allergy
Allergy to tartrazine in psychotropic drugs.

Bhatia MS.

Department of Psychiatry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. dbmi ucms.ernet.in

BACKGROUND: High psychiatric morbidity has been reported among those who complain of food intolerance or allergy. Many cases of food allergy or intolerance to drugs are not due to allergy to the food or drugs themselves, but to the additives used for coloring, flavoring, preserving, thickening, emulsifying, or stabilizing the product. Of various coloring dyes used, tartrazine (FD & C yellow no. 5) is the color most frequently incriminated in producing allergic reactions. The exact epidemiology and pattern of allergic reactions to tartrazine in psychotropic drugs have not been frequently studied and reported. METHOD: The present study included consecutive outpatients (May 1996 to April 1998) who developed allergic reactions or intolerance to tartrazine in psychotropic drugs. Total patients exposed to tartrazine-containing drugs were also recorded. The subjects showing allergic reactions to tartrazine were then exposed to non-tartrazine-containing brands. RESULTS: Of 2210 patients exposed to tartrazine-containing drugs, 83 (3.8%) developed allergic reactions. The symptoms subsided within 24 to 48 hours of stopping the drug. None of the patients showed allergy to non-tartrazine-containing brands. History of allergy to tartrazine was present in 13.2%, and 15.7% of patients had a history of aspirin sensitivity. CONCLUSION: Tartrazine allergy should be considered in patients developing drug allergy, because it would require changing the brand rather than stopping treatment with that drug.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10937604&dopt=Abstract allergy medicine



allergy
[Allergy to nickel, chromium and cobalt after osteosynthesis]

[Article in Polish]

Liebhart J, Kus H, Martosz M, Rutowski R, Malolepszy J, Obojski A, Medrala W.

Katedry i Kliniki Chorob Wewnetrznych i Alergologii Akademii Medycznej we Wroclawiu.

Metals are known as a common cause of contact allergies. The prevalence of sensitisation to the composite metals makes for a potential risk of osteosynthesis complications in patients suffering from long bones fractures. In the study the prevalence of delayed allergy to nickel sulphate, potassium dichromate and cobalt was estimated as well as the relation to the osteosynthesis complications. The atopy prevalence was estimated too. Persons under examination were divided into 3 groups. I--treated with osteosynthesis without complications (n = 20), II--treated with osteosynthesis with synostosis complications (n = 16) and III--negative controls (n = 34). We estimated 5% prevalence of delayed allergy to nickel in group I, 6.25% in group II and 5.8% in group III. In patients exposed to chromium we observed delayed allergy prevalence of 5.8% in group I and 3% in group III. No allergy to chromium in group II was revealed. No allergy to cobalt in all groups was revealed. The prevalence of atopy in group II was rare (6.35%) when in group I it was 45% and in controls 32%. The more frequent occurrence of type IV allergy to metals in atopic patients was not confirmed. There was no difference between the prevalence of delayed allergy to metals in groups I and II. Only one case of secondary allergy to chromium was observed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10944950&dopt=Abstract allergy medicine



allergy
Costs of beta-lactam allergies: selection and costs of antibiotics for patients with a reported beta-lactam allergy.

MacLaughlin EJ, Saseen JJ, Malone DC.

School of Pharmacy, Texas Tech Health Sciences Center, Amarillo, TX 79106, USA. ericmac cortex.ama.ttuhsc.edu

OBJECTIVE: To evaluate antibiotic selection and the cost effect of reported beta-lactam allergies. DESIGN: Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported beta-lactam allergy with a group in which no such allergy had been documented. SETTING: University-based family medicine clinic. PATIENTS: Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion. MAIN OUTCOME MEASURES: Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported beta-lactam allergy. RESULTS: Of the 660 patients eligible for inclusion, 99 (15%) had a documented beta-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a beta-lactam allergy was significantly higher compared with those without a beta-lactam allergy ($26.81 vs $16.28, respectively; P =.004). Patients with a beta-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P =.001). CONCLUSIONS: Patients with a beta-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true beta-lactam allergies; however, further study is needed to determine its cost-effectiveness.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10927711&dopt=Abstract allergy medicine



allergy
The psychological burden of peanut allergy as perceived by adults with peanut allergy and the parents of peanut-allergic children.

Primeau MN, Kagan R, Joseph L, Lim H, Dufresne C, Duffy C, Prhcal D, Clarke A.

Divisions of; Allergy/Clinical Immunology; Rheumatology, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.

BACKGROUND: Peanut-allergic patients are affected by a condition which forces them and their families to exercise extreme dietary vigilance and experience constant uncertainty throughout their lives. OBJECTIVE: To compare the quality of life and family relations of children and adults with a peanut allergy to that of children and adults with a rheumatological disease. METHODS: Patients with a confirmed diagnosis of peanut allergy or a rheumatological disease completed (for children less than 18 years, by proxy) self-report questionnaires regarding the impact of their condition on their quality of life and family relations. A vertical visual analogue scale and the Impact on Family Questionnaire (IFQ) served as outcome measures. RESULTS: One hundred and fifty-three peanut-allergic children were compared with 69 children with a rheumatological disease while 37 peanut-allergic adults were compared with 42 adults with a rheumatological disease. The parents of peanut-allergic children, compared to the parents of children with a rheumatological disease, reported that their children had significantly more disruption in their daily activities. Furthermore, the parents of peanut-allergic children reported more impairment in the familial-social dimension of the IFQ. Conversely, adults with a chronic rheumatological disease reported more disruption in their family relations than peanut-allergic adults. CONCLUSION: Given the considerable disruption in daily activities and family relations reported by the parents of peanut-allergic children, accurate diagnosis of peanut allergy is essential. Our work should make health care professionals dealing with children with confirmed peanut allergy more aware of the support that these families may require. Furthermore, we hope to motivate food industries to offer more 'peanut free' products to decrease the dietary restrictions of these patients while minimizing their potential for accidental ingestion.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10931121&dopt=Abstract allergy medicine



allergy
Allergy caused by ingestion of zucchini (Cucurbita pepo): characterization of allergens and cross-reactivity to pollen and other foods.

Reindl J, Anliker MD, Karamloo F, Vieths S, Wuthrich B.

Paul-Ehrlich Institute, Department of Allergology, Langen, Germany.

BACKGROUND: Allergy to zucchini (Cucurbita pepo), a member of the Cucurbitaceae family, has not previously been reported. We examined 4 patients complaining of allergic symptoms, such as oral allergy syndrome, nausea, diarrhea, or pruritus, after the intake of zucchini. OBJECTIVE: After the confirmation of food allergy, we wanted to characterize zucchini allergens and examine possible cross-reactions to pollen and food. METHODS: The patients underwent skin prick and prick-to-prick-testing with different allergens, including zucchini, latex, and birch, ragweed, and grass pollen. Moreover a double-blind, placebo-controlled, food challenge was performed to confirm food allergy. Total and specific serum IgE levels were determined by using CAP-FEIA and the enzyme allergosorbent test method (EAST), respectively. Proteins from zucchini reacting with patient IgE were detected by means of immunoblotting. To characterize cross-reacting IgE antibodies, immunoblot- and EAST-inhibition assays were carried out. RESULTS: All patients in this study had positive reactions to zucchini both in prick-to-prick tests and double-blind, placebo-controlled, food challenges. Specific serum IgE levels to zucchini were found in all cases. In blot- and EAST-inhibition assays IgE from two patients revealed binding to zucchini profilin at about 15 kd. Furthermore, in two cases, including one of the profilin-positive patients, IgE directed against cross-reacting carbohydrate determinants was detected. For one patient, no cross-reacting IgE could be found, but IgE from this patient reacted strongly with a zucchini protein at 17 kd. CONCLUSIONS: We report the first 4 cases of food allergy to zucchini. Zucchini allergens can cause systemic reactions and are at least partially heat stable. We suggest that allergy to zucchini can occur as a result of primary sensitization to zucchini, as well as to cross-reactions to the panallergen profilin and cross-reacting carbohydrate determinants.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10932084&dopt=Abstract allergy medicine



allergy
Prevalence of latex allergy may be vastly overestimated when determined by in vitro assays.

