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)

The increase in neutrophil chemotactic activity (NCA) is related to degranulation of mast cells. The study included 10 patients in whom aspirin-induced urticaria was related to NCA increase. Tolerance state to ASA was achieved by administering this drug in incremental doses. In none of the examined patients after 600 mg of ASA given during induced tolerance state, the increase of NCA was observed. The authors conclude that in patients with ASA-urticaria, after ASA desensitization, mast cells degranulation does not occur.
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PMID:[Chemotactic activity of serum granulocytes after aspirin in patients with aspirin-sensitive urticaria who find themselves in a state of tolerance for this drug]. 840 40

The aim of the paper was to estimate the value of challenge tests with acetylsalicylic acid in diagnosis of ASA-induced urticaria. The study was performed in 71 persons with suspected urticaria/angioedema type of sensitivity to ASA. The anamnesis confirmed sensitivity in 67 examined patients (94.4%) and showed that the sensitive patients usually suffered from extensive urticaria (37 persons, i.e. 55.5%) after ingestion of ASA. Eight persons (12%) reacted with loss of consciousness and 4 (6.0%) with oedema of the larynx. Oral challenge test with acetylsalicylic acid was performed in 53 examined persons, in 49 (92.4%) of which it was positive. Threshold doses of acetylsalicylic acid ranged from 40 to 300 mg. In 11 persons the test was repeated and in 8 performed three times. It was observed that both the threshold acetylsalicylic acid doses and the time of appearance of the sensitivity symptoms were changeable. All ASA-sensitive reacted to indomethacin in the similar way as to ASA. Paracetamol, on the other hand, was well tolerated by all 25 tested patients with urticaria/angioedema type of sensitivity to ASA.
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PMID:[Urticaria-angioedema type of sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs; diagnostic value of anamnesis and challenge tests with acetylsalicylic acid in detecting this sensitivity]. 849 80

Aspirin (acetylsalicylic acid) and other NSAIDs are responsible for many adverse effects. Among them, pseudo-allergic reactions (urticaria/angioedema, asthma, anaphylaxis) affect up to 9% of the population and up to 30% of asthmatic patients. The mechanisms provoking these reactions have not been fully elucidated, but it appears that inhibition of cyclo-oxygenase (COX) plays a central role. The anti-inflammatory action of nimesulide differs from that of other NSAIDs, possibly because of its chemical structure. In particular, nimesulide is selective for COX-2 and displays additional properties in terms of its effects on inflammatory mediator synthesis and release. For these reasons, nimesulide is generally well tolerated by NSAID-intolerant patients and patients with NSAID-induced asthma. The good tolerability of nimesulide as an alternative drug for use in patients with NSAID intolerance has been demonstrated in a large number of clinical studies.
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PMID:Nimesulide in the treatment of patients intolerant of aspirin and other NSAIDs. 885 24

ASA and NSAIDs are responsible for a large number of adverse reactions. The association of adverse reactions to acetaminophen and to ASA is uncommon, especially in children, and raises the problem of finding alternative treatments. We present a case report of a 7-year-old boy with combined adverse reaction to acetaminophen and ASA/NSAIDs. The child, who had no history of atopy, first displayed the condition at age 6, when he suffered two episodes of urticaria and angioedema, 2 hours after administration of 500 mg of acetaminophen, following two earlier doses of 500 mg (total 1500 mg). At age 7 he suffered a third episode 3 hours after administration of 180 mg of ASA. The patient submitted to oral challenges with acetaminophen (positive at a cumulative dose of 2,040 mg), ASA (positive at a cumulative dose of 204 mg) and nimesulide (negative at a cumulative dose of 119 mg). In conclusion, nimesulide (an NSAID not available in the United States) may be regarded as an alternative treatment in such patients, but more research is needed in pediatric age groups.
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PMID:Adverse reactions to acetaminophen, ASA, and NSAIDs in children: what alternatives? 933 26

