    Anaphylaxis in a food allergy outpatient department: one-year review.
    Eur Ann Allergy Clin Immunol 2017 Nov 30. Epub 2017 Nov 30.
    Allergy and Clinical Immunology Department, Coimbra University Center, Coimbra, Portugal.
    Summary: Anaphylaxis is an acute, potentially fatal, multi-organ allergic reac-tion. Our aim was to characterize the population with food induced anaphylaxis followed over a one-year period.Retrospective analysis of clinical files of patients with food anaphylaxis observed in our food allergy consultation during 2016. Read More

    Resolution of unilateral sensorineural hearing loss in a pediatric patient with a severe phenotype of Muckle-Wells syndrome treated with Anakinra: a case report and review of the literature.
    J Otolaryngol Head Neck Surg 2018 Jan 30;47(1). Epub 2018 Jan 30.
    Department of Pediatric Otolaryngology Head and Neck Surgery, McGill University Health Center, Montreal Children's Hospital, 1001, boul. Décarie - Local A02.3017, Montreal, QC, H4A 3J1, Canada.
    Background: Muckle-Wells syndrome (MWS) is a rare auto-inflammatory disease characterized by the presence of recurrent urticaria, deafness and amyloidosis. Progressive sensorineural hearing loss (SNHL) is reported to occur in up to 85% of patients occurring in the second and third decades and as early as the first decade in patients with a more severe phenotype, thus potentially having a significant impact on a child's development. IL-1 inhibitors, such as Anakinra, have been described to improve systemic inflammation, and stabilize or improve hearing status as well. Read More

    The EAACI/GA²LEN/EDF/WAO Guideline for the Definition, Classification, Diagnosis and Management of Urticaria. The 2017 Revision and Update.
    Allergy 2018 Jan 15. Epub 2018 Jan 15.
    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergy-Centre-Charité.
    This evidence and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. The conference was held on December 1st, 2016. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-founded network of excellence, the Global Allergy and Asthma European Network (GA²LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of 48 delegates of 42 national and international societies. Read More

    Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.
    Acta Med Iran 2017 Nov;55(11):705-711
    Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. Read More

    Cause and Clinical Presentation of Anaphylaxis in Singapore: From Infancy to Old Age.
    Int Arch Allergy Immunol 2018 Jan 5. Epub 2018 Jan 5.
    Department of Allergy and Immunology, KK Women's and Children's Hospital, Singapore, Singapore.
    Background: The study objective was to compare age-related differences in the cause and clinical presentation of anaphylaxis.

    Methods: We conducted a prospective study of patients visiting the emergency department for anaphylaxis. Data were collected from 3 emergency departments from 1 April 2014 to 31 December 2015. Read More

    Gene mutations and clinical phenotypes in 15 Chinese children with cryopyrin-associated periodic syndrome (CAPS).
    Sci China Life Sci 2017 Dec 2;60(12):1436-1444. Epub 2017 Dec 2.
    Department of Rheumatology and Immunology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
    The aim of our study is to explore the features of clinical manifestations and genetic mutations in Chinese CAPS patients. Fifteen confirmed patients with CAPS were enrolled. The onset time ranges from 2 days after birth to 6 years and 1 month. Read More

    Elevated circulating heat shock protein 70 and its antibody concentrations in chronic spontaneous urticaria.
    Int J Immunopathol Pharmacol 2017 Dec 1:394632017750440. Epub 2017 Dec 1.
    1 Department of Internal Diseases, Dermatology and Allergology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
    Heat shock proteins (Hsp) play a complex role in cytoprotection, inflammation, and function of the immune system. They may be involved in pathogenesis of various diseases. Our aim was to determine circulating Hsp70 and anti-Hsp70 antibodies concentrations in patients with chronic spontaneous urticaria (CSU). Read More