Yeang HY.

Biotechnology and Strategic Research Unit, Rubber Research Institute of Malaysia, Kuala Lumpur.

BACKGROUND: The prevalence of latex-specific IgE computed from the results of serologic assays is commonly thought to reflect, to a greater or lesser extent, the prevalence of latex allergy and its implied risk. OBJECTIVE: The study examines how imperfect test specificity of in vitro assays influences the precision of latex allergy prevalence that it estimates. METHODS: Various models encompassing a range of hypothetical test sensitivity and specificity values are investigated to gauge their influence on the estimate of latex allergy prevalence. The models examine these interactions in situations of high or low allergy prevalence. RESULTS: Serologic latex diagnostic assays with test specificity within the range of those of commercially available assays can greatly overestimate prevalence where the true prevalence is low (eg, of the order of one in 100 or one in 1,000). A formula to correct for errors in prevalence estimates arising from imperfect test sensitivity and specificity of an in vitro assay is presented. CONCLUSION: While serologic assays for latex IgE pose few hazards to the patient and are useful for confirming the diagnosis of latex allergy, the test results may vastly overestimate the true prevalence of latex allergy and its associated risks in situations where latex allergy is actually rare.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10875493&dopt=Abstract allergy medicine



allergy
A murine model of peanut anaphylaxis: T- and B-cell responses to a major peanut allergen mimic human responses.

Li XM, Serebrisky D, Lee SY, Huang CK, Bardina L, Schofield BH, Stanley JS, Burks AW, Bannon GA, Sampson HA.

Department of Pediatrics, Mount Sinai School of Medicine, New York, USA.

BACKGROUND: Peanut allergy affects 0.6% of the US population. At the present time, allergen avoidance is the only therapeutic option. Animal models of food-induced anaphylaxis would facilitate attempts to design novel immunotherapeutic strategies for the treatment of peanut allergy. OBJECTIVE: The purpose of this study was to develop a murine model of IgE-mediated peanut hypersensitivity that closely mimics human peanut allergy. METHODS: C3H/HeJ mice sensitized orally with freshly ground whole peanut and cholera toxin as adjuvant were challenged orally 3 and 5 weeks later with crude peanut extract. Anaphylactic reactions were determined. T- and B-cell responses to Ara h 1 and Ara h 2, the major peanut allergens, were characterized by evaluating splenocyte proliferative responses and IgE antibody concentrations. Furthermore, IgE antibodies in the sera of patients with peanut allergy and mice were compared for antibody binding to Ara h 2 isoforms and allergenic epitopes. RESULTS: Peanut-specific IgE was induced by oral peanut sensitization, and hypersensitivity reactions were provoked by feeding peanut to sensitized mice. The symptoms were similar to those seen in human subjects. Ara h 1- and Ara h 2-specific antibodies were present in the sera of mice with peanut allergy. Furthermore, these Ara h 2-specific IgE antibodies bound the same Ara h 2 isoforms and major allergenic epitopes as antibodies in the sera of human subjects with peanut allergy. Splenocytes from mice with peanut allergy exhibited proliferative responses to Ara h 1 and Ara h 2. CONCLUSION: This murine model of peanut allergy mimics the clinical and immunologic characteristics of peanut allergy in human subjects and should be a useful tool for developing immunotherapeutic approaches for the treatment of peanut allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10887318&dopt=Abstract allergy medicine