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

During the interval from January 1989 to March 1990, signs and symptoms of anaphylaxis developed in six patients during barium enema examinations in our institution. In all six cases the symptoms of anaphylaxis began during the procedure, usually within 10 min of starting the examination. The principal manifestation of anaphylaxis was severe hypotension, usually accompanied by edema and urticaria. The symptoms were considered potentially life threatening in all patients, and one patient died despite prompt recognition of the anaphylactic nature of the reaction and resuscitative efforts. Serum samples were obtained within a few hours of the reaction in two patients and at autopsy in the fatal case: all three samples showed elevated concentrations of mast cell tryptase, demonstrating the systemic release of anaphylactic mediators. In vitro tests demonstrated the presence of immunoglobulin E antibodies specific for latex allergens in five of the six cases. Further in vitro inhibition tests confirmed the specificity of the antibodies for latex allergens and demonstrated that similar allergens were found in both raw latex, latex gloves, and catheter balloons. Only one patient was willing to undergo a skin test, and her skin test was positive for extracts of latex products. After considering multiple possibilities, we conclude that the reactions associated with barium enemas observed in these six patients are most probably the result of latex allergy.
 ...
PMID:Anaphylaxis associated with latex allergy during barium enema examinations. 201 49

We described a case of anaphylaxis diagnosed by the evaluation of plasma mast cell tryptase and a case of anaphylactoid reaction. In a patient undergoing pulmonary lobectomy, anaphylaxis, showing the elevation of plasma tryptase, was provoked by physiological glue for hemostasis during the operation. During the operation, cardiovascular collapse occurred suddenly, at which time the cause was not diagnosed. After completion of the operation and removal of drapes, diffuse urticaria with wide erythema on the torso and the upper extremity was noticed. Suspecting allergic adverse reaction, plasma tryptase was measured 2h and 5h after the start of the episode, showing 34.6 ng.ml-1 at 2h and 15.3 at 5h. Because these elevations of plasma tryptase indicated degranulation of mast cells, evaluation of the causative drugs was performed 7 weeks after the episode. Physiological glue was confirmed to be causative drug. In another patient for total hysterectomy and bilateral oophorectomy, adverse reaction occurred after completion of the operation and extubation. Increase in plasma histamine concentration to 4.94 ng.ml-1 that could induce systemic reaction was noticed; however, concentrations of plasma tryptase 25 min, 3h and 7h after the episode were not elevated. This finding indicated that the adverse reaction was not based on degranulation of mast cell, and was anaphylactoid reaction provoked by nonspecific histamine-release. In conclusion, measurement of plasma tryptase is a useful method for differential diagnosis of anaphylaxis and anaphylactoid reaction.
 ...
PMID:[Usefulness of measurement of mast cell tryptase for differential diagnosis of anaphylaxis and anaphylactoid reaction]. 852 64

Anaphylaxis is an acute systemic hypersensitivity reaction with symptoms of immediate-type allergy, which involves particularly the skin, respiratory tract, cardiovascular system and gastrointestinal tract. The severity of anaphylactic reactions is variable but some are fatal. Hymenoptera venom anaphylaxis affects about 3% and food hypersensitivity 2.6-3.2% of the general population; drugs are the other frequent cause. Symptoms of anaphylaxis are characteristic, but none of them is obligatory--even urticaria is absent in about 10%--and each symptom may be found also in other conditions. Hence, there are numerous differential diagnostic considerations, and anaphylaxis may be overlooked in many cases. Diagnosis of anaphylaxis is based on the occurrence of characteristic symptoms, especially when they develop upon exposure to a potential trigger. It can be significantly supported by evidence of release of mediators in the course of the reaction. For clinical purposes, demonstration of an increase of mast cell tryptase serum concentration above the individual baseline value is useful. The correct diagnosis of anaphylaxis is not only important with regard to treatment of an acute reaction, but also for subsequent allergologic diagnostics and long-term management of the patient.
 ...
PMID:[Anaphylaxis. Clinical manifestations and diagnosis]. 1799 42

Reported herein is an autopsy case of mast cell leukemia, a rare form of systemic mastocytosis, complicated with portal hypertension. A 52-year-old woman presented with urticaria-like skin symptoms, anemia, and thrombocytopenia. Atypical mast cells (CD2+, CD25+, CD117+) with toluidine blue metachromasia were found in the peripheral blood and on bone marrow aspiration smears. Chemotherapy with cytosine arabinoside and idarubicin was ineffective and the patient died of multi-organ failure with rapidly progressing hepatosplenomegaly and large-volume ascites 3 months after admission. At autopsy the bone marrow, spleen, liver, and lymph nodes were extensively infiltrated by atypical tumor cells with occasional bi- or multi-lobated nuclei. They were positive for mast cell tryptase and possessed an activating mutation of the c-kitgene (D816V). Ascites (2200 mL) and non-ruptured esophageal varices with submucosal hemorrhage indicated the presence of severe portal hypertension. Although there was no evidence of liver cirrhosis, the hepatic sinusoids were clogged with tumor cells, with a tendency to be more severe in the perivenular areas, and the lumens of central veins were obliterated by tumor cell infiltration. The present case demonstrates that non-cirrhotic portal hypertension due to blocking of sinusoidal and venous flow could be a serious complication in mast cell leukemia.
 ...
PMID:Mast cell leukemia with rapidly progressing portal hypertension. 1988 34

Anaphylaxis is defined as a severe, life-threatening, generalised or systemic hypersensitivity reaction. Diagnosis is based on the presenting symptoms and signs which classically develop rapidly, typically evolving over minutes but in some cases hours. Various combinations of airway and/or breathing and/or circulatory problems are possible, as well as urticaria, and hypotension. Skin and/or mucosal changes (typically urticaria and/or angioedema) are seen in around 75% of cases, but importantly these features alone are insufficient for a diagnosis of anaphylaxis. As soon as possible after successful emergency treatment, timed blood samples should be taken for the mast cell tryptase (MCT) test. Serum samples need to be taken within 1-2 hours but no later than 4 hours from the onset of symptoms. It is important to document the acute clinical features (record BP, respiratory rate etc) and the time course of the onset of symptoms/signs and their resolution. Because of the risk of relapse patients should be observed for 6-12 hours after the onset of symptoms. Children under 16 years should be admitted and supervised by a paediatrician. An adrenaline injector device for intramuscular use only, should be prescribed as an interim measure before referral to a specialist allergy clinic. Referral to a specialist allergy service (or specialist paediatric service), is strongly recommended. Diagnosis can be confirmed, and further investigations organised.
 ...
PMID:Following up patients after treatment for anaphylaxis. 2266 16