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

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

Cetirizine, an H1 antihistamine, has properties in addition to H1 blockade that may be useful in the treatment of seasonal rhinitis and urticaria. For example, cetirizine has been shown to block the influx of eosinophils into the site of antigen-stimulated skin blisters. Studies with other antihistamines suggest that this is not a universal property of this type of drug. Pretreatment with cetirizine also has been found to block the augmented sensitivity to methacholine that occurs 24 hours after antigen provocation of the nasal mucosa. This reduction takes place despite the absence of an effect on eosinophil influx into this area, and suggests another action of cetirizine. Our study of allergic rhinitis patients examined the effect of cetirizine on early response to nasal challenge with antigen. Cetirizine, although it did not block the release into nasal secretions of histamine, significantly reduced sneezing and decreased levels of albumin and TAME-esterase activity, which are indicators of vascular permeability. Cetirizine also blocked the generation of leukotriene C4. In vitro studies have shown that cetirizine does not block the release of leukotriene from anti-IgE stimulated mast cells, raising the possibility that cells in the nasal mucosa in addition to mast cells generate leukotrienes.
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PMID:Additional properties of cetirizine, a new H1 antagonist. 168 95

Histamine, which is stored mainly in mast cells and basophils, is a prominent contributor to allergic disease. Elevations in plasma or tissue histamine levels have been noted during anaphylaxis and experimental allergic responses of the skin, nose, and airways. Of the four cardinal signs of asthma (bronchospasm, edema, inflammation, and mucus secretion), histamine is capable of mediating the first two through its H1 receptor and mucus secretion through its H2 receptor. Of the five cardinal signs of allergic rhinitis (pruritus, mucosal edema, sneezing, mucus secretion, and late-phase inflammatory reactions), histamine is capable of mediating the first three through its H1 receptor. In the nose, mucus secretion can be reflexively mediated by H1 and possibly also by H2 receptors. In the skin the cardinal features of urticaria (vasodilation, vascular permeability, and pruritus) can be mediated by stimulation of the H1 receptor. In anaphylaxis histamine H1-receptor stimulation can mediate vascular permeability, smooth muscle contraction, and tachycardia, whereas H2-receptor stimulation can mediate mucus secretion. Stimulation of both receptors can mediate vasodilation and reduce peripheral vascular resistance. Thus although histamine is only one of many mediators of allergic disease, it plays a primary role in allergic rhinitis, urticaria, anaphylaxis, and to a lesser degree, asthma.
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PMID:The role of histamine in allergic diseases. 169 87

Intravenous fluorescein angiography is a commonly performed and extraordinarily valuable diagnostic procedure. The frequency of adverse reactions after angiography has varied considerably in previous reports. In a prospective study of 2789 angiographic procedures in 2025 patients, the authors found that the percentage of adverse reactions depended strongly on the patient's angiographic history. Overall, adverse reactions followed 4.8% of the angiographic procedures. These reactions included nausea (2.9%), vomiting (1.2%), flushing/itching/hives (0.5%), and other reactions (dyspnea, syncope, excessive sneezing) (0.2%). No cases of anaphylaxis, myocardial infarction, pulmonary edema, or seizures occurred. The percentage of reactions was 1.8% for patients who had had previous angiography without ever having had an adverse reaction. In contrast, the percentage of reactions was 48.6% for patients who had had an adverse reaction to angiography previously.
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PMID:Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. 189 Dec 25

Various cells are associated with inflammatory events characteristic of atopic allergy and asthma. As well as T cells and eosinophils, mast cells, basophils, mononuclear phagocytes and platelets have all to be considered particularly as their mediators have potential for contributing directly to the features of bronchial asthma. Nevertheless, mast cell/T lymphocyte/eosinophil interactions may be of particular significance. For instance, the acute symptoms of allergy and asthma such as sneezing, bronchospasm and hives are believed to be largely the result of mediator release from mast cells whereas chronic symptoms (the result of allergic inflammation) can be explained on the basis of eosinophil-mediated tissue damage. Allergen is recognized directly by T cells. Specialized T cell subsets, possibly the Th2 equivalent, predominate in allergy and elaborate IL-4 (an essential co-factor for IgE production) and IL-5 which brings about terminal differentiation and activation of the eosinophil. Basic proteins derived from the crystalloid granule together with PAF and leukotrienes produce chronic wheeze, bronchial irritability, and might also be involved in permanent nasal blockage in chronic rhinitis. This general hypothesis is continually being tested. It is clearly important to identify precise molecular targets in allergy and asthma in order to construct therapeutic strategies.
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PMID:T lymphocytes and their products in atopic allergy and asthma. 193 73

The efficacy of hyposensitization with a standardised extract of Dermatophagoides pteronyssinus (D. pteronyssinus) conjugated to alginate and containing known amounts of antigen P1 (Conjuvac) was tested in a double blind, placebo controlled, multi-centre study in 66 adult patients with perennial rhinitis. Patients received 11 weekly injections of increasing concentrations of Conjuvac containing from 56 x 10(1) to 448 10(3) IU D. pteronyssinus or placebo injections of the alginate diluent to some of which 5 micrograms of histamine has been randomly added. This was followed by 15 monthly injections of Conjuvac or placebo. The severity of nasal blockage, sneezing and rhinorrhoea was recorded twice daily in a diary and visual analogue assessments (VAS) made at each clinic visit. Nasal provocation testing (NPT) was performed with increasing concentrations of the same extract of D. pteronyssinus as used in the hyposensitization injections, and changes in nasal airways resistance measured by passive anterior rhinomanometry. VAS was recorded and NPT was performed on entry to the study and after the fifth, ninth and final monthly injection. Conjuvac injections were well tolerated. Large local reactions (greater than 5 cm) occurred within 30 min in only 1% of patients but later in 23%. No systemic reactions or anaphylaxis occurred within 30 min of injections, but urticaria or worsening of asthma and rhinitis was reported later in 3% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A double-blind study of hyposensitization with an alginate conjugated extract of D. pteronyssinus (Conjuvac) in patients with perennial rhinitis. 1. Clinical aspects. 265 91

From clinical-pharmacologic and clinical data involving over 2,800 patients, astemizole appears to be a very effective and well-tolerated antihistamine. It is superior to placebo and commonly used antihistamines for the relief of rhinitis, particularly rhinorrhea and sneezing. It has a pronounced effect on ocular itching and lacrimation in conjunctivitis and on pruritus and wheals in urticaria. This superiority is due to a very specific, almost complete and sustained histamine H1-blockade. The clinical data confirm the experimental data in relation to its lack of sedative effects.
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PMID:Clinical profile of astemizole. A survey of 50 double-blind trials. 288 7

A previously undescribed anaphylactoid reaction to haemodialysis, haemofiltration, or membrane plasma separation occurred in 15 patients receiving regular dialysis. The illness varied in severity from urticaria, sneezing, and watering of the eyes to severe bronchospasm and cardiovascular collapse, and began within a minute of blood being returned from the dialyser or filtration device to the patient. Reactions developed only when a dialyser sterilised with ethylene oxide was used for the first time and never after sterilisation with formalin. Several patients had more than one reaction while three had a reaction each time a new dialyser was used. Incorrect priming of the dialysers may be a partial explanation of these attacks, but the exact reason for their occurrence is unknown. This is a dramatic and potentially life-threatening syndrome that may not previously have been recognised as a reaction to dialysis.
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PMID:Anaphylactoid reactions due to haemodialysis, haemofiltration, or membrane plasma separation. 681 70

The purpose of the present phase IV multicentre trial was to evaluate general patient tolerance to Omnipaque 350 mgI/ml (iohexol) supplied in polypropylene containers compared to that of the same product supplied in routinely used glass vials, with emphasis on allergy-like adverse events. Polypropylene is a pure plastic material with practically no additives, and has been tested in vitro as a contrast medium packaging material for several years. Handling of these containers is easier and safer than handling of glass vials. Iohexol was administered to 1481 patients undergoing urography (741 patients in the glass vial group, 740 in the polypropylene container group), all of whom successfully participated in the trial. Six centres, representing four European countries, participated. Patients were randomized to receive iohexol from either polypropylene containers or traditional glass vials according to a double blind, parallel design. Pre-established inclusion and pre-admission exclusion criteria were followed, as well as routine procedures for preparation of the patients and conduct of the urography examinations at each hospital. Patient tolerance was assessed by recording all adverse events experienced over a period of up to 1 h after the procedure. Allergy-like events were defined as coughing, sneezing, nausea, vomiting, urticaria or itching. No adverse events were experienced by 56.5% of the patients in the glass vial group, nor by 58.0% of those in the polypropylene group. Discomfort (mainly a sensation of warmth) was reported by 39.4% and 38.6% of the patients, and adverse events other than discomfort by 7.4% and 5.9% of the patients, respectively. There seemed to be a correlation between the speed of injection and the frequency of discomfort (an increase with increasing speed), both of which varied a lot between centres. There was no significant difference in the incidence of allergy-like events between the two groups. Such reactions were seen in 2.0% of patients in the glass vial group and 1.9% of those in the polypropylene container group. There was no significant difference between the patients' tolerance to iohexol supplied in traditional glass vials or in polypropylene containers. Therefore, the new polypropylene container can be recommended as a container for Iohexol.
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PMID:Iohexol in patients undergoing urography: a comparison of polypropylene containers (Unique Soft Pack) and glass vials. 783 73

To investigate the incidence of latex IgE-mediated hypersensitivity, 224 hospital employees were interviewed and prick skin tests were performed to six common aeroallergen extracts, one non-latex "synthetic" glove extract, and four different latex glove extracts. Of the 224 subjects, there were 136 nurses, 41 laboratory technicians, 13 dental staff, 11 physicians, 6 respiratory therapists, and 17 housekeeping and clerical workers. All 224 subjects tested negative for the nonlatex glove (Tactylon) extract but 38 (17%) tested positive for latex extracts. The incidence ranged from 0% in housekeeping staff to 38% in dental staff. Eighty-four percent of the latex skin test-positive employees complained of itching and 68% of rash upon exposure to latex, whereas the latex skin test-negative employees reported these symptoms in 29% and 17%, respectively. Urticaria was a symptom in 55% of the latex skin test-positive and 0.5% of the skin test negative-subjects. Anaphylaxis occurred in 10.5% of the skin test-positive and in none of the skin test-negative employees. Symptoms of sneezing (34% vs 7%), nasal congestion (39% vs 7%), and lacrimation and ocular itching (45% vs 6%) were also significantly different between the latex skin test-positive and latex skin test-negative subjects. We conclude that the incidence of latex IgE-mediated allergy in hospital employees is 17%. The symptoms of anaphylaxis and hives when using latex gloves are sensitive predictors of IgE-mediated latex allergy.
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PMID:Latex allergy in hospital employees. 812 17


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