Allergy and asthma proceedings :
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Mold-induced hypersensitivity pneumonitis results from macrophage- and lymphocyte-driven inflammation, which may be attributable to contaminated humidifiers or heating-ventilation systems or sources in homes, schools, or workplaces. A case may be suspected when there is water intrusion or inadequate drainage. Some fungal causes include species of Alternaria, Aspergillus, Cryptostroma, Penicillium, Pullularia, Rhodotorula, and Trichosporon. The differential diagnosis includes mold-induced asthma, sick building syndrome, mass psychogenic illness (epidemic hysteria), unjustified fears of "toxic" molds, and conditions causing recurrent pneumonitis.
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Allergy Asthma Proc · Jul 2004
Small bowel of patients with asthma and allergic rhinitis: absence of inflammation despite the presence of major cellular components of allergic inflammation.
Eosinophils participate in the pathogenesis of inflammatory diseases of the respiratory tract and the gut. We investigated the constitutive presence of eosinophils and mononuclear cells in the macroscopically normal duodenal mucosa of patients with asthma and allergic rhinitis. Macroscopically normal duodenal specimens were obtained at routine endoscopy for upper gastrointestinal symptoms from 16 patients with asthma and 13 patients with allergic rhinitis. ⋯ Mononuclear cells expressing CD4 (helper T cells) and CD68 (macrophages) also were significantly increased in the duodenal mucosa of asthma and rhinitis compared with controls. Accumulation of eosinophils in conjunction with IL-4+ cells and IL-5+ cells in the noninflamed duodenal mucosa may reflect a predominant T helper cell subset 2 systemic immune response in patients with asthma and allergic rhinitis. The absence of intestinal inflammation despite the marked presence of cells implicated in the allergic inflammation suggests that local mechanisms might determine the state of nonresponsiveness in the gut mucosa of patients with asthma and allergic rhinitis.
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Allergy Asthma Proc · Jul 2004
Case ReportsMucoid impaction: a localized form of allergic bronchopulmonary aspergillosis.
Mucoid impaction is defined as the obstruction of proximal bronchi by mucous plugs and exudates. There are striking similarities between patients with mucoid impaction and those with allergic bronchopulmonary aspergillosis (ABPA), often referred to as "mucoid microimpaction." We evaluated three patients with mucoid impaction for diagnostic criteria of ABPA and human leukocyte antigen type. We found that certain human leukocyte antigen types were common among mucoid impaction patients and those with ABPA. It is possible that patients with mucoid impaction could represent a localized form of ABPA.
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Since the elucidation of the structure of the cysteinyl leukotrienes (LTs) > 20 years ago, considerable progress has been made in our understanding of the role of these molecules in health and disease, particularly regarding bronchial asthma. This study will review the biochemistry of the 5-lipoxygenase pathway for LT generation. ⋯ It will briefly review tile evidence that LT-modifying drugs are effective in the management of bronchial asthma and will discuss novel developments in our understanding of the proinflammatory properties of the LTs including their role as autocrine mediators of leukocyte responses. The pharmacogenomics of 5-lipoxgenase and LTC4 synthase in bronchial asthma will be discussed.
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The incidence of generalized reactions during anesthesia has been reported to range from 1 in 5000 to 1 in 25,000 cases with a mortality rate of up to 6%. The most common causes are neuromuscular blocking agents, latex, and antibiotics. ⋯ We report a case of perioperative anaphylaxis to cefazolin. Sensitization to cefazolin was determined through skin testing, and the patient underwent successful surgery subsequently with the avoidance of cefazolin.