    Elevated plasma il-8 concentration is related to severity of systemic inflammation in chronic spontaneous urticaria.
    J Biol Regul Homeost Agents 2017 Oct-Dec;31(4):957-961
    Department of Internal Diseases, Dermatology and Allergology in Zabrze, SMDZ in Zabrze, Medical University of Silesia in Katowice, Poland.
    Chronic spontaneous urticaria (CSU) is associated with activation of acute phase response. Questions arise regarding its association with other inflammatory mediators. To determine plasma IL-8 concentration in CSU patients and its association with C-reactive protein (CRP) concentration, a nonspecific inflammatory marker of the disease activity, concentrations of plasma IL-8 and serum CRP were measured in CSU patients and compared with healthy controls. Read More

    Nicolau's syndrome: A rare but preventable iatrogenic disease.
    Acta Dermatovenerol Croat 2017 Oct;25(3):251-253
    Assist. Prof. Tasleem Arif, MD, Postgraduate Department of Dermatology, STDs and Leprosy, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh, India;
    Dear Editor, Nicolau's syndrome, also called embolia cutis medicamentosa or livedoid dermatitis, is a rare injection site reaction characterized by immediate intense pain at the injection site followed by erythema and a hemorrhagic patch with a livedoid reticular pattern after injections of non-steroidal anti-inflammatory drugs (NSAIDS), antiepileptics, antibiotics, antihistaminics, corticosteroids, etc. (1). To the best of our knowledge, only one case of Nicolau's syndrome has been reported after the use of triamcinolone acetonide. Read More

    Phosgene oxime: Injury and associated mechanisms compared to vesicating agents sulfur mustard and lewisite.
    Toxicol Lett 2017 Nov 12. Epub 2017 Nov 12.
    Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA. Electronic address:
    Phosgene Oxime (CX, ClCNOH), a halogenated oxime, is a potent chemical weapon that causes immediate acute injury and systemic effects. CX, grouped together with vesicating agents, is an urticant or nettle agent with highly volatile, reactive, corrosive, and irritating vapor, and has considerably different chemical properties and toxicity compared to other vesicants. CX is absorbed quickly through clothing with faster cutaneous penetration compared to other vesicating agents causing instantaneous and severe damage. Read More

    [Acute hemorrhagic edema of infancy: alarming lesions of a benign condition. Case report].
    Arch Argent Pediatr 2017 12;115(6):e432-e435
    Salud total EPS, Urbanización El Bosque.
    We report a case of acute hemorrhagic edema of infancy in an 18-month-old boy after an episode of otitis media. The clinical presentation begins with skin erythematous macules on the thighs, followed by purpuric lesions in arms, legs, and ankle edema. It was initially interpreted as urticaria, whereby steroids were indicated. Read More

    Analysis of pediatric dermatology inpatient consultations in a pediatric teaching hospital.
    Arch Argent Pediatr 2017 12;115(6):e377-e384
    Ataturk Research and Training Hospital, Department of Dermatology, Izmir, Turkey.
    Introduction: Although skin diseases are associated with low rate of hospitalization, dermatological manifestations are frequent in hospitalized patients. The aim of the study was to describe the inpatient dermatological consultations in a pediatric teaching hospital.

    Population And Methods: Recorded data from inpatient pediatric dermatology consultation requests on a total of 539 consecutive inpatients (aged 0-18 years) from January 2004 to April 2010 were analyzed for consult diagnosis, dermatological disease group, primary diagnosis, requesting department, diagnostic pattern, treatment modality and referral to another department. Read More

    Severe forms of food allergy.
    J Pediatr (Rio J) 2017 Nov - Dec;93 Suppl 1:53-59. Epub 2017 Sep 21.
    Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Programa de Residência Médica em Gastropediatria, Recife, PE, Brazil.
    Objectives: To guide the diagnostic and therapeutic management of severe forms of food allergy.

    Data Sources: Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields.

