Allergie et immunologie
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Allergie et immunologie · Oct 2002
[Impact of the development of anesthesia protocols on the incidence of peri-anesthetic anaphylactoid reactions].
What impact does the use of new drugs and latex gloves it have on the frequency and the severity of peri-anaesthetic anaphylactoid reactions? Does the evolution of in vitro techniques does represent a progress in the imputability of the substances at the origin of the shock? ⋯ The experience of 17 years of allergo-anaesthetic consultation confirms the first row for the muscles relaxants for the target of anaphylactic shock, but the imputability of Vecuronium and Rocuronium increases to the detriment of the Suxamethonium. The Latex is in the second row, but the target questioning, the systematic use of Prick tests and "latex free" surgery room limit its increase which should change down. The antibiotherapy occupies the third row and might increase. 54 accidents have remained unexplained.
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Allergie et immunologie · Sep 2002
Review Comparative StudyAnaphylaxis to muscle relaxants: rational for skin tests.
IgE-dependent allergy to muscle relaxants (MR) has an estimated prevalence of 1 out of 6500 General Anesthesias (GA). 62% of anaphylaxis during surgery are due to MR anaphylaxis. All the molecules are divalent, carrying two NH4+ epitopes (quaternary ammonium ions), either structurally or after rapid in vivo protonization (vecuronium). The excellent overall performance of skin test makes them the golden standard for the diagnosis of anaphylactoid reactions. ⋯ Both types of tests can be used for the diagnosis. IDT have to be carried out for the search of the cross sensitization. 84% of patients do have cross sensitization to MRs but only 16% react to all MRs. The further use of MRs selected by negative IDTs has been proved to be safe.
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Cold urticaria is characterized by the development of urticaria, usually superficial and/or angioedematous reaction after cold contact. It was found predominantly in young women. The diagnosis is based on the history and ice cube test. ⋯ Doxepin may be useful in the treatment. Leukotriene receptor antagonists may be a novel, promising drug entity. In patients who do not respond to previous treatments, induction of cold tolerance may be tried.
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Allergie et immunologie · May 2002
[Study of the coverage of pollen capture in Lyon over three seasons (1999, 2000, 2001)].
For the third consecutive year, the two sensors of the type HIRST of the National Network of aerobiology monitoring (RNSA) worked on the agglomeration of Lyon. The primary trap (Lyon 1) is located at 26 m height on a roof in southern zone of Lyon (district of Gerland), the second (Lyon 2) is located in northern zone of the city (district of Vaise) on a roof at 15 m height compared to the ground. ⋯ Only the curves of pollens of ambrosia presented different layouts between the two pollen traps. The study of this third year makes it possible to consolidate the proceeding results and to appreciate the value of the cover of a Hirst pollen trap in urban implantation within the framework of the allergo-pollinic monitoring.
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Allergie et immunologie · Apr 2002
Review Case ReportsFood allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy).
Spices originate in various botanical families: Apiaceae, Lamiaceae, Lauraceae, Leguminosae, Liliaceae, Myristicaceae, Myrtaceae, Piperaceae, Solanaceae, Zingiberaceae.... ⋯ Frequent sensitization to Apiaceae is observed: coriander, caraway, fennel, celery: 32% of prick-tests in children, 23% of prick-tests in adults. Sensitization to Liliaceae: garlic, onion, chive, is observed in 4.6% of prick-tests in children, 7.7% of prick-tests in adults. Rare cases of sensitization to paprika and saffron are recorded. Prick-tests to nutmeg, ginger and clove are currently negative. 10 food allergies related to the mugwort-celery-spices syndrome are reported: coriander: 1, caraway: 2, fennel: 3, garlic: 3, onion: 1. Food allergy to spices is unfrequent: 2% of the totality of food allergies. However, only adults are allergic to spices and allergy to spices accounts for 6.4% of food allergies in adults. Tiny amount of proteins are usually ingested. Patients at risk of spice allergy are young adults sensitized to mugwort and birch allergens, sharing cross-sensitization with various food vegetal allergens. The clinical suspicion raises from frequent post-prandial systemic reactions. Other allergens of vegetal origin have to be cleared. Diagnosis can be established by DBPCFC using powdered spices in capsules.