Japanese Journal of Allergology最新文献

Hereditary angioedema (HAE) is a rare genetic disease characterized by recurrent episodes of temporary organ swelling. Here, we report a case of HