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)

Acute, potentially life-threatening systemic reactions to contrast media are less frequent with lower osmolality, nonionic contrast agents, but they are not totally eliminated. Severe reactions remain a reality in all radiology departments. Typical reactions to contrast media include nausea and/or vomiting, scattered to extensive urticaria, bronchospastic reaction, hypotension (isolated) with compensating tachycardia, anaphylactoid reaction, vagal reaction, cardiovascular collapse, convulsion, and seizure. For each type of reaction, rapid recognition and initiation of specific corrective therapy enhance response and minimize side effects of drugs. Specific drugs for treating each reaction type are reviewed, including recommended dose, contraindications, and alternative choices. An approach to the high-risk patient and prevention of acute systemic reactions is discussed and pretreatment protocols are outlined.
AJR Am J Roentgenol 1991 Dec
PMID:Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment. 195 Aug 58

Although the ideal treatment for urticaria is identification and removal of its cause, no underlying cause can be discerned in the majority of instances. The chief clinical problem is the treatment of chronic idiopathic urticaria. H1-receptor antagonists are the major class of therapeutic agents used in the management of chronic idiopathic urticaria. The H1 antagonists have been divided into subgroups based on their chemical structure. The second-generation H1 antagonists now available are particularly advantageous for individuals who must remain alert while working. Terbutaline, a beta-adrenergic agonist, is of occasional benefit as an adjunct therapy in combination with an H1 antagonist. The oral administration of disodium cromoglycate is ineffective in patients with chronic idiopathic urticaria, although a few individuals with urticaria caused by food allergy may respond to this drug. It is best to avoid repeated injections of epinephrine and the systemic administration of corticosteroids. Urticaria has a capricious course: it may respond to the administration of placebos or it may resolve spontaneously. About 50% of the patients with urticaria are free of lesions within 1 year, but 20% continue to have episodes for more than 20 years.
J Allergy Clin Immunol 1990 Dec
PMID:Urticaria: current therapy. 197 95

Chronic urticaria is a problem for both physician and patient. In an effort to avoid the risks associated with corticosteroid treatment, many first-generation H1-receptor antagonists have been tried and found to induce undesirable levels of sedation when given in amounts sufficient to control urticaria. Cetirizine, a pharmacologically active oxidized metabolite of hydroxyzine, was developed to provide selective H1-receptor inhibition without depression of the central nervous system. In a 4-week, multicenter, double-blind, placebo-controlled safety and efficacy study, cetirizine, in a once-a-day dose (5 to 20 mg), was equivalent in efficacy to hydroxyzine in divided doses (25 to 75 mg/day). The incidence of somnolence in the cetirizine group was not significantly different from that of the placebo group. However, in the hydroxyzine group, the incidence of somnolence was significantly higher than that in the placebo group (p = 0.001). The results of this study demonstrate that cetirizine has a greater safety margin over the older parent drug hydroxyzine.
J Allergy Clin Immunol 1990 Dec
PMID:Urticaria: clinical efficacy of cetirizine in comparison with hydroxyzine and placebo. 197 96

For three decades, traditional H1 antihistamines have been used in the treatment of allergic diseases. They are effective in reducing histamine-related symptoms, but the use of such agents has been limited by sedation and anticholinergic side effects. These adverse effects are fewer with the recently introduced H1 antihistamines. One of these, cetirizine, a human metabolite of hydroxyzine, is characterized by its high selectivity for the H1 receptor site and its reliable and consistent inhibition of histamine-induced allergic reactions. It also blocks eosinophil infiltration to the site of allergen-induced cutaneous reactions. Cetirizine has proved effective in the treatment of seasonal and perennial allergic rhinitis and urticaria. It is excreted primarily by renal mechanisms. It is well tolerated by elderly patients. Cetirizine has a low rate of penetration of the blood-brain barrier, and it has minimal central nervous system impairment. Furthermore, it can be given once a day. Cetirizine's low incidence of sedation and anticholinergic side effects contribute to its high profile of safety. In this article the characteristics, pharmacology, pharmacokinetics, and mode of action of cetirizine are reviewed.
J Allergy Clin Immunol 1990 Dec
PMID:Cetirizine: antiallergic therapy beyond traditional H1 antihistamines. 197

Three patients with multiple myeloma were treated with recombinant alpha-interferon (r IFN-alpha 2b Intron AR) along with combination chemotherapy i.e. melphelan and prednisolone. In one case it was given as an initial therapy, while the other two patients had refractory and relapsing disease respectively. IFN-alpha 2b was given in the dose of 2 x 10(6) Mu/m2 by subcutaneous injection thrice in a week for six months in two patients and for three months in one patient. All three patients experienced improvement in bone pains; partial response with reduction in the paraprotein level was seen in one patient; while there was no radiological, biochemical or haematological improvement in two patients. Side effects noted were flu like syndrome in all three patients and urticaria in one patient. They were treated symptomatically and did not require cessation of interferon therapy.
Indian J Cancer 1990 Dec
PMID:Recombinant alpha-interferon therapy in multiple myeloma. 209 May 74

A 60-year-old woman with acute asthma developed generalised urticaria and rapidly worsening bronchospasm immediately after IV administration of methylprednisolone sodium succinate. Subsequent skin testing was positive for this, but for no other corticosteroid. Later, both IV dexamethasone during a recurrent attack and oral prednisone for panhypopituitarism were well tolerated. This patient and a review of the literature reveal that corticosteroids are a very rare but important cause of anaphylaxis-like reaction.
Br J Clin Pract 1990 Dec
PMID:An allergic reaction to intravenous methylprednisolone administration. 210 12