    Summary Of Data: Food allergy can be serious and life-threatening. Read More

    Angioedema without urticaria caused by oral acitretin.
    Acta Dermatovenerol Alp Pannonica Adriat 2017 09;26(3):67-68
    Department of Dermatology, University of Patras, Rio-Patras,Greece.
    The efficacy of oral acitretin in the systemic treatment of severe and recalcitrant dermatoses has been established in a large number of clinical trials. Its mucocutaneous and ocular adverse reactions are common or relatively common, whereas systemic side effects are either uncommon or rare and include teratogenesis, hyperlipidemia, hepatotoxicity, intracranial hypertension, myopathy, and peripheral neuropathy. Angioedema is a term used to describe an acute, solitary or multiple, circumscribed, and non-pitting mucocutaneous swelling that affects the dermis and the subcutaneous tissue, lasts 24 to 72 hours, and may become potentially life-threatening when the pharynx and/or the larynx are involved. Read More

    [Acute skin infections and their imitators in children : A photo quiz].
    Hautarzt 2017 Oct;68(10):774-783
    Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz.
    Background: Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed. Read More

    The Histopathology of Urticaria Revisited-Clinical Pathological Study.
    Am J Dermatopathol 2017 Oct;39(10):753-759
    *Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel; and †Institute of Pathology, Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Background: The classic histopathological findings of urticaria include dermal edema and a sparse perivascular infiltrate of neutrophils, eosinophils, macrophages, and lymphocytes. However, this pattern is inconsistently described.

    Objective: To describe the histological and immunofluorescence characteristics of urticaria and to identify distinctive patterns. Read More

    In Vitro Anti-Inflammatory Activity of Ilex cornuta Extract Mediated by Inhibition of Extracellular Signal-Regulated Kinase Phosphorylation.
    J Med Food 2017 Oct 30;20(10):981-988. Epub 2017 Aug 30.
    College of Pharmacy, Chung-Ang University , Seoul, Korea.
    Ilex cornuta, commonly known as Chinese holly, is an evergreen shrub from the family Aquifoliaceae, and it is widely distributed in Korea and China. In folk medicine, the leaves of I. cornuta are used for treatment of several disorders, including weakness of the waist and knees, arthrodynia, headache, acute conjunctivitis, toothache, urticaria, rheumatic arthralgia, and cardiovascular diseases. Read More

    Different expression patterns of plasma Th1-, Th2-, Th17- and Th22-related cytokines correlate with serum autoreactivity and allergen sensitivity in chronic spontaneous urticaria.
    J Eur Acad Dermatol Venereol 2017 Aug 28. Epub 2017 Aug 28.
    Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, China.
    Background: Clinical features and basophil activation levels correlate with serum autoreactivity and allergen sensitivity in patients with chronic spontaneous urticaria (CSU).

    Objectives: To explore the relationship of the expression patterns of plasma T-helper cell (Th) 1-, Th2-, Th17- and Th22-related cytokines with the serum autoreactivity and the allergen sensitivity in CSU.

    Method: Twenty related cytokines were measured and analysed in 60 patients with CSU, 15 patients with acute urticaria, 10 patients with atopic dermatitis (AD) and 15 healthy persons, respectively. Read More

    Allergy-like immediate reactions with herbal medicines in children: A retrospective study using data from VigiBase.
    Pediatr Allergy Immunol 2017 Nov 3;28(7):668-674. Epub 2017 Oct 3.
    Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, Czech Republic.
    Background: The use of herbal medicines in children and the general population is continually on the rise with an overall herbal lifetime and current use ranging between 0.8%-85.5% and 2. Read More

    Dtsch Arztebl Int 2017 Jul;114(29-30):489-496
    Department of Otorhinolaryngology, Ulm University Hospital; Department of Anaesthesiology, Ulm University Hospital.
    Background: Acute angioedema of the upper airways can be life-threatening. An important distinction is drawn between mast-cell-mediated angioedema and bradykinin-mediated angioedema; the treatment of these two entities is fundamentally different.

