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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

Based on data from three studies with complete recording of adverse events in about 12,000 patients each, we determined that angioedema in association with the angiotensin converting-enzyme inhibitor enalapril maleate occurred during the first week of therapy at the rate of one case per 3000 patients per week. Thereafter, the incidence was 14-fold lower, without evidence of a temporal trend in incidence beyond the first week of therapy. The cumulative incidence was one case per 1000 patients treated (0.1%). An additional 138 case reports consistent with the diagnosis of angioedema were obtained from our overall controlled and marketed experience using enalapril in more than 1.2 million patients. These reports were examined to further characterize the reaction. The cases generally were mild, and they resolved on discontinuation of drug therapy. Seven patients experienced angioedema or urticaria in association with both enalapril and captopril, a structurally different angiotensin converting-enzyme inhibitor. This further suggested that the side effect is mechanism based. If angioedema is suspected, therapy with any angiotensin converting-enzyme inhibitor should be interrupted promptly, respiratory distress should be treated appropriately, and subsequent therapy should be initiated with an agent from an alternative class of medication.
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PMID:Clinical profile of angioedema associated with angiotensin converting-enzyme inhibition. 284 May 22

A 60-year-old atopic female was admitted for investigation of progressive neurological deficits involving her left hand, arm, and shoulder. A computed tomography scan demonstrated a right parietal lesion of her brain, which was removed. Increasing intracranial pressure necessitated the administration of mannitol 20% 250 ml. The patient stated she had a "tightness" in her chest during the mannitol administration. Five days later, rises in intracranial pressure again necessitated the infusion of mannitol 20% 150 ml. After 100 ml of the solution had been infused, the patient experienced mild respiratory distress, cyanosed lips, and hives of her abdomen. Supportive therapy, including aminophylline and diphenhydramine administration, abated her distress. Anaphylaxis to mannitol administration has only been reported twice previously, despite mannitol's widespread use. Physicians and pharmacists should be aware that severe hypersensitivity reactions may occur, especially in patients with a history of atopy.
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PMID:Hypersensitivity reaction to mannitol. 299

During her 26th week of pregnancy a 20-year-old woman developed generalized pruritus, urticaria, flushing, tinnitus, and tachycardia during plasmapheresis with 5% human serum albumin (HSA) as adjunctive treatment for anti-Kell isoimmunization. The reaction was controlled with intravenous diphenhydramine. Despite pretreatment with diphenhydramine and betamethasone a subsequent attempt to perform plasmapheresis with infusion of 5% HSA resulted in a more severe reaction which progressed to respiratory distress. Intradermal skin testing with 5% HSA produced a 9 x 11-mm wheal and 17 x 21-mm erythema at 15 minutes. An enzyme-linked immunoassay was positive for IgE antibody to 5% HSA before and after dialysis for removal of Na caprylate. These results are consistent with an IgE-mediated basis for this patient's reaction to HSA.
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PMID:Anaphylaxis to human serum albumin. 230 85

A patient with an immediate type hypersensitivity reaction against poppy seed is reported. Clinical symptoms consisted of swelling of the oral mucosa, vomiting, respiratory distress, and urticaria. Specific IgE antibodies were demonstrable by RAST.
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PMID:[Poppy seed allergy]. 338 34

The syndrome of exercise induced anaphylaxis represents a distinct form of physical allergy. This syndrome and the features which distinguish it from other forms of physical allergy are discussed in the context of 10 case reports. The symptoms usually start after 5-30 minutes' exercise with cutaneous pruritus, warmth and progress to urticaria and angioedema. In 3 cases signs of laryngeal edema were present; additional manifestations included upper respiratory distress, gastrointestinal tract symptoms and collapse. The syndrome is distinct from exercise induced asthma or cholinergic urticaria. One patient had both cholinergic urticaria induced by stress, heat and exercise, and anaphylactoid symptoms induced by exercise alone. While the symptoms of cholinergic urticaria subsided after 2-4 hours, the anaphylactoid symptoms lasted up to 48 hours. The symptoms are elicited irregularly, which suggests a multifactorial trigger mechanism. The intake of particular foods or acetylsalicylic acid, and certain weather conditions, are possible cofactors. In 8 of 10 patients an atopic diathesis was found but no exposition to a specific allergen, which could explain the symptoms, was observed. Therapy consists of avoidance of cofactors, change of training habits and cessation of exercise as soon as prodromal symptoms develop. If attacks are frequent, antihistamines or ketotifen can be tried. The acute attack should, like other anaphylactoid reactions, be treated by antihistamines, injection of epinephrine (s.c.) and infusions (colloidal solutions).
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PMID:[Exertion-induced anaphylaxis]. 381 Jan 6

In a retrospective study, 113 bites which occurred in Switzerland within a 16-year period by either of the two indigenous adders (Vipera berus and Vipera aspis) were analyzed. 13 patients showed no signs of envenomation. Out of the other 100, 62 patients had merely minor (local edema only) and 24 moderate envenomation (vomiting, diarrhea, cramps, hypotension), while 24 had severe envenomation (shock and angioneurotic edema of the tongue and lips). No fatalities were recorded. In residents of the endemic area the bites occurred accidentally in 86% of the cases, while tourists were bitten after manipulating the snake in 42%. Specific antivenin was given to 49 of 95 hospitalized patients. In cases of severe envenomation (n = 14) a reduction of the median duration of hospitalization from 10 days in patients without antivenin therapy (n = 4) to 5 days in patients with antivenin therapy (n = 10) was obtained. In cases of moderate (n = 21) or minor envenomation (n = 49), antivenin therapy did not influence the hospital stay of 4 and 2 days respectively. In the 11 patients with bites not followed by envenomation the antivenin treatment increased the duration of hospitalization from 1 day (in 6 patients without antivenin) to 2 days (in 5 patients with antivenin). Side effects of the antivenin treatment, such as urticaria, angioneurotic edema, respiratory distress, fever and lymphadenopathy were noted in 4 out of 49 patients.
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PMID:[Poisoning by domestic vipers (Vipera berus and Vipera aspis). A retrospective study of 113 patients]. 402 76

Forty-five patients who have been maintained on hemodialysis using a regenerated cellulose hollow fiber artificial kidney (HFAK) were dialyzed on a cuprophan HFAK for the first time. Three black patients (6.6%), one male and two females, ages 43-61, who had been stable on hemodialysis for 30-88 months developed hypersensitivity reactions. The recommended setup procedure was carefully followed. Within seconds in 1 patient and within 10-16 minutes in the remaining two, respiratory distress, urticaria, pruritus, hypertension/hypotension, and facial edema developed. Dialysis was discontinued immediately. They were treated with oxygen, epinephrine, and diphenhydramine. Two patients received IPPB treatments and one received IV methyl-prednisolone. After allowing 10-15 minutes for stabilization, the dialysis was resumed on a non-cuprophan HFAK. Patients were discharged with no sequelae. The cause of the hypersensitivity reaction is unknown. It could be due to substances used in the sterilization procedure, to the membrane itself, or to substances that leach out of the potting compound or membrane. Hypersensitivity reaction during hemodialysis has been reported to be very severe or even fatal. Personnel delivering direct patient care should be aware of the symptoms and react quickly with proper treatment. Patients suspected to have this reaction should be changed to a dialyzer without a cuprophan membrane.
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PMID:Hypersensitivity reaction on first-time exposure to cuprophan hollow fiber dialyzer. 684 36

Sixteen patients were seen because of possibly life-threatening exercise-associated symptoms similar to anaphylactic reactions. Asthma attacks, cholinergic urticaria and angioedema, and cardiac arrythmias are recognized as exertion-related phenomena in predisposed patients but are distinct from the syndrome described here. A syndrome characterized by the exertion-related onset of cutaneous pruritus and warmth, the development of generalized urticaria, and the appearance of such additional manifestations as collapse in 12 patients, gastrointestinal tract symptoms in five patients, and upper respiratory distress in 10 patients has been designated exercise-induced anaphylaxis, because of the striking similarity of this symptom complex to the anaphylactic syndrome elicited by ingestion or injection of a foreign antigenic substance. There is a family history of atopic desease for 11 patients and cold urticaria for two others and a personal history of atopy in six. The size of the wheals, the failure to develop an attack with a warm bath or shower or a fever, and the prominence of syncope rule against the diagnosis of conventional cholinergic urticaria. There is no history or evidence of an encounter with an environmental source of antigen during the exercise period.
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PMID:Exercise-induced anaphylaxis. 740 Apr 73

Reports of children and adults having allergic reactions after latex exposure are appearing in the literature in increasing numbers. The reactions have ranged from rashes, hives and swelling to respiratory distress and even death. Unfortunately, although latex is a common component in many hospital and household products, many health care workers remain unaware of the potential implications of latex allergy on their work and on the health and safety of their patients.
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PMID:Latex allergy alert. 778 Sep 22


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