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)

Ethylene oxide (ETO) is widely employed in sterilization of hemodialysis materials. Many studies have shown that ETO may act as an antigenic compound when bound to human albumin, therefore eliciting allergic reactions during hemodialysis. In the present study, we investigated in 93 patients undergoing long-term hemodialysis the prevalence of sensitization to ETO. All the patients were investigated for the presence of allergic or pseudo allergic reactions during the treatment. Specific IgE to ETO were found in sera of 3 patients: 1 suffered from urticaria and 1 from glottic edema and hypotension during the dialysis. The third one had non symptoms. The employ of a gamma-rays sterilized filter determined the disappearance of clinical manifestations in the two symptomatic patients, therefore suggesting a pathogenetic role of the specific IgE to ETO in determining the clinical manifestations.
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PMID:[IgE-mediated allergy to ethylene oxide in hemodialyzed patients]. 195 38

Anaphylaxis is a syndrome including one or more of the following life-threatening responses: hypotension, bronchospasm, upper airway angio-oedema. Other manifestations such as urticaria or rhinitis may also occur. Anaphylaxis is due to release of mediators such as histamine or leukotrienes; this mediator release may be due to immunological or non-immunological mechanisms. Ethylene oxide (ETO) is used to sterilize haemodialysers and other medical equipment that cannot with-stand heat sterilization. There is significant scientific evidence that ETO can haptenize human proteins such as human serum albumin (HSA), thus rendering the allergen ETO-HSA. Approximately two-thirds of patients who experience dialysis anaphylaxis have IgE against ETO-HSA, whereas only about 5% of those without anaphylaxis have IgE against ETO-HSA. No other allergens or mechanisms have been described to account for a significant number of anaphylaxis reactions.
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PMID:Hypersensitivity. 806 15

We describe a case of severe anaphylactic shock without exanthema in an 8-year-old boy who was undergoing elective surgery for an ileostomy. The boy had a history of four anorectal operations in the newborn period, but no history of allergies. Sudden, profound bronchospasm and cardiorespiratory collapse occurred 30 min after the beginning of the operation. No signs of exanthema or urticaria were seen. The patient was resuscitated successfully and remained ventilated for 25 h. During this time, he needed epinephrine in dosages of 0.3-0.05 microg.kg-1.min-1. Radioallergosorbent (RAST) tests for the patient were positive Cap Class 3 and 4, and specific immunoglobulin E was highly positive, suggesting a natural rubber latex allergy as the cause of the anaphylactic shock. Ethylene oxide was negative. Eleven days later, a further operation was performed with a strict latex-free protocol in the presence of histamine 1 and 2 receptor antagonists. On this occasion, the intraoperative course was uneventful. Incidence of anaphylactic reactions, prevalence of latex sensitization, special risk groups and management are discussed.
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PMID:Severe anaphylactic shock without exanthema in a case of unknown latex allergy and review of the literature. 1213 98

Ethylene oxide (EO) is widely used as a sterilization gas for heat-sensitive devices. In EO-sensitized patients, this type of sterilization can cause rare but major allergic reactions such as hives, rash, asthma, or anaphylactic shock. Hemodialysis patients in particular are at risk of developing hypersensitivity to EO. In these patients, surgical interventions should be planned far in advance allowing a thorough EO-free preparation of all equipment needed for the surgery as well as for the pre-, peri-, and postoperative care. In contrast to elective surgery, kidney transplantation with allografts from deceased donors cannot be planned; exact timing is unpredictable. Furthermore, transplantation may take place years after patients have been put on the waiting list. Listing of patients sensitive for EO is therefore a logistical and medical challenge for all health care professionals involved in the patient's care (eg, surgeons, nephrologists, anesthetists, nurses, pharmacists, and sterilization specialists). This case report describes a patient with chronic kidney disease stage V who developed EO allergy during hemodialysis while waiting for a kidney transplantation. Diagnosis was made based on clinical signs and confirmed biochemically (including a positive radioallergosorbent test). Because the only treatment is avoidance of contact with EO-sterilized materials, a strict EO-free protocol was developed to allow an uneventful transplantation thereafter. Subsequently, 4 newly diagnosed EO-sensitive patients on the active kidney transplantation waiting list were diagnosed, and 1 of these patients has been transplanted successfully. EO allergy in patients on the waiting list for kidney transplantation is a unique challenging situation which, to the best of our knowledge, has not been reported yet for kidney transplantation. This report further highlights the logistical preparation of a renal transplantation, including anesthesiologic, surgical, and postoperative care.
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PMID:Ethylene oxide allergy in patients on hemodialysis waiting for kidney transplantation: logistical nightmare or challenge? A case report. 2116 2