    Methods: This review is based on pertinent articles retrieved by a selective search in PubMed and on guidelines concerning the treatment of angioedema. Read More

    Urticaria vasculitis in a child: a case report and literature review.
    Clin Case Rep 2017 Aug 21;5(8):1255-1257. Epub 2017 Jun 21.
    Department of DermatologyHospital Universitario Severo OchoaAvenida de Orellana28911LeganésMadridSpain.
    Annular urticarial lesions in a child must establish a main differential diagnosis with urticaria multiforme, common urticaria, acute hemorrhagic edema of infancy, erythema marginatum, erythema annulare centrifugum, annular erythema in childhood, erythema multiforme, Sweet's syndrome, Schönlein-Henoch purpura, erythematosus lupus, several systemic vasculitis, and serum sickness. Read More

    Urticaria and Angioedema: an Update on Classification and Pathogenesis.
    Clin Rev Allergy Immunol 2018 Feb;54(1):88-101
    Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
    Urticaria is a common, mast cell-driven disease presenting with wheals or angioedema or both. In the last years, urticaria has increasingly attracted notice to clinicians and researchers, last but not least inspired by the approval of omalizumab, an anti-IgE antibody, for urticaria treatment. There is wide consensus on the clinical classification based on duration and elicitation. Read More

    [Clinical characteristics of urticaria in children versus adults].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Jul;19(7):790-795
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China.
    Objective: To study the clinical characteristics of urticaria in children versus adults, and to provide reference for the etiological analysis, disease evaluation, and treatment of urticaria in children.

    Methods: The clinical data of 2 411 patients with urticaria who visited the Department of Dermatology at Xiangya Hospital of Central South University from January 2013 to May 2017 were collected to study their socio-demographic characteristics. The clinical characteristics of urticaria were compared between the 68 children and 672 adults of the 740 patients with complete follow-up data. Read More

    Histaminergic Angioedema.
    Immunol Allergy Clin North Am 2017 Aug 13;37(3):467-481. Epub 2017 May 13.
    Division of Allergy and Clinical Immunology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029-6574, USA.
    Angioedema is frequently categorized into histamine- or bradykinin-mediated disease. It is critical to determine the underlying mediator of symptoms as it directs treatment. Histaminergic angioedema is the most frequent cause of angioedema. Read More

    Decreased plasma kallikrein 5 concentrations in patients with chronic spontaneous urticaria.
    J Biol Regul Homeost Agents 2017 Apr-Jun;31(2):407-411
    Department of Internal Diseases, Dermatology and Allergology in Zabrze, SMDZ in Zabrze, Medical University of Silesia in Katowice, Poland.
    Little is known about the role of the kallikrein-kinin system in chronic spontaneous urticaria (CSU). Kallikrein 5 (KLK5), a trypsin-like enzyme, is the most abundant in the skin and plays a role in itching and inflammatory reaction. In this study, we determined plasma KLK5 concentration, and its associations with acute phase response in CSU patients. Read More

    Acute and Chronic Urticaria: Evaluation and Treatment.
    Am Fam Physician 2017 Jun;95(11):717-724
    University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
    Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and uncommonly represent a serious systemic disease or life-threatening allergic reaction. Read More

    Patient satisfaction and experience with intravenously administered C1-inhibitor concentrates in the United States.
    Ann Allergy Asthma Immunol 2017 07;119(1):59-64
    CSL Behring, King of Prussia, Pennsylvania.
    Background: Hereditary angioedema (HAE) is a rare genetic disorder with substantial morbidity and mortality. Despite expanded choices for effective acute treatment, prophylactic options are more limited. Intravenous C1 esterase inhibitor (C1-INH[IV]) is licensed and used to prevent HAE symptoms. Read More

