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)

Drug allergy is an important and increasing problem in everyday practice. It is estimated that about 15% of adverse side effects of drugs are of allergic nature. This kind of adverse reactions appear where antibodies or activated T cells are directed against drugs. The pathomechanism and symptoms of drug allergy may be connected with every of 4 types of hypersensitivity according to Gell and Coombs. Most frequently, drug allergy manifests as different forms of skin reactions. Some of them like urticaria and angioedema are IgE-related and appear rapidly after drug intake. Others appear as delayed-type reactions and manifest as maculopapular, pustular or bullous exanthema. The diagnosis of drug-induced skin allergy is based on history, clinical picture, in vitro laboratory tests and skin tests (prick, intradermal and patch). The treatment includes drug withdrawal and symptomatic pharmacotherapy.
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PMID:[Drug-induced skin allergy]. 1452 79

Adverse drug reactions are common and important complications of therapy. The clinical picture of drug-induced reactions is characterised by considerable polymorphism: from mild local lesions to fatal systemic processes. The classification of drug hypersensitivity encompasses systemic or specific organ forms. Skin has a special position in the diagnostics of adverse drug-induced reactions. Cutaneous lesions are almost universal and highly pathognomonic symptoms of drug-induced hypersensitivity. Urticaria, erythema-like skin reactions, drug-induced exanthemas, purpuric and hemorrhagic reactions are the most common cutaneous drug-induced manifestations.
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PMID:[Skin adverse drug reactions]. 1452 80

The aim of this study was to analyse the usefulness of oral challenge test with different drugs in confirming cutaneous adverse drug reactions in routine clinical practice. During the years 1975-2000 a total of 1,001 challenges were carried out in 784 patients. Patients with serious drug reactions were excluded and those with positive skin test reactions were challenged only in dubious cases. Of 1,001 challenges, 136 (13%) patients developed a positive challenge reaction. Antimicrobial drugs were most commonly suspected, accounting for 67% of challenges and 66% of the positive reactions. Exanthema was the most common skin reaction (72%), followed by fixed drug eruption (16%) and urticaria (12%). One serious challenge reaction with salazosulfapyridine was seen. We conclude that the challenge test is most useful as a tolerance test or to exclude drug hypersensitivity. It may be useful to complete studies of adverse drug reactions in patients with a history of exanthema, if other diagnostic methods are not available or if other diagnostic tests yield negative results. Out-patient protocol can be used in most cases.
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PMID:Oral challenge in patients with suspected cutaneous adverse drug reactions: findings in 784 patients during a 25-year-period. 1639 95

We describe the case of a 30-year-old woman who reported several episodes of anaphylaxis with angioedema and relapsing urticaria. Some events were related to nonsteroidal anti-inflammatory drug intake and one episode followed alcohol ingestion, but in most cases no triggers could be identified. Specific immunoglobulin E determination was negative for food and drug allergens, C3 and C4 were in the normal range, C1 inhibitor was slightly reduced and serum tryptase was undetectable. In vivo autologous serum skin test and in vitro basophil histamine release assay were positive indicating the presence of circulating histamine-releasing factors. When oral tolerance tests were performed, only doxycycline was tolerated whereas levofloxacin, clarithromycin, nimesulide and tramadol caused mild urticaria. Premedication with cetirizine allowed the patient to tolerate levofloxacin, clarithromycin and nimesulide. The demonstration of circulating histamine-releasing factors in a patient with idiopathic anaphylaxis and multiple drug allergy syndrome provides a new mechanistic insight and might open the way to new therapeutic approaches.
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PMID:Detection of serum histamine-releasing factors in a patient with idiopathic anaphylaxis and multiple drug allergy syndrome. 1746 Sep 52

2 series of patients with pollinosis and drug allergy studied 10 years apart and comprising 115 cases are presented. In both series grass pollens and parietaria are as usual the most common cause of pollinosis but Parietaria was more common in the first series. Beta-lactams were the major cause of drug allergy in the first group, supersed by NSAID in the second group. Rhinitis was the more frequent symptom on pollinosis and urticaria/angioedema on drug allergy.
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PMID:Drug allergy and pollinosis. A short report. 1771 73

An acute anaphylactic reaction after a conventional antipyretic dose of ibuprofen was diagnosed in a child with allergic rhinitis, recurrent idiopathic urticaria, and nonimmunologic cross-reactive hypersensitivity to nonsteroidal antiinflammatory drugs and acetaminophen. The patient reported several previous, mild (isolated cutaneous) hypersensitivity reactions after exposure to acetaminophen or ibuprofen. There was no evidence of an underlying inflammatory disease except as described above. Patients with chronic or recurrent idiopathic urticaria and those with atopic disease represent groups at increased risk of nonsteroidal antiinflammatory drug hypersensitivity. Mild hypersensitivity reactions to acetaminophen and/or ibuprofen may precede subsequent, more-severe adverse reactions. Risks and benefits of continued use of nonsteroidal antiinflammatory drugs in these children should be carefully considered.
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PMID:Severe anaphylactic reaction to ibuprofen in a child with recurrent urticaria. 1776 14

This review highlights some of the research advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects that were reported primarily in the Journal in 2007. Advances in diagnosis include possible biomarkers for anaphylaxis, improved understanding of the relevance of food-specific serum IgE tests, identification of possibly discriminatory T-cell responses for drug allergy, and an elucidation of irritant responses for vaccine allergy diagnostic skin tests. Mechanistic studies are discerning T-cell and cytokine responses central to eosinophilic gastroenteropathies and food allergy, including the identification of multiple potential therapeutic targets. Regarding treatment, clinical studies of oral immunotherapy and allergen vaccination strategies show promise, whereas several clinical studies raise questions about whether oral allergen avoidance reduces atopic risks and whether probiotics can prevent or treat atopic disease. The importance of skin barrier dysfunction has been highlighted in the pathogenesis of atopic dermatitis (AD), particularly as it relates to allergen sensitization and eczema severity. Research has also continued to identify immunologic defects that contribute to the propensity of patients with AD to have viral and bacterial infections. New therapeutic approaches to AD, urticaria, and angioedema have been reported, including use of sublingual immunotherapy, anti-IgE, and a kallikrein inhibitor.
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PMID:Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2007. 1877 68

Cystic fibrosis is an autosomal recessive disease reported in 1 in 2500 live births in Northern American and Northern European Caucasian populations. Classic disease findings include chronic bacterial infection of airways and sinuses, malabsorption of fat, infertility in men, and elevated concentrations of chloride in sweat. Less well-recognized findings associated with cystic fibrosis include cutaneous findings, which can be primary or secondary manifestations of the disease process. Patients demonstrate more atopic and drug hypersensitivity reactions than the general population, but have similar rates of urticaria compared with the general population. In atypical presentations of cystic fibrosis, the nutrient deficiency dermatitis of the disease may aid with diagnosis, and notably can be the presenting sign. Other dermatologic manifestations of cystic fibrosis include early aquagenic skin wrinkling and cutaneous vasculitis, which can be associated with arthralgias. Familiarity with the nutrient deficiency dermatitis of this entity may play a role in the timely diagnosis of the disease, and the other cutaneous findings add to our understanding of the protean nature of its manifestations.
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PMID:Cutaneous manifestations of cystic fibrosis. 1842 69

Melkersson Rosenthal Syndrome (MRS) is a rare disorder characterized by relapsing facial paralysis, persistent or recurrent orofacial edema, and lingua plicata. It may cause difficult airway, drug allergy, and angioedema. In our anesthetic management of two patients with MRS, preanesthetic immunological blood examination and skin tests for hypersensitivity to anesthetic drugs were applied. Because the principal goal is to avoid all factors that may stimulate, an allergic reaction, anesthetic drugs known to trigger urticaria were avoided. Body and operating room temperatures, changes of which may trigger allergic reactions, were kept constant during the perioperative period. Emergency precautions were taken for probable angioedema. MRS is a rare syndrome, and if its manifestations are misunderstood as simple facial paralysis, it may be overlooked by anesthesiologists. Anesthesiologists must be careful of several problems in patients with MRS.
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PMID:Anesthetic management of patients with Melkersson Rosenthal syndrome. 1868 38

There is little data in the literature regarding outpatient consultation in allergy/immunology (A/I). The purpose of this study was to determine the relative frequency of different reasons for A/I outpatient consultation to help guide graduate medical education (GME) and assist with A/I practice management. We retrospectively reviewed the electronic medical records of all outpatient A/I consultations from January 1, 2006 to December 31, 2006. The study was performed at our tertiary care referral center which is a GME training site. There were 1412 A/I consults requested during the 1-year period. The consults per month ranged from a low of 69 to a high of 157. The referrals consisted of 35% pediatric and 65% adult patients. There were 52.8% female and 47.2% male patients. We received 74.3% of referrals from primary care, 19.8% from specialty care, and 5.9% from the emergency department. The most common reasons for consultation included 808 (57.2%) patients for chronic rhinitis, 288 (20.4%) for asthma, 196 (13.9%) for food allergy, 89 (6.3%) for venom allergy, 68 (4.8%) for atopic dermatitis, 66 (4.7%) for drug allergy, 62 (4.4%) for chronic urticaria, 45 (3.2%) for acute urticaria, 34 (2.4%) for immunodeficiency, 31 (2.2%) for anaphylaxis, and 162 (11.5%) for other reasons. More than one reason was given for 27.1% of consults, and there was an average of 1.3 reasons for consultation per patient. Although the allergist/immunologist is consulted for a variety of reasons, the top three reasons make up a majority of outpatient consults, and consults are often requested to address more than one diagnosis.
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PMID:Reasons for outpatient consultation in allergy/immunology. 1933 22


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