Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The mast cell, equipped with enzymes, chemotactic factors, a vasoactive amine, an anticoagulant, and lipid-derived proinflammatory products, may be essential in tissue modeling as well as in defense. Its primarily perivascular location in skin and the mucosa of the respiratory tract and the gut assures its availability to counter parasites. By the same token, the mast cell is responsible for interactions with inhaled, ingested, and injected antigens that comprise IgE-mediated allergic reactions. Abnormally high numbers of mast cells in the skin, either localized or generalized, result in urticaria pigmentosa or generalized cutaneous mastocytosis, respectively. Tissue infiltration by excessive mast cells, primarily in gut, bone, liver, and spleen, results in systemic mastocytosis; this may be accompanied by myelodysplasia or lymphoma and may eventuate in mast cell leukemia. Until the etiology of mastocytosis is understood, the treatment is symptomatic: histamine antagonism by H1 +/- H2 blockade for flushing, itching, and gastric distress; cyclooxygenase inhibition to prevent prostaglandin D2 (PGD2)-induced hypotension when indicated; and oral cromolyn to prevent gastrointestinal symptoms and bone pain.
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PMID:Mast cell disease. 149 Jun 22

Acetate dialysate is currently the most widely used in hemodialysis. The adverse effect of acetate during hemodialysis is well known upon the cardiovascular system. However, hypersensitivity reactions related to acetate during dialysis therapy are rare. We report a patient who developed hypersensitivity reactions such as generalized skin itching, flushing, hypotension and shortness of breath within a few minutes of beginning hemodialysis with acetate dialysate. Changing dialyzer membranes failed to alleviate these symptoms. Using the same dialyzer and tubing, these reactions disappeared immediately when bicarbonate dialysate was substituted for acetate dialysate. The patient's serum IgE and total eosinophile counts were normal. We conclude that acetate may initiate hypersensitivity reactions during hemodialysis. The exact mechanism is still unclear.
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PMID:Hypersensitivity to acetate dialysate: report of a case. 168 77

Sixty patients scheduled for elective surgery underwent intradermal testing with 0.1 ml of the following solutions diluted in 0.9% saline: vecuronium and tubocurarine (1 in 1,000), atracurium (1 in 1,000 and 1 in 10,000), thiopentone (1 in 100) and also a 0.9% saline control. Thirty minutes later, an area of erythema of greater than 1.5 cm, or a wheal exceeding 1.0 cm in diameter, was recorded as a positive reaction. The patients then randomly received equipotent doses of atracurium, vecuronium or tubocurarine during a standardized anaesthetic induction. Any cutaneous reaction and the percentage fall in systolic pressure three minutes after administration of the relaxant were recorded. In 51 patients plasma IgE levels were measured. The incidence of positive cutaneous reactions to intradermal and intravenous relaxants was significantly different with each agent (p less than 0.01). The percentage fall in systolic pressure after tubocurarine was significantly different relative to the other two agents (p less than 0.01). This was regarded as reflecting potency in releasing histamine and placed the relaxants in the same order: tubocurarine, atracurium and vecuronium. The response to intradermal administration was no guide to the subsequent response after intravenous administration of the three relaxants. IgE levels below 15 IU X ml-1 occurred significantly more often in females and were associated with a significantly higher incidence of cutaneous reactions after intradermal atracurium (1 in 1,000 and 1 in 10,000) (p less than 0.05 and 0.001 respectively) and tubocurarine (1 in 1,000). With these two agents, generalized flushing after intravenous administration was also more common in this group, relative to the normal/high IgE group.
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PMID:Histaminoid responses to atracurium, vecuronium and tubocurarine. 240 13

During a 7 year period, 16 episodes of VM-26 (teniposide) hypersensitivity occurred in our Department of Pediatrics. Eight of these (50%) were observed in neuroblastoma patients, of whom a total of 22 children had been treated with VM-26. The predominant signs were facial edema, flushing, urticaria, bronchospasm, tachycardia, and hypotension. All children with hypersensitivity recovered, but four of them were critically ill. No risk factors were found. In order to elucidate the mechanism of the hypersensitivity episode further, and to identify a possible allergen, histamine release from basophil leukocytes was performed by use of a glass microfiber method. Blood samples from nine cases reacting to VM-26, eight controls (children exposed to VM-26 without any hypersensitivity reactions), and 12 healthy children without previous exposure were challenged with VM-26 alone and with its vehicle, cremaphor. In all samples, it was found that VM-26 degranulated basophils, whereas no histamine release was seen after challenge with cremaphor. The reaction was dose-dependent, and not IgE-mediated, since IgE depletion of the cells did not abolish histamine release after VM-26 challenge.
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PMID:VM-26 (teniposide)-induced hypersensitivity and degranulation of basophils in children. 246 73

Rubber hypersensitivity is well described but usually as a contact dermatitis caused by chemicals added during the process of making natural latex or synthetic rubber. IgE-mediated reactions, mainly contact urticaria, have rarely been reported in Europe. We report a case of immediate hypersensitivity to latex. A 34-year-old female operating room nurse developed hand eczema to natural latex. On two occasions, while she was gloving for surgery, she had the following reactions: flushing, tachycardia, urticaria, angioedema, wheezing, and light-headedness. Prick and patch testing to thiuram mix, mercaptobenzothiazole, phenylenediamine mix, and carbamate mix (common rubber additives) were negative. Prick tests to natural latex elicited a 4+ reaction associated with immediate flushing, tachycardia, urticaria, and light-headedness. Five control subjects did not react. IgE antibodies to latex by RAST demonstrated 17.7% binding (control, 4%). This case demonstrates that natural latex can cause IgE-mediated symptoms. The route of exposure was cutaneous absorption of relevant latex allergens. As the use of latex rubber products continues to escalate, more cases are likely to occur.
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PMID:Hypersensitivity to natural latex. 252 40