    Preventing Hereditary Angioedema Attacks in Children Using Cinryze®: Interim Efficacy and Safety Phase 3 Findings.
    Int Arch Allergy Immunol 2017 30;173(2):114-119. Epub 2017 Jun 30.
    Department for Children and Adolescents, Angioedema Centre, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
    Background: Hereditary angioedema (HAE) is a rare genetic disease causing unpredictable and potentially life-threatening subcutaneous and submucosal edematous attacks. Cinryze® (Shire ViroPharma Inc., Lexington, MA, USA), a nanofiltered C1 inhibitor (C1-INH), is approved in Europe for the treatment, preprocedure prevention, and routine prophylaxis of HAE attacks, and for the routine prophylaxis of attacks in the USA. Read More

    [Prevalence of urticaria in Cartagena, Colombia].
    Rev Alerg Mex 2017 Apr-Jun;64(2):163-170
    Unidad de Prevención Clínica La Candelaria, Cartagena de Indias, Colombia.
    Background: In Colombia, there have been studies on the prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis. Prevalence studies of urticaria in Colombia are scarce.

    Objective: Our objective objective of this study was to estimate the prevalence of urticaria in Cartagena (Colombia) in order to contribute to national epidemiological estimates of disease. Read More

    Dermatitis caused by arthropods in domestic environment: an Italian multicentre study.
    J Eur Acad Dermatol Venereol 2017 Sep 18;31(9):1526-1533. Epub 2017 Jul 18.
    Department of Veterinary Medicine, University of Perugia, Perugia, Italy.
    Background: Skin diseases caused by mites and insects living in domestic environments have been rarely systematically studied.

    Objectives: To study patients with dermatitis induced by arthropods in domestic environment describing their clinical features, isolating culprit arthropods and relating the clinical features to the parasitological data.

    Methods: The study was performed in 105 subjects with clinical and anamnestic data compatible with the differential diagnosis of ectoparasitoses in domestic environments. Read More

    The role of the complement system in hereditary angioedema.
    Mol Immunol 2017 Sep 7;89:59-68. Epub 2017 Jun 7.
    3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
    Hereditary angioedema (HAE) is a rare, but potentially life-threatening disorder, characterized by acute, recurring, and self-limiting edematous episodes of the face, extremities, trunk, genitals, upper airways, or the gastrointestinal tract. HAE may be caused by the deficiency of C1-inhibitor (C1-INH-HAE) but another type of the disease, hereditary angioedema with normal C1-INH function (nC1-INH-HAE) was also described. The patient population is quite heterogeneous as regards the location, frequency, and severity of edematous attacks, presenting large intra- and inter-individual variation. Read More

    Analysis of the changes in Th9 cells and related cytokines in the peripheral blood of spontaneous urticaria patients.
    Biomed Rep 2017 Jun 3;6(6):633-639. Epub 2017 May 3.
    Department of Dermatology, Peking Hepingli Hospital, Beijing 100013, P.R. China.
    Spontaneous urticaria (SU) is characterized by immune deregulation of mast cells and T helper (Th) cells. Th9 cells, a subset of Th cells, serve a key role in initiating mast cell accumulation and activation. To understand the role of Th9 cells in the pathogenesis of SU, the authors conducted a control study of 28 patients with acute SU (ASU) and chronic SU (CSU) and 28 healthy controls. Read More

    Recurrent elevated liver transaminases and acute liver failure in two siblings with novel bi-allelic mutations of NBAS.
    Eur J Med Genet 2017 Aug 30;60(8):426-432. Epub 2017 May 30.
    Centro de Desenvolvimento da Criança, Hospital Pediátrico, CHUC, Coimbra, Portugal; Serviço de Bioquímica, Faculdade de Medicina, Universidade de Coimbra, Portugal.
    Background: Acute liver failure (ALF) in children can be life-threatening. Although many causes are known, ALF remains unexplained in about half of the cases. Recently, bi-allelic mutations in NBAS were reported to underlie recurrent episodes of elevated liver transaminases (ELT) and ALF in the context of diverse extrahepatic phenotypes. Read More

