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

The physician should be familiar with preventive measures for acute urticaria or its most severe form, anaphylaxis, and with the general principles of management. Treatment does not differ basically whether given in a nonmedical setting, the emergency room, or the office, except for the availability of special supplies and equipment, such as oxygen, if needed. In all cases, a history should be obtained quickly, the patient should be examined to confirm the diagnosis, and epinephrine should be administered. Hospitalization is indicated in severe cases with systemic symptoms. Once the acute episode has been treated, the physician must decide whether further investigation is necessary. Quite often a presumptive etiologic diagnosis is made on the basis of the history. Allergy testing is not part of the routine evaluation of the patient with urticaria.
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PMID:Managing acute urticaria. 0 81

Hemoglobin J Capetown was found incidentally in a patient of french origin suffering from urticaria with delayed pressure oedema. Using a preparative finger-print technique, the structural determination was easy. A functional study of the purified component confirmed the high oxygen affinity of hemoglobin J Capetown and demonstrated a low reactivity for organic phosphates. These results may explain the perturbations observed in the whole blood.
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PMID:[A new case of hemoglobin J Capetown alpha 92 (FG 4) Arg replaced by gln]. 89 32

The article deals with a 16-year old patient who was suffering from bronchial asthma with frequent severe respiratory obstructive crises and decreased values of functional pulmonary tests since his eleventh year. He was on salbutamol and teoline therapy, and since one year and a half on continuous inhalation corticosteroid therapy. During one of the episodes of bronchobstruction when he was on broncholdilatation and oxygen therapy the patient was given novalgetol because of headache. This provoked a grave astmatic attack with loss of consciousness. One and a half year later he was given novalgetol during a dyspneic drisis with headacke. Five minutes later asthatic attack and generalized urticaria appeared as anaphylactic reaction to novalgetol. This is a good example how drugs form the group of amonomethansulphonate (novalgetol), used in analgetic purposes, can induce, like aspirin, asthamtic crisis and anaphylactic reaction. Therefore they should be avoided in asthamtic patients.
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PMID:[An anaphylactic reaction after administration of Novalgetol in an asthmatic patient]. 178 18

Delayed hypersensitivity to rubber chemicals is well known, but there has been an increasing number of reports of immediate-type hypersensitivity due to latex causing contact urticaria, angioedema, bronchial asthma, and anaphylactic shock in adults. We report a 10-year-old boy who developed anaphylactic shock during surgery due to surgical gloves containing latex. The patient was atopic and had a history of neurodermatitis and localized angioedema on exposure to rubber. There had been two previous uneventful surgical procedures. Thirty-five minutes after induction of anesthesia and 5 min after laparotomy for appendectomy there was an acute onset of increased airway pressure, oxygen desaturation, and profound hypotension. The circulation and gas exchange stabilized after treatment with oxygen, intravenous fluids, epinephrine, H1 and H2 blockers, aminophylline, and methylprednisolone. A positive skin test and RAST revealed a latex allergy. Latex can cause life-threatening allergic reactions in patients with a history of rubber allergy or frequent exposure to latex products.
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PMID:[Intraoperative anaphylactic shock due to a latex allergy]. 186 73

Anaphylaxis is an often severe, potentially life-threatening symptom complex. Urticaria, airway edema, vascular collapse, asthma, abdominal pain, and diarrhea are common clinical signs. Recently recognized syndromes of anaphylaxis include reactions due to exercise, food preservatives, aspirin, steroids, dialysis, various serums, and human seminal fluid. Initial therapy is directed at maintaining an effective airway and circulatory system. Administration of aqueous epinephrine is always indicated. Other measures may include oxygen delivery by controlled flow, administration of an aerosolized beta agonist, slow infusion of aminophylline, and rapid infusion of intravenous fluid. Patients with severe acute reactions should be monitored in-hospital.
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PMID:Anaphylaxis. Why it happens and what to do about it. 289 Jan 45

The results of infusion of fluorocarbon blood substitute (FCBS) in surgical patients (including war casualties) are presented. One hundred and forty patients (male 82, female 58, age 17-71 years) were infused with 200-1,000 ml of FCBS during operation. Fourteen cases were emergency operations because of trauma and/or hemorrhagic shock and 113 cases were selective operations. Thirteen cases were war casualties. Seventy-three patients also received 300-2,700 ml of banked blood. The vital signs and ECG received normal and blood pressure increased significantly (compared to pre-infusion P 0.01) during and after infusion. Hemoglobin and RBC values did not change significantly, however, WBC counts increased for a week. PaO2 increased significantly (P less than 0.05) compared with preinfusion or the control group (infused with same dose of HES). pH and PaCO2 did not change remarkably. Platelet count decreased transiently, but platelet function did not change, nor did coagulation function. Fibrinolysis was more active, but recovered in 24 hours. The decrease of CH50 was observed immediately after infusion and recovered in 72 hours. There was no change in hepatic and renal function; however, transient increase of SGPT was found in 3 cases. The results suggested that the FCBS had the capacity of carrying oxygen and expanding plasma volume. It is efficient to apply as an alternative to blood transfusion during operation in treatment of traumatic and/or hemorrhagic shock even in war casualties. Transient chest tightness and/or flushing were found in 5 cases at the beginning of the infusion, and disappeared when the infusion slowed down. Urticaria after infusion were observed in 2 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Perfluorocarbon as blood substitute in clinical applications and in war casualties. 326 55

