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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Considering the high incidence of chronic urticaria among female patients and the frequent difficulty in identifying the etiologic factor of factors the author decided to investigate the possible role of Candida albicans and other yeasts usually found as contaminants in certain foods and beverages or purposely cultivated for industrial products, as the sensitizing agents leading to the clinical picture of chronic urticaria. One hundred female patients with urticaria which had persisted for more than 6 weeks were selected and investigated, disregarding those with dermographism or cholinergic and cold urticaria. Aside from a careful history and laboratory tests to complement the physical examination that could rule out chronic bacterial infectious foci, intestinal parasitic infestation and thyroid disorders, intradermal skin tests with standard doses of Candida albicans and Saccharomyces cerevisiae and other common environmental and food allergens were done. The patients' age ranged from 4 to 70 years. The skin tests sites were examined for Type I reactions at 15 and 20 minutes; for Type III reactions at 8 and 12 hours; and for Type IV reactions at 48 and 72 hours. When tested with Candida albicans antigen, 35% had Type I/III reactions and 60% presented Type IV reaction. When Saccharomyces cerevisiae antigen was used for testing, 29% had Type I/III reactions and none presented Type IV. Forty-nine of the sixty patients who presented Type IV reaction to Candida albicans had in the past significant vaginal discharge (or vaginal symptoms: burning, itching) that obliged the patients to consult a gynecologist, but only ten had stained smears and cultures from the vaginal secretions and four were told to have a monilia vaginal infection confirmed by the microbiological tests, although forty of them received Nistatin therapy at the time of the gynecological complaints. At the time the patients were seen by the allergist, complaining about urticaria, only four had symptoms and signs of monilia infection and were confirmed by culture: one presented oral moniliasis following broad-spectrum antibiotic, two had vaginal moniliasis developing right after their menstrual period; one had intestinal and cutaneous manifestations (perineal and crural) developing also after broad-spectrum antibiotic therapy. All the four patients had exacerbation of the urticaria while undergoing the monilia infection. After 1-2 weeks of elimination diet, each patient was challenged with yeasts-containing foods (bread, buns, sausages, beer, wines, grapes, cheese, vinegar, tomato catsup). Twenty-five patients (71%) of the group who positively reacted with a Type I/III reaction when tested with Candida antigen, showed a positive provocation test (reappearance of urticaria) and twenty patients (69%) of the group who reacted with Saccharomyces had a positive challenge test...
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PMID:[Hypersensitivity to "Candida albicans" and other fungi in patients with chronic urticaria]. 77 52

This is a clinical description of an unusual arthropathy in 2 members of a family with familial cold urticaria. Relevant investigations, X-ray illustrations and the family pedigree are presented. The nature of the arthropathy and its possible relationship to other arthropathies is discussed.
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PMID:Arthropathy associated with familial cold urticaria. 84 33

Psychosomatic investigations were made in 18 patients with dermographism, 17 with cold urticaria, and 13 with cholinergic urticaria, and 13 with cholinergic urticaria. The Maudsley Personality Inventory was used and electroencephalograms were recorded from most patients. In the majority of cases of dermographism first symptoms coincided with frustrating situations and psychic stress-intensified manifestations. 81.8% of the patients with dermographism had abnormal electroencephalograms. In cold urticaria the role of psychic factors could not be demonstrated, whereas in cholinergic urticaria 'brief' emotions provoked symptoms in three-quarters of the patients, although no other signs of the role of psychic factors were detected,
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PMID:Neuropsychic factors in physical urticaria. 84 37

Sera were obtained from the venous effluents of cold-challenged arms of patients with idiopathic cold urticaria without plasma or serum cryoproteins; these sera exhibited increased neutrophil chemotactic activity without alterations of the complement system. A two- to fourfold augmentation of the base-line neutrophil chemotactic activity of serum from the immersed extremity began within 1 min, peaked at 2 min, and returned to base-line levels within 15 min, whereas there was no change in the serum chemotactic activity in the control arm. The augmented chemotactic activity in the serum specimens from the challenged arm of each patient appeared in a high molecular-weight region, as assessed by the difference in activity recovered after Sephadex G-200 gel filtration of the paired lesional and control specimens. Sequential purification of this high molecular-weight activity by anion- and cation-exchange chromatography revealed a single peak of activity at both steps. The partially purified material continued to exhibit a high molecular weight, being excluded on Sepharose 4B, and had a neutral isoelectric point. The partially purified material showed a preferential chemotactic activity for neutrophilic polymorphonuclear leukocytes, required a gradient for expression of this function, and exhibited a capacity to deactivate this cell type. This active principle, termed high molecular-weight neutrophil chemotactic factor, exhibited a time-course of release that could be superimposed upon that of histamine and the low molecular-weight eosinophil chemotactic factor and may represent another mast cell-derived mediator.
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PMID:Cold urticaria. Recognition and characterization of a neutrophil chemotactic factor which appears in serum during experimental cold challenge. 87 83

A cryo-stimulation test performed on 300 allergic and non-allergic individuals showed that this test is positive in most of the cold urticaria patients but negative in patients having other allergic or non-allergic disorders. The chief causes of false positive reactions were a state of atopy and dermographism.
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PMID:Evaluation of cryo-stimulation test for the diagnosis of cold urticaria. 120 Apr 26

A patient with lymphosarcoma and cold urticaria showed evidence of complement activation by the classical pathway with low levels of the early complement components, normal levels of late acting components, normal functioning of the alternate pathway and reduction of the C1-inhibitor level. The serum contained an IgG1 monoclonal cryoglobulin responsible for the complement activation. In vitro tests demonstrated a high capacity of the serum to activate C1.
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PMID:Lymphosarcoma, cold urticaria, IgG1 monoclonal cryoglobulin and complement abnormalities. 124 41

Platelet factor 4 (PF4) has previously been linked to precipitation of cold urticaria (CU). The aim of the study was to assess the liberation of PF4, eosinophil cationic protein (ECP) and histamine after cold challenge in patients with CU. Ten controls and 8 patients with CU verified by clinical data and cold challenge test were investigated. Assessment of histamine, ECP and PF4 were done using radioimmunoassays. In patients histamine increased after 10 min on the challenged arm (NS), PF4 increase was statistically significant (p less than 0.05) both in patients and controls. ECP release showed no significant changes. Treatment with doxepin results in clinical improvement, but no changes in mediator release were seen. Thus, in contrast to previous reports an increase of PF4 was seen both in controls as well as in patients. An involvement of ECP was not ascertained. Our data suggest that neither basophils, nor eosinophils or platelets are directly involved in cold urticaria and that mast cell-dependent mediators may be of greater relevance.
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PMID:Cold urticaria as a model of mediator release: platelet factor 4, eosinophil cationic protein and histamine. 128 Sep 16

The ice cube test performed in 24 children (6 cold urticaria, 6 healthy, 6 allergic and 6 chronic urticaria) showed that a 3 and 5-minute ice cube test was the appropriate time for the diagnosis of cold urticaria without false positive results. If the test was prolonged to 10 and 20 minutes, 17% and 33% respectively showed false positive results in chronic urticaria other than cold urticaria patients. After four weeks of cyproheptadine therapy, the ice cube test showed only 17% positive at 3 minutes and 33% at 5 minutes. When the ice cube test was performed for 10 and 20 minutes, 67% showed positive results. In conclusion, the ice cube test should be performed for 3 to 5 minutes to diagnose cold urticaria in children. The time should be increased to 10 or 20 minutes if the test shows negative results at 3 to 5 minutes after antihistamine therapy.
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PMID:Ice cube test in children with cold urticaria. 130 12

The efficacy of the new nonsedating antihistamines loratadine and cetirizine was compared in a randomized, single-blind, crossover, controlled study with that of the classical antihistamines cyproheptadine and ketotifen in seven patients with primary acquired cold urticaria (ACU). The patients received each of the four drugs for 14 consecutive days with a 7-day interval between drugs. We evaluated clinical symptomatology, adverse effects, minimum time of cold contact stimulation required to induce an immediate coalescent wheal (CSTT), and inhibition of histamine-induced wheal response. Both loratadine and cetirizine showed suppression of symptoms with infrequent adverse effects. Important side-effects were observed in patients receiving cyproheptadine. Improvement in CSTT was statistically significant for all drugs compared with baseline values, without differences among them. The histamine-induced skin test was significantly inhibited by all antihistamines. Wheal reductions were 34.6% for loratadine and 50.9% for cetirizine. This study suggests that both loratadine and cetirizine may be effective in the treatment of primary ACU.
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PMID:A comparison of new nonsedating and classical antihistamines in the treatment of primary acquired cold urticaria (ACU). 136 68

Exercise is a physical cause of allergic reactions, including exercise-induced anaphylaxis (EIAna), exercise-induced urticaria (EIU), exercise-induced asthma (EIA), and exercise-induced rhinitis (EIR). Since its first description in 1979, EIAna has been reported with variable clinical manifestations, with exercise alone, and in combination with food ingestion. Elevated serum histamine levels and cutaneous mast cell degranulation have been noted. Exercise-induced urticaria appears as small, punctate lesions that differ from the classic coalescent type seen with EIAna. Variant forms of EIAna with cholinergic urticarial lesions manifesting systemic collapse and/or respiratory distress have been studied. Exercise-induced urticaria and cold-induced urticaria may cause elevated plasma histamine levels coincident with the onset of pruritus and hives. Theories accounting for EIA include respiratory heat loss, water loss, and mast cell activation. Although some studies have shown increased plasma histamine with EIA, others have not. Recently, bronchoalveolar lavage in atopic subjects with EIA has been evaluated preexercise and postexercise, with no significant differences in histamine or tryptase, suggesting a pathogenesis of EIA independent of the mast cell. Exercise-induced rhinitis, with varying degrees of rhinorrhea, congestion, and sneezing, has been increasingly recognized in athletes who run, cycle, and ski. Cold-air-induced rhinorrhea in laboratory challenges displays a mediator release pattern similar to that produced by allergen-induced nasal challenges. Therapeutically, H1 antihistamines are recommended for EIAna both as pretreatment and acute therapy. H1 antihistamines may be helpful in EIU, but are recommended for EIAna both as pretreatment and acute therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exercise-induced allergies: the role of histamine release. 137 Oct 41


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