    Rituximab-induced urticarial dermatitis during the treatment of membranous nephropathy.
    Saudi J Kidney Dis Transpl 2017 May-Jun;28(3):657-660
    Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
    Rituximab is a monoclonal antibody directed against B cells and is being increasingly used for various renal indications. Acute dermatologic manifestations such as urticaria are well known to occur during rituximab infusion. Here, we report the case of a 53- year-old female who was treated with rituximab for membranous nephropathy and developed an exanthematous rash, which progressed with a further dose of rituximab and was diagnosed as urticarial dermatitis. Read More

    Drug-Induced Inhibition of Angiotensin Converting Enzyme and Dipeptidyl Peptidase 4 Results in Nearly Therapy Resistant Bradykinin Induced Angioedema: A Case Report.
    Am J Case Rep 2017 May 25;18:576-579. Epub 2017 May 25.
    Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm-Michelsberg, Germany.
    BACKGROUND Bradykinin is an underestimated mediator of angioedema. One subgroup of bradykinin induced angioedema is angioedema triggered by treatment with angiotensin converting enzyme (ACE) inhibitors. Due to its localization in the head and neck region and its unpredictable course, it is a possibly life-threatening condition. Read More

    Hypersensitivity reactions to gadolinium-based contrast agents.
    Curr Opin Allergy Clin Immunol 2017 Aug;17(4):241-246
    aDepartment of General Medicine bDepartment of Clinical Immunology and Allergy, Flinders Medical Centre, Bedford Park cDepartment of Clinical Immunology and Allergy, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
    Purpose Of Review: Gadolinium-based contrast agents (GBCAs) have been utilized since the late 1980s to enhance the diagnostic value of MRI studies. They are known to have excellent safety profile and serious adverse reactions are uncommon despite widespread global use. However, immediate hypersensitivity reactions are well described in the literature, with urticaria the most common manifestation. Read More

    Effect of Intravenous Ferric Carboxymaltose on Hemoglobin Response Among Patients With Acute Isovolemic Anemia Following Gastrectomy: The FAIRY Randomized Clinical Trial.
    JAMA 2017 May;317(20):2097-2104
    Cancer Registration and Biostatistics Branch, Center for Clinical Trials, National Cancer Center, Goyang, Republic of Korea.
    Importance: Acute isovolemic anemia occurs when blood loss is replaced with fluid. It is often observed after surgery and negatively influences short-term and long-term outcomes.

    Objective: To evaluate the efficacy and safety of ferric carboxymaltose to treat acute isovolemic anemia following gastrectomy. Read More

    Obstructive sleep apnea and dermatologic disorders.
    Clin Dermatol 2017 May - Jun;35(3):319-327. Epub 2017 Jan 21.
    Department of Medicine, University of Toronto School of Medicine, 645 Windermere Road, London, Ontario, Canada, N5X 2P1.
    Obstructive sleep apnea (OSA) is present in at least 2% of women and 4% of men, and its prevalence is increasing, because a major predisposing factor for OSA is a high body mass index. Psoriasis has the most strongly substantiated link with OSA, where the relationship may be bidirectional. Dermatologic disorders may be comorbid with OSA due to several factors: (i) the heightened proinflammatory state in OSA, which can occur independent of body mass index, and may exacerbate inflammatory dermatoses; (ii) intermittent hypoxemia may promote neovascularization and tumor growth in certain cancers, such as melanoma; (iii) obesity, present in majority of OSA patients, can be associated with a heightened proinflammatory state; (iv) upper airway obstruction due to local tumors or soft tissue swelling due to physical urticaria or angioedema; (v) acute nasal congestion in the atopic patient with allergic rhinitis; (vi) dermatologic disorders associated with other OSA risk factors (eg, acanthosis nigricans and metabolic syndrome); and (vii) a high sympathetic tone (eg, in atopic dermatitis) and resultant sleep fragmentation contributing to upper airway instability during sleep. Read More

