Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Epidural analgesia for caesarean section is increasingly used and is gradually replacing general anaesthesia. Hypotension is one of the main risks: preloading of the maternal circulation is used to prevent maternal hypotension and its consequences. For this, various colloid and crystalloid solutions are used. We report a case of maternal anaphylactoid reaction with apparent death in a neonate after dextran administration to the mother. After 100ml of a dextran 40 solution administered intravenously, immediately before an epidural blockade, the mother fainted and developed urticaria and mild respiratory disturbances, without hypotension. At that point dextran infusion was stopped. An apparently dead neonate was rapidly delivered. Immediate and vigorous cardiopulmonary resuscitation was successful. Clonismus appeared 12h later, followed by 3 general epileptic fits treated by phenytoin infusion and subsequently oral phenobarbital. No aetiology was found. After 2 months of treatment, barbiturates were stopped following clinical and electroencephalogram (EEG) improvement. Several similar cases of neonatal disorders resulting from preventive dextran administration during delivery were studied in a national pharmacovigilance survey in France. There were 32 cases reported with moderate maternal anaphylactoid reaction associated with severe acute fetal distress; it is probably advisable to take a cautious approach and avoid preventive fluid preload by dextran administration. Gelatins or crystalloid solutions should be preferred, with intravenous vasopressive amine administered promptly and repeated if necessary should significant maternal hypotension occur during epidural anaesthesia.
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PMID:Fetal risks with dextrans during delivery. 137 90

Nine patients with neuroblastoma stage IV were treated with the murine monoclonal antibody 14.G2a, directed against disialoganglioside GD2. The antibody was injected daily for 5-10 days and the total applied dosage ranged between 100 mg/m2 and 400 mg/m2. The peak serum levels of mAb 14.G2a ranged from 28 micrograms/ml to 61 micrograms/ml. Pharmacokinetic data obtained in three patients indicated that the serum elimination of mAb 14.G2a fits a two-compartment model, with an alpha-half-time (t1/2 alpha) between 0.66 h and 1.98 h and a beta-half-time (t1/2 beta) between 30.13 h and 53.33 h. All patients presented with a human anti-(mouse IgG) antibody response either during or shortly after therapy. Eight patients showed a continuous decrease in complement component C4 during therapy, as well as an initial decrease in C3c and an initial increase in C3a, all suggesting an activation of the complement cascade. Side-effects consisted of allergic reactions like pruritus, exanthema, urticaria and of severe pain, predominantly located in the abdomen and lower extremities, which required the use of continuous intravenous morphine. Four patients additionally developed a transient hypertension and one patient experienced a transient nephrotic syndrome. Three patients were treated in an adjuvant setting and are not evaluable for tumor response. Of the remaining six patients, two had a complete remission, two showed a partial remission, and two patients did not respond to treatment.
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PMID:A phase I study of neuroblastoma with the anti-ganglioside GD2 antibody 14.G2a. 163 57

The use of Gadolinium-DTPA as a paramagnetic contrast agent in MRI with adults and juveniles concerning brain and spinal cord pathology is well proven since years. Tolerance and safety were excellent. In the FRG it is only introduced for children over two years of age. Therefore this report deals with the experience in four infants and small children under the age of two, who received gadolinium-DTPA for diagnostic purposes in pre- or post-operative circumstances. They all were suffering from neurological tumors and got additional diagnostic information in three cases. Clinical side-effects like urticaria, vomiting or convulsions had not been observed nor had pathologic changes of the biochemical parameters been noticed.
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PMID:[Initial experiences with the use of gadolinium DTPA in infants and children under 2 years of age]. 191 97

Acute, potentially life-threatening systemic reactions to contrast media are less frequent with lower osmolality, nonionic contrast agents, but they are not totally eliminated. Severe reactions remain a reality in all radiology departments. Typical reactions to contrast media include nausea and/or vomiting, scattered to extensive urticaria, bronchospastic reaction, hypotension (isolated) with compensating tachycardia, anaphylactoid reaction, vagal reaction, cardiovascular collapse, convulsion, and seizure. For each type of reaction, rapid recognition and initiation of specific corrective therapy enhance response and minimize side effects of drugs. Specific drugs for treating each reaction type are reviewed, including recommended dose, contraindications, and alternative choices. An approach to the high-risk patient and prevention of acute systemic reactions is discussed and pretreatment protocols are outlined.
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PMID:Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment. 195 Aug 58

This article concerns itself with three common reactions (local, toxic and anaphylactic) resulting from insect or arthropod bites and stings. A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours. A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings. An anaphylactic reaction may be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms). Even though most bites and stings are not serious, nurse practitioners should be aware of potential death resulting from insect sting allergy. They should teach hypersensitive patients, or patients with a history of a systemic reaction to any agent, about prophylactic measures. Tables showing the characteristics of insects that cause cutaneous lesions in humans, and measures necessary to decrease the risk of being stung, can be used as learning tools to prevent insect sting allergy. Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.
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PMID:Insect bites and stings: managing allergic reactions. 286 63