Aspirin is one of the world's most commonly used medications and its use benefits many diverse conditions. Adverse reactions, however, are relatively common as well. Hypersensitivity to aspirin can be manifested as acute asthma, urticaria and/or angioedema, or a systemic anaphylactoid reaction. We report 3 cases in whom aspirin was indicated for secondary prophylaxis of myocardial infarction but in whom a remote history of an untoward reaction to it prevented its initial use. These patients all underwent further evaluation of their pulmonary and allergic history and all 3 were challenged with aspirin. Two patients were found not to be sensitive and started on aspirin, the other had a classic asthmatic reaction to the drug and was successfully desensitized to aspirin allowing for its use.
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PMID:Aspirin sensitivity: the role for aspirin challenge and desensitization in postmyocardial infarction patients. 1039 93

Asthma is a common condition, affecting approximately 7% of people worldwide. However, the prevalence varies among countries, and in Australia, asthma affects 10% of adults and approximately 20% of children. For some of these patients, ingredients in some over-the-counter analgesics may pose problems. Aspirin sensitivity, defined as urticaria, angioedema, or rhinitis after aspirin ingestion, affects only 0.3% of the general population. However, certain patient groups, such as asthmatics, are at an increased risk, with reports of an incidence as high as 20% in this patient population. This phenomenon is not restricted to aspirin, as all nonsteroidal anti-inflammatory drugs (NSAIDs) that inhibit the enzyme cyclooxygenase display a high incidence of cross-sensitivity. In contrast, paracetamol (acetaminophen) is well tolerated by the majority of people with asthma and is seldom associated with cross-sensitivity. Determining who is likely to be affected is difficult because the sequence of symptoms is hard to predict, and patients often do not associate an asthma attack with the use of aspirin or an NSAID. The only definitive way to diagnose sensitivity is by provocation tests. In view of these difficulties, it is important for health care practitioners to take a pro-active stance by asking questions to determine whether aspirin sensitivity is a problem, counseling people about the risks, and helping them make an appropriate analgesic choice.
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PMID:Recommending analgesics for people with asthma. 1131 74

Aspirin intolerance manifests itself as two clinical symptoms, urticaria/angioedema and asthma. However, there is seldom patient of aspirin intolerance who has the both symptoms, urticaria and asthma. So we suspect that the pathogenic mechanism for aspirin urticaria differs from that for aspirin asthma. We examined 18 patients of aspirin urticaria at dermatology of Yodogawa Christian Hospital, especially as to oral aspirin challenge test. All patients had no symptom of asthma. Threshold dose evoke urticaria/angioedema after ingesting 100 to 500 mg of aspirin (average, 311 mg). Urticaria/angioedema occurred within 50 minutes to 14 hours (average, 3 hours 16 minutes) after ingesting aspirin. The dose and the time of oral aspirin challenge test for these 18 patients were more spent than those for reported patients of aspirin asthma. These results support the opinion that aspirin urticaria has the different pathogenic mechanism from aspirin asthma. In addition, we experienced one patient of aspirin intolerance which caused hyperemia and edema of the bulbar conjunctiva. She had no symptom of urticaria and asthma, and had the both character of aspirin urticaria and asthma as to aspirin challenge test. We propose that aspirin intolerance is classified in reaction of the skin (urticaria/angioedema) and reaction of the mucosa (asthma), and it has an intermediate type.
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PMID:[The study of 18 cases of aspirin urticaria at dermatology of Yodogawa Christian Hospital--on the difference between aspirin asthma and aspirin urticaria]. 1176 86

Urticaria is characterized by strongly pruritic wheals and in some cases, angioedema. On the basis of a careful case history, the type of urticaria presenting can usually be determined. In the case of the acute form, no complicated diagnostic work-up is necessary. Treatment is symptomatic: the use of ASA should be avoided, while an acute infection requires treatment. When there is recurrent angioedema, chronic urticaria and physical forms, a multitude of triggering factors must be considered. In many cases, symptoms may persist for years. Symptomatic treatment with antihistaminics is often inadequate, but long-term treatment with glucocorticoids should be avoided on account of their side effects. For this reason, further diagnostic work-up is usually necessary and, where indicated, treatment should be initiated by a dermatologist with specialist training in allergology.
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PMID:[Acute, chronic or physical urticaria. What causes the hives?]. 1192 59

Cis-atracurium is a stereoisomer of atracurium, about five times more potent than the racemate. Whereas cis-atracurium is routinely used in adults, its effects on children are still poorly defined. We compared equipotent doses of atracurium and cis-atracurium in children aged between 2 and 12 years regarding the quality of neuromuscular blockade, the intubation conditions and the occurrence of side-effects. After approval by the ethics committee and with informed parental consent, 84 children (ASA I or ASA II) were randomly allocated to receive either 0.5 mg/kg atracurium (group A, n = 42) or 0.1 mg/kg cis-atracurium (group C, n = 42). In both groups anaesthesia was induced with 15 micrograms/kg alfentanil and 5-7 mg/kg thiopentone. We assessed the intubation conditions according to the Krieg Scale. Anaesthesia was maintained with a nitrous oxide/oxygen mixture of 2:1 and isoflurane in an endexpiratory concentration of approximately 0.6 Vol.%. Neuromuscular blockade was controlled acceleromyographically in response to supramaximal stimulation of the ulnar nerve. We measured the onset time (T1 = 5%), duration of effect (T1 = 25%), recovery index (T1 = 25%-75%) and the recovery time at a train-of-four-ratio (T4/T1) of 0.7. These parameters did not show any significant differences between group A and group C: onset time: 3.1 +/- 1.5 min (group A) versus 3.4 +/- 1.1 min (group C), duration of effect: 34.1 +/- 5.5 min (group A) versus 34.1 +/- 6.5 min (group C), recovery index: 9.3 +/- 3.3 min (group A) versus 9.6 +/- 2.5 min (group C), recovery time at a TOF-ratio of 0.7:49.3 +/- 8.4 min (group A) versus 52.3 +/- 6.6 min (group C). In group A, the intubation conditions were "excellent" or "good" in 98% of the patients, whereas in group C the figure was only 69%. Regarding side-effects, we found significantly more frequent urticaria in group A (6 of the 42 patients) (p < or = 0.05) than in group C, in which no patient showed urticaria. Flush and tachycardia occurred much less frequently and there were no significant differences in the two groups: two patients in group A and only one in group C. The authors conclude that atracurium and cis-atracurium lead to comparable neuromuscular effects in children aged between 2 and 12 years. Only the intubation conditions were better after atracurium, but atracurium was followed by urticaria more often than cis-atracurium.
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PMID:[Cis-atracurium--an equivalent substitution for atracurium in pediatric anesthesia?]. 1223 66

The relationship of aspirin sensitivity to urticaria is complex. Aspirin sensitivity can cause acute urticaria in some individuals, aggravate pre-existing chronic urticaria in others or, rarely, act as a cofactor with food or exercise to provoke anaphylaxis. Individuals who react with urticaria appear to come from a different population to those who react with asthma, although there is some overlap. Aspirin-sensitive chronic urticaria patients may also react adversely to some food additives. The pharmacological mechanisms of aspirin-sensitive urticaria are not fully understood but probably involve diversion of arachidonic acid metabolism from prostaglandin to cysteinyl leukotriene formation leading to direct effects on blood vessels and delayed mast cell degranulation with release of histamine. Cross-reactivity amongst all nonsteroidal drugs is common in aspirin-aggravated chronic urticaria but appears not to occur with selective cyclo-oxygenase 2 inhibitors.
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PMID:Aspirin sensitivity and urticaria. 1265 94


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