A 24-year-old white woman reported sexual intercourse-related pruritus, hives, wheezing, and dyspnea within 5 minutes after ejaculation. Systemic reactions (SRs) were prevented by use of condoms. Prick testing confirmed sensitization to five Sephadex G-100-separated fractions of her husband's seminal plasma. The intradermal end point threshold concentrations (ETC) were 10(-4) and 10(-1) micrograms of protein per milliliter to fractions 2 and 3, respectively. Leukocyte histamine release studies exhibited 100% release to fraction 2 and 37% release to fraction 3. A 2-day protocol of rapid immunotherapy (IT) was performed with subcutaneous incremental doses of human seminal plasma (HuSePl) fractions 2 and 3. The patient experienced an SR after receiving a cumulative dose of 38.55 micrograms of fraction 2 on day 1. On day 2, rapid IT with fraction 2 was administered until the patient experienced a mild SR after having received a cumulative dose of 102.8 micrograms. There was a one-log10 increase in the intradermal ETC to both fractions 2 and 3 at the end of day 2. IT was continued three times weekly for 4 months until the patient tolerated 100 micrograms doses of both fractions 2 and 3. At 4 months, coitus was resumed without SRs, and HuSePl IT was stopped. The intradermal ETC to fractions 1, 3, 4, and 5 was increased 6 months after cessation of HuSePl injections, but there was a one-log decrease in the ETC to fraction 2. Our experience demonstrated that systemic tolerance can be achieved by parenteral administration of selected HuSePl fractions. Partial immunologic desensitization of patients with anaphylactic sensitivity can be achieved.(ABSTRACT TRUNCATED AT 250 WORDS)
J Allergy Clin Immunol 1990 Dec
PMID:Selective desensitization to seminal plasma protein fractions after immunotherapy for postcoital anaphylaxis. 226 50

Thirty-four dermatology out-patients with chronic idiopathic urticaria and 34 with idiopathic generalized pruritus were investigated using standardized self-assessment psychological questionnaires to determine the incidence of significant symptoms of depression and anxiety. These patients were compared with age- and sex-matched but otherwise unselected general dermatology out-patients. Using the Beck depression inventory, significantly more patients with generalized pruritus (32.4%) had depressive symptomatology (score greater than 14) than controls (13.2%, P less than 0.05). Although more patients with chronic urticaria had depressive symptomatology (14.7%) than controls (4.4%), the difference was not statistically significant. Using the Speilberger state-trait anxiety inventory there were no significant differences between the patients with pruritus or urticaria and their controls with respect to state or trait anxiety scores above the upper 90% probability limit for the general population. Thus, significant depression may be expected in a substantial proportion of patients with idiopathic generalized pruritus but in a relatively small proportion of those with chronic urticaria.
Br J Dermatol 1990 Dec
PMID:Anxiety and depression in patients with chronic urticaria and generalized pruritus. 226 93

Contact allergens produce three types of reactions. The commonest reaction is allergic contact dermatitis (ACD). The commonest contactants in Singapore causing ACD are, in decreasing order of importance, nickel, fragrances, neomycin, lanolin, colophony, flavine, rubber chemicals, paraphenylenediamine, clioquinol and chromates. Another type of allergic contact reaction is immunologic contact urticaria (ICU). ICU is an IgE mediated mechanisms. Contact allergens causing ICU in Singapore are proteinaceous foodstuffs and rubber latex products. Photoallergic contact dermatitis is occasionally seen in Singapore. The commonest agent is Musk Ambrette, a perfume fixature found in male colognes.
Singapore Med J 1990 Dec
PMID:Common environmental contact allergens in Singapore. 228 61

Study was made of immune responses in cow's milk allergy by a new immunoassay that measures total Ig-secreting cells and specific antibody-secreting cells during their maturation cycle in peripheral blood. These primed gut-associated lymphoid tissue-derived lymphocytes are assumed to reflect the intestinal immune responses. During diagnostic milk provocation, 15 patients had acute urticarial skin eruptions, eight patients had slow onset of eczema, and 15 showed symptoms from the gastrointestinal tract. A significant increase in IgM-secreting cells (means with 95% confidence intervals) from 382.2 (265, 552) to 621.4 (381, 1013)/10(6) cells, p less than 0.01, but not IgA- and IgG-secreting cells was associated with acute urticaria. In patients with eczematous skin eruptions and gastrointestinal symptoms, the response involved all these Ig isotypes. The magnitude of the postchallenge Ig-secreting cell responses in patients with gastrointestinal symptoms in the IgM class [from 657.9 (428, 1012) to 3544.0 (1696, 7406)/10(6) cells, p less than 0.001] and the IgA class [from 974.6 (590, 1610) to 2482.4 (1528, 4028)/10(6) cells, p = 0.001] significantly exceeded that of the patients with cutaneous symptoms. Notwithstanding the distinct increase in the total number of Ig-secreting cells, the specific antibody-secreting cell response specifically directed against beta-lactoglobulin and alpha-casein was small and inconsistent. These findings indicate that immune exclusion of milk antigens is defective in cow's milk allergy. The quality and extent of the response varied in the three reaction types, suggesting that different immunopathogenic mechanisms are operative in cow's milk allergy.
Pediatr Res 1990 Dec
PMID:Local immune response measured in blood lymphocytes reflects the clinical reactivity of children with cow's milk allergy. 228 53


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