    Comparative Efficacy and Safety of Ebastine 20 mg, Ebastine 10 mg and Levocetirizine 5 mg in Acute Urticaria.
    J Clin Diagn Res 2017 Mar 1;11(3):WC06-WC09. Epub 2017 Mar 1.
    Senior Resident, Department of Dermatology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.
    Introduction: Acute and chronic urticaria can result in severely impaired quality of life from pruritus and associated sleep lessness, as well as anxiety and depression. Various treatment modalities are available out of which second generation non sedating H1 antihistamines e.g. Read More

    The relationship between circulating concentrations of interleukin 17 and C reactive protein in chronic spontaneous urticaria.
    Allergy Asthma Clin Immunol 2017 10;13:25. Epub 2017 May 10.
    Department of Internal Diseases, Dermatology and Allergology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland.
    Background: Up-regulation of interleukin 17 (IL-17) family cytokines and acute phase response have been observed in patients with chronic spontaneous urticaria (CSU). It has been demonstrated that IL-17 stimulates C-reactive protein (CRP) expression.

    Aim: To determine relationship between circulating concentrations of IL-17 and CRP in CSU. Read More

    Levocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Trial.
    Ann Emerg Med 2018 Jan 3;71(1):125-131.e1. Epub 2017 May 3.
    Pôle de Médecine d'Urgences, Centre Hospitalier Universitaire, Toulouse, France; Université Paul Sabatier Toulouse III, Toulouse, France; INSERM UMR 1027 Equipe 5, Toulouse, France.
    Study Objective: We evaluate the efficacy of a 4-day course of prednisone added to antihistamine for the management of acute urticaria in an emergency department (ED).

    Methods: In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older and with acute urticaria of no more than 24 hours' duration. Patients with anaphylaxis or who had received antihistamines or glucocorticoids during the previous 5 days were not included. Read More

    Acute hypersensitivity reaction to Crotalidae polyvalent immune Fab (CroFab) as initial presentation of galactose-α-1,3-galactose (α-gal) allergy.
    Clin Toxicol (Phila) 2017 Aug 26;55(7):668-669. Epub 2017 Apr 26.
    a Department of Emergency Medicine, Division of Medical Toxicology , University of Virginia , Charlottesville , VA , USA.
    Crotalidae polyvalent immune Fab antivenom (CroFab), commonly used for the treatment of clinically significant North American crotalinae envenomation, is generally well-tolerated. A novel form of anaphylaxis due to an IgE antibody response to the mammalian oligosaccharide galactose-α-1,3-galactose (α-gal) has been established following red-meat consumption as well as IV administration of cetuximab, which contain the α-gal epitope. We present a case of α-gal allergy discovered after acute hypersensitivity reaction to FabAV. Read More

    New Perspectives on the Diagnosis of Allergy to Anisakis spp.
    Curr Allergy Asthma Rep 2017 May;17(5):27
    Unit of Immunology, University Hospital La Paz, Paseo de La Castellana 261, 28046, Madrid, Spain.
    Purpose Of Review: To compare the prevalence of sensitization in different countries based on specific IgE values and to evaluate the use of isolated native or recombinant allergens for diagnosis.

    Recent Findings: Isolated allergens help in the diagnosis of truly sensitized patients avoiding false positives due to cross-reactions. Their use is therefore highly recommended, especially when used as a combination of several relevant allergens. Read More

    Debromoaplysiatoxin as the Causative Agent of Dermatitis in a Dog after Exposure to Freshwater in California.
    Front Vet Sci 2017 6;4:50. Epub 2017 Apr 6.
    VCA Sacramento Veterinary Referral Center, Sacramento, CA, USA.
    Contamination of recreational waters with cyanobacterial toxins continues to increase and presents a risk to animals and humans. Although cases of acute hepato- and neurotoxicoses in dogs following cyanotoxin exposure exist, no reports of skin-related reactions in dogs exist. A 5-year-old female spayed 34 kg Bracco Italiano was initially presented for rapid onset of severe pruritus and urticaria. Read More

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