Hot water epilepsy is a reflex epilepsy. Seizures are provoked by hot water, and result from the association of both cutaneous and heat stimuli. Described mainly in India and Japan, the condition seems to be rare in Europe, where it occurs in young children. We report five infants aged from 6 months to 2 years. They had brief seizures during bathing with activity arrest, hypotonia, and vasoactive modification; clonic movements were observed. A simple treatment-decreasing the bath temperature-can be sufficient. Sometimes an antiepileptic drug is required. Seizure course and psychomotor development are favorable. Hot water epilepsy is a benign form of epilepsy. Its incidence could be underestimated because of confusion with febrile convulsions, vagal fits, or aquagenic urticaria.
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PMID:Hot water epilepsy: a benign and unrecognized form. 1069 97

A growing body of evidence shows that at least 40% of patients with unexplained (idiopathic) chronic urticaria have clinically relevant functional autoantibodies to the high-affinity IgE receptor on basophils and mast cells. The term "autoimmune urticaria" is used for this subgroup of patients presenting with continuous ordinary urticaria. This article reviews the evidence for the autoimmune hypothesis and other nonantibody serum histamine-releasing factors in the etiopathogenesis of urticaria; defines autoimmune urticaria; looks at how autoimmune urticaria fits into existing classifications of urticaria; proposes diagnostic criteria that may be useful to the clinician; and reviews the management implications for patients with this subset of chronic disease.
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PMID:Autoimmune urticaria. 1512 Jan 46

A device that provides an electric shock makes it possible to collect pure venom from several thousand honey bees (Apis mellifera). The collection apparatus fits underneath the brood chamber of a colony of bees and may be moved from hive to hive. Each colony is "milked" for 5 minutes. An average of 20 hives must be "milked" to obtain 1 gram of venom. Under optimum conditions this quantity of venom is produced by 10,000 worker bees.
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PMID:Venom Collection from Honey Bees. 1783 40

Nefopam is widely used for the relief of moderate acute pain. Its safety profile remains to be specified. The objective of the study was to review adverse reactions to nefopam spontaneously reported to the French Pharmacovigilance system. All cases of adverse drug reactions (ADRs) associated with nefopam, registered in the French Pharmacovigilance database from January 1, 1995 to December 31, 2004, were reviewed. For each reported ADR, information about patient (age, gender, medical history), drug exposure (suspected and concomitantly used drugs), characteristics of ADRs (imputability score, time of onset, seriousness, outcome) were collected. A total of 114 ADRs with an imputability rated from 'plausible' (I2) to 'likely' (I3) and 'very likely' (I4) was analysed. The most frequent ADRs included 'expected' ADRs such as sweating, nausea, tachycardia, malaise or vomiting; 61 ADRs were 'unexpected. No overdose was reported; 26 ADRs (23%) were considered as 'serious'. Most of them were 'unexpected', including neuropsychiatric (hallucinations, convulsions) or cutaneous (pruritus, erythema, urticaria) ADRs. Six cases of anaphylactic ADRs (two angioedema and four anaphylactic shocks) were reported, all occurring shortly after use of nefopam during the post-operative period. Physicians should be aware of the possible occurrence of some serious ADRs when using nefopam such as convulsions and anaphylactic shocks, especially when the drug is used in special medical conditions, like post-operative periods.
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PMID:Overview of adverse reactions to nefopam: an analysis of the French Pharmacovigilance database. 1786 9

The first-generation antihistamines are widely prescribed medications that relieve allergic reactions and urticaria by blocking the peripheral histamine H(1) receptor. Overdose of these drugs often results in serious neuronal toxic effects, including seizures, convulsions and worsening of epileptic symptoms. The KCNQ/M K(+) channel plays a crucial role in controlling neuron excitability. Here, we demonstrate that mepyramine and diphenhydramine, two structurally related first-generation antihistamines, can act as potent KCNQ/M channel blockers. Extracellular application of these drugs quickly and reversibly reduced KCNQ2/Q3 currents heterologously expressed in HEK293 cells. The current inhibition was concentration and voltage dependent. The estimated IC(50) (12.5 and 48.1 microM, respectively) is within the range of drug concentrations detected in poisoned patients (30-300 microM). Both drugs shifted the I-V curve of KCNQ2/Q3 channel to more depolarized potentials and altered channel gating properties by prolonging activation and shortening deactivation kinetics. Mepyramine also inhibited the individual homomeric KCNQ1-4 and heteromeric KCNQ3/Q5 currents. Moreover, mepyramine inhibited KCNQ2/Q3 current in an outside-out patch excised from HEK293 cells and the inhibitory effect was neither observed when it was applied intracellularly nor affected by blocking phospholipase C (PLC) activity, indicating an extracellular and direct channel blocking mechanism. Finally, in cultured rat superior cervical ganglion (SCG) neurons, mepyramine reduced the M type K(+) current in a concentration-dependent manner and led to marked membrane potential depolarization. It is likely that these effects may be involved in the adverse neuroexcitatory effects observed in patients experiencing an overdose of antihistamines.
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PMID:Antihistamine mepyramine directly inhibits KCNQ/M channel and depolarizes rat superior cervical ganglion neurons. 1822 95


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