During her 26th week of pregnancy a 20-year-old woman developed generalized pruritus, urticaria, flushing, tinnitus, and tachycardia during plasmapheresis with 5% human serum albumin (HSA) as adjunctive treatment for anti-Kell isoimmunization. The reaction was controlled with intravenous diphenhydramine. Despite pretreatment with diphenhydramine and betamethasone a subsequent attempt to perform plasmapheresis with infusion of 5% HSA resulted in a more severe reaction which progressed to respiratory distress. Intradermal skin testing with 5% HSA produced a 9 x 11-mm wheal and 17 x 21-mm erythema at 15 minutes. An enzyme-linked immunoassay was positive for IgE antibody to 5% HSA before and after dialysis for removal of Na caprylate. These results are consistent with an IgE-mediated basis for this patient's reaction to HSA.
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PMID:Anaphylaxis to human serum albumin. 230 85

Histamine is well recognized as a product of both mast cells and basophils. Its release from these sources in IgE-mediated reactions unquestionably contributes to the allergic response. It is often stated that ingestion of foods rich in histamine can result in absorption of sufficient histamine to provoke signs and symptoms reminiscent of an allergic reaction. A review of literature relevant to this issue suggests that certain foods do indeed contain histamine as measured by current methodology. Further, histamine ingestion in excess of 36 to 250 mg may or may not result in a clinical response which includes abdominal complaints, feelings of warmth, flushing and headache. Taken together, this evidence supports the hypothesis that ingestion of large amounts of histamine-containing foods or foods which contain the histamine precursor, histidine, under some circumstances can result in adverse reactions.
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PMID:Histamine in foods: its possible role in non-allergic adverse reactions to ingestants. 330 58

The Restaurant syndromes can be caused by five major factors: food allergens, sulfites, monosodium glutamate (MSG), tartrazine, and scombroidosis (and other seafood poisoning). A history of atopy and ingestion of known food allergens such as peanuts, egg, fish, and walnuts, together with positive results of skin tests or RAST to these foods, will favor a diagnosis of food allergy. Allergic reactions to peanuts have produced fatalities in minutes through an IgE mediated reaction. An extremely rapid onset (minutes) of symptoms consisting of flushing, bronchospasm and hypotension is consistent with a sulfite reaction. Burning, pressure, and tightness or numbness in the face, neck, and upper chest following ingestion of Chinese food favors a diagnosis of adverse reaction to MSG. Also, development of late onset bronchospasm (up to 14 hours) may be related to MSG reactions. Bronchospasm and urticaria in a patient with a history of aspirin intolerance suggests tartrazine sensitivity. If everyone ingesting a fish meal develops flushing, urticaria, pruritus, gastrointestinal complaints, or bronchospasm, this implies scombroidosis, ciguatera, or other seafood poisoning. Finally, severe headache or hypertension can result from ingestion of naturally occurring amines, such as tyramine (cheese, red wine) and phenylethylamine (chocolate). A double-blind oral challenge test may be the only way of confirming the diagnosis for most of the etiological factors of the Restaurant syndromes. The treatment of choice for acute reaction is epinephrine followed by antihistamine. Proper labeling and avoidance of these ingredients in sensitive individuals are the best preventive measures.
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PMID:The restaurant syndromes. 330 66

Cefotiam (CTM) is one of the most popular cephem antibiotics in Japan. Recently we experienced two cases of nurses with CTM-induced contact anaphylaxis. When they were preparing drip infusions of antibiotics or working around other nurses doing so, they suddenly fell into shock with other symptoms such as flushing, urticaria, abdominal distress, vomiting, dyspnoea and/or loss of consciousness. The symptoms never occurred after they avoided exposure to CTM. Passive cutaneous or open patch tests were positive for CTM. Histamine release was induced by CTM from washed leucocytes. RAST analysis using CTM-human serum albumin-coupled discs showed high % RAST count, suggesting that these reactions were mediated by IgE antibodies. A RAST inhibition test suggested that the methyl-thiotetrazole side-chain was the main antigenic determinant. Both patients had hand dermatitis that had appeared preceding the episodes of anaphylaxis. Although the dermatitis had been resistant to treatments, it also disappeared after they avoided exposure to CTM. It seemed likely that it was also induced or exacerbated by CTM and facilitated the penetration of CTM to cause anaphylaxis. The literature is also reviewed.
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PMID:Cefotiam-induced IgE-mediated occupational contact anaphylaxis of nurses; case reports, RAST analysis, and a review of the literature. 751 90

Recombinant gamma interferon (IFN-gamma) was employed to treat adult-type atopic dermatitis. Eight cases received subcutaneous injections of 500,000 JRU of IFN-gamma for 8 weeks. They responded relatively well to this treatment; however, the overall response to the treatment was not significantly better than that to conventional therapy in the control group. There was no significant suppression of itch or erythema. Swelling was reduced at the 8th week in the treatment group. Frequency of flushing attacks on the face was reduced and disappeared within four weeks in 6 of these patients; however, a similar reduction of frequency was observed in the control group. Papular and lichenified lesions on the trunk and extremities responded significantly to the treatment later than 5 weeks after its initiation. Serum IgE level was not affected by the treatment. Seven had the same level of serum IgE before and after the treatment. The serum cytokine level in the treated patients was also unaltered. Therefore, although IFN-gamma treatment has some benefit in the treatment of severe cases of atopic dermatitis, it should be applied to limited cases because of its high cost.
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PMID:Gamma-interferon therapy for severe cases of atopic dermatitis of the adult type. 773 73


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