Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
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Eighty per cent of all childhood asthma has its onset by 3 years of age. A similar percentage of childhood asthma is associated with atopy (presence of allergic rhinitis or eczema and/or positive skin prick tests). Defined risk factors for childhood asthma include allergen exposure, environmental tobacco smoke, viral respiratory illness, the presence of other atopic disease, and gender. Although a large percentage of children will have remission of asthma as they grow, they will retain the intermediate phenotypes of increased airway responsiveness and allergen and, therefore, be at risk of recrudescence of disease in adult life.
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Immediate adverse reactions to anaesthetics have an immune mechanism in more than 50% of the cases. They are mainly due to muscle relaxant drugs. A prospective evaluation of tryptase, histamine and serotonin for diagnosing anaphylaxis to anaesthetics was performed over 2 years. ⋯ Specific IgE have been already observed in serum from patients allergic to muscle relaxant, thiopentone, morphine, phenoperidine, propofol and radio-contrast media. However, the recent progress in the identification of drug epitopes by Sepharose-solid drug phase IgE radioimmunoassay has to be reconsidered as non-specific binding of hydrophobic drugs such as propofol to hydrophobic serum IgE has been observed recently in patients with drug allergy. In addition, association of drugs such as propofol and muscle relaxant may potentiate the mediator release by a non-elucidated mechanism.