Immunology and allergy clinics of North America
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Sarcoidosis is a multisystem granulomatous syndrome with a vast range of clinical manifestations. Since the first description of sarcoidosis in 1869, it has simultaneously intrigued and perplexed generations of physicians. ⋯ Medication is considered when there is risk of irreversible vital organ damage, substantial progression, or symptoms that are affecting quality of life. Recently, a range of steroid-sparing therapies have been adopted for sarcoidosis.
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The epidemiology of asthma and outdoor air pollution has shown that respiratory health effects can vary in relation to different emission sources, types of pollutants, underlying nutritional status, medication use, and genetic polymorphisms. Using sophisticated exposure assessment methods in conjunction with clinical tests and biomarkers that provide mechanistic information, the study of outdoor epidemiology and asthma has evolved into a complex multidisciplinary field. This article presents an overview of the mechanisms by which outdoor air pollution and traffic-related emissions lead to changes in respiratory health and lung function in subjects with asthma.
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Immunol Allergy Clin North Am · May 2015
ReviewAnaphylaxis to chemotherapy and monoclonal antibodies.
Hypersensitivity reactions are increasingly prevalent, although underrecognized and underreported. Platins induce immunoglobulin E-mediated sensitization; taxenes and some monoclonal antibodies can induce reactions at first exposure. Severe hypersensitivity can preclude first-line therapy. ⋯ Newer tests are promising diagnostic tools to help identify patients at risk before first exposure. Safe management includes rapid drug desensitization. This review provides information regarding the scope of hypersensitivity and anaphylactic reactions induced by chemotherapy and biological drugs, as well as diagnosis, management, and treatment options.
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Immunol Allergy Clin North Am · Aug 2009
ReviewThe variable clinical picture of drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms in relation to the eliciting drug.
Drug-induced hypersensitivity syndrome (DIHS)/drug rash with eosinophilia and systemic symptoms (DRESS) is a life-threatening adverse reaction characterized by skin rashes, fever, leukocytosis with eosinophilia or atypical lymphocytosis, lymph node enlargement, and liver or renal dysfunction. The syndrome develops 2 to 6 weeks after initiation of administration of a specific drug. It has been demonstrated that various herpesvirus reactivations, in addition to human herpesvirus 6, contribute to internal organ involvement and the relapse of symptoms observed long after discontinuation of the causative drugs. A better understanding of the interplay in the development of DIHS/DRESS has implications for safer and more efficient treatment of this syndrome.
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Immunol Allergy Clin North Am · Nov 2012
ReviewUpdate on diffuse alveolar hemorrhage and pulmonary vasculitis.
Diffuse alveolar hemorrhage is a clinical syndrome that can be a manifestation of multiple different causes. Identification of the underlying etiology is of utmost importance and dictates treatment. ⋯ For AAV, treatment includes induction followed by maintenance therapy. Rituximab has an increasing role in the treatment of AAV.