Human C5a anaphylatoxin is a potent bioactive molecule that possesses both spasmogenic and leukocyte-related properties. As such, it normally serves as a local mediator of the acute inflammatory response. Additionally, C5a, through its actions of mononuclear phagocytes, may act to bridge the gap in the acute-chronic inflammatory continuum. While these properties are critical to normal host defense mechanisms, it is now apparent that this anaphylatoxin and/or its des-Arg74 derivative, may exert significant systemic effects that are manifest as cardiopulmonary abnormalities and intravascular activation of granulocytes. Knowledge of these properties is critically important for understanding the clinical sequelae exhibited by patients undergoing extracorporeal circulation since we now know that both hemodialysis and cardiopulmonary bypass [28-30] procedures promote intravascular complement activation and C5a formation. Viewed in this context, it seems reasonable to postulate that many of the immediate and delayed responses to extracorporeal circulation might be mediated by C5a formed in the extracorporeal circuit (table IV). For example, it is now recognized that a few particularly susceptible patients display adverse reactions during the initial phases of hemodialysis. The symptoms of this so-called 'first-use syndrome' may range from severe urticaria and angioedema to life-threatening bronchospasm, hypotension, and cardiopulmonary collapse. Some investigators have presented data which suggest that complement-derived products may be causative of these symptoms in some patients [31]. While this hypothesis remains to be confirmed, present evidence clearly demonstrates that C5a alone may produce many of the observed phenomena. In addition to the acute effects produced by C5a, both our own basic studies and the clinical investigations presented by others at this conference suggest that the long-term effects of repeated C5a exposure in the dialyzed patient may be considerable. Thus, there has been a great deal of interest in the role of complement-derived mediators as initiators of leukocyte degranulation and toxic oxygen radical production and an exploration of the significance of these events in the eventual development of chronic pulmonary fibrosis in the dialyzed patient. Similarly, the effects of repeated exposure to IL-1 that has been postulated to occur as a result of C5a triggering of monocytes during dialysis is currently an active area of investigation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The properties of human C5a anaphylatoxin. The significance of C5a formation during hemodialysis. 332 50

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

A 64-year-old woman was scheduled for cholecystectomy. Her past history revealed that serious anaphylactic reactions including generalized flushing and urticaria, severe hypotension and unconsciousness which occurred after eating crab four years ago. Puncture and/or intradermal skin test and subsequent lymphocyte stimulation test to several drugs commonly used in perioperative period were performed prior to anesthesia. Positive reactions to intravenous anesthetics and muscle relaxants, and negative reactions to inhalational and local anesthetics were found. Famotidine and ketotifen fumarate were given to prevent histamine release for four days before operation. After premedication with scopolamine, a catheter was inserted into epidural space at Th9-T10 level and 2% lidocaine 2 ml was administered initially into the epidural space. Anesthesia was induced with inhalation of nitrous oxide and oxygen, and deepened gradually by the increments of sevoflurane. Tracheal intubation was performed smoothly without adjunct muscle relaxant. Anesthesia was maintained with sevoflurane and epidural anesthesia with intermittent lidocaine administration. No adverse responses were noted at the time of iopamidol injection for intraoperative cholangiography. The anesthesia and postoperative course of this patient were uneventful.
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PMID:[Anesthetic management of a multiallergic patient scheduled for cholecystectomy]. 783 7

The pathogenesis of the physical urticarias has not been completely defined. Indeed, different stimuli can induce similar clinical manifestations, some of which are capable of generating reactive oxygen species. In order to evaluate whether the generation of an oxidative stress response could be a common pathogenetic mechanism of the disease, we have determined the profile of a number of chemical and enzymatic antioxidants in blood samples from a group of patients with physical urticarias. Compared with controls, a systemic imbalance of the antioxidants was detected in the patient group with a decrease of both plasma vitamin E and cellular catalase and glutathione peroxidase activities along with an increase of superoxide dismutase activity. Moreover, an increase in the percentage of plasma polyunsaturated fatty acids, as a target for peroxidative damage, was also observed. These alterations may lead to an increased percentage of peroxidable compounds in skin and to the intracellular generation of reactive oxygen species and could therefore provide one possible explanation for the patients' urticarial response to stimuli. Even if the alteration of the antioxidant status is secondary to changes in cytokine or complement activation, our results suggest a common biochemical profile in patients with different forms of physical urticaria.
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PMID:Oxidative stress in physical urticarias. 1142 77


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