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

A research has been carried out on a total of 121 persons with survival post-drug shock (DS), which registered 192 DS. Mention should be made of their predominance in the feminine sex (85 per cent) and their maximum frequency between the ages of 21-50 (average age 34). DS was the first adverse reaction to drugs in 71 per cent of the cases. Therefore DS unpredictability is very frequent. A retrospective study suggested the role of risk factors which should help the doctor to prevent DS (personal allergic antecedents, antecedents of adverse reactions to drugs, neuroses, disorders of endocrine glands, feminine sex, etc.). In 1970, the clinical concept of shock imminence (SI) was formulated and it is applied to various etiologies (drugs, insect stings, food). The existence of SI was identified in the case history of 14 per cent of the persons with DS. SI is a syndrome which includes all clinical manifestations with imminent potential of transformation into shock condition, and represents the stage precursory to the setting up of shock. The utility of SI diagnosis is maximum if it also includes the causal factor (e.g. SI by penicillin or aspirin). The clinical image of SI may vary from the monosymptomatic aspect (urticaria, vomiting, diarrhoea, headaches, etc.) to the one with complex symptomatology (mixed form). Usually the symptoms are dramatic and depend on the administration of a certain drug (often in SI of allergic origin) or of various drugs (mainly on non-immunologic form). The absence of vascular collapse differentiates SI from shock. Differential diagnosis is more difficult in border cases with a slight diminution of blood pressure. SI can be diagnosed especially in several circumstances: when the first adverse drug reaction is dramatic; when the first allergic-type reaction to a drug occurs; when the repetition of drug reactions is amplified in intensity or frequency; when it occurs in persons with risk factors. The differential diagnosis of SI is made with a crude or minimum shock and with pre-shock condition. The advantages of SI diagnosis are the institution of efficient treatment with rapid recoverability and the prevention of subsequent shock to the respective drug.
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PMID:Imminent shock; a useful diagnosis in drug pathology. 1 47

Portuguese man-of-war and jellyfish stings are common occurrence in the coastal waters of the southern United States. Signs and symptoms of Portuguese man-of-war envenomation usually appear immediately following a sting but may be delayed for several hours. Reactions are commonly localized and comprise pain, paresthesia, and intense burning with a linear, red, papular eruption or urticaria at the contact site. Systemic signs may include nausea, myalgia, headache, chills, or pallor. Cardiovascular collapse and death have been reported. Venom can be inactivated with dilute acetic acid (vinegar), proteolytic meat tenderizer, or baking soda. Tentacle debris should be removed. Resolution of symptoms usually occurs within 72 hours, without sequelae.
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PMID:Portuguese man-of-war envenomation. 135 Dec 83

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

Five patients with exercise-induced anaphylactoid reactions are reported. Because of a growing interest in physical exercise and the severity of the symptoms it is important to recognize this condition, even though rare. All of our 5 patients had a history of urticaria and anaphylaxis in association with physical stress, but it seems difficult to induce anaphylactoid reactions under laboratory conditions. Two different clinical patterns could be distinguished in these patients. Three had the anaphylactoid form with signs of alternative complement pathway activation, while 2 patients had the variant form presenting first as cholinergic urticaria and progressing to angioedema and vascular collapse. The latter patients had elevated plasma histamine levels during challenge, but no sign of complement activation was observed. Our findings suggest differing pathomechanisms for these two forms.
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PMID:Exercise-induced urticaria and anaphylaxis. 167 22

A 62 year-old female developed bronchospasm after intravenous vecuronium administration. Vecuronium is reported to have major advantages over pancuronium due to the lack of significant histamine-releasing activity and cardiovascular side effects. However, macular rash, systemic collapse and bronchospasm have been reported before. The patient received cholecystectomy under general anesthesia. She had a history of urticaria when she had had a intravenous pyelography and showed positive skin test to antibiotic, ceftizoxime. During induction with thiopental plus vecuronium and on addition of vecuronium, bronchospasm was induced within five minutes in each time. Both episodes of bronchospasms were relieved with intravenous aminophylline and methylprednisolone. During the operation arterial blood gas samples were taken twice and showed no abnormal findings. Further blood samples were taken for complement C3, C4, plasma IgE and white blood cell counts. Skin test to vecuronium was also performed. In spite of these data, the mechanism of bronchospasm remained obscure. Careful attention should be paid to the use of vecuronium, especially for the patient who showed allergic response to some drugs.
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PMID:[Possible bronchospasm after administration of vecuronium]. 167 99

A 44-year-old man with a two-year history of episodes of exercise-related urticaria and facial angioedema was admitted to our department because of vascular collapse during an athletic activity. The diagnosis of exercise-induced anaphylaxis was established after excluding other causes of shock. This clinical syndrome was described recently; it consists of urticaria, local angioedema and/or cardiorespiratory failure following exercise. Factors possibly associated with or predisposing to attacks include personal and family histories of atopy, food ingestion and weather conditions. Not every effort evokes these reactions, indicating the presence of other, still unknown variables and therefore complicating the diagnosis because provocation tests often have false-negative results. With reference to this case, the clinical syndrome, its pathophysiology and its treatment are discussed.
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PMID:[Anaphylaxis induced by exertion]. 186 53

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

Latex products have recently been identified as the cause of severe intraoperative anaphylactic reactions. We have identified a group of pediatric patients who appear to be at increased risk for such reactions. Fifteen patients with either spina bifida or congenital urologic abnormalities experienced 19 intraoperative anaphylactic reactions. All patients had frequent previous exposures to rubber materials since infancy as part of their management and/or investigative procedures. Seven of 15 patients had a previous history of local skin reactions to rubber. Only four patients were atopic. All patients had undergone multiple (two of 26) operative procedures before their reactions, the onset of which ranged from 40 to 290 minutes after induction of anesthesia. The reactions varied in intensity from urticaria to severe cardiorespiratory collapse. All these patients subsequently had positive allergy skin tests and positive RAST to latex antigen. We conclude that this group is at risk when they are exposed to latex intraoperatively as a result of frequent past exposure to these materials. Allergic evaluation for latex allergy may assist in the preoperative evaluation of similar patients. In sensitized patients, appropriate prophylactic measures, particularly the avoidance of latex, is required.
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PMID:Intraoperative anaphylaxis: an association with latex sensitivity. 200 17

We report a case of nearly fatal cardiovascular collapse attributable to an idiopathic anaphylactic reaction in a 76-year-old man. The event began with gastrointestinal symptoms of abdominal cramps, diarrhea, nausea, and vomiting as manifestations of IA. The patient subsequently progressed to develop urticaria, flushing, cardiovascular symptoms of chest pain, hypotension, and eventually cardiovascular collapse and myocardial infarction over a five-hour interval. This case emphasizes that the potential for life-threatening cardiovascular events from IA exists in patients without previously defined cardiac risk factors.
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PMID:Nearly fatal idiopathic anaphylactic reaction resulting in cardiovascular collapse and myocardial infarction. 237 90

Allergic reactions are often unpredictable, sudden in onset and may be potentially lethal. Clinical manifestations are confined to skin (rash, urticaria, angioedema), respiratory tract (laryngeal edema, bronchospasm) and cardiovascular system (hypotension, bradycardia, dysrhythymia). Because cardiovascular collapse is the most common life-threatening clinical feature, immediate and proper treatment is necessary. We have experienced two cases of intraoperative anaphylatic shock between September 1988 and April 1989. The precipitating factors were of nonanesthetic origin (case 1 was probably due to cephalothin and case 2 was due to dextran 40). Both cases manifestated with hypotension, bradycardia, cutaneous rash and urticaria. Recovery was smooth and without sequela after volume expansion and sympathomimetic drug. We discuss these two cases with a brief review.
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PMID:[Intraoperative anaphylactic shock--report of two cases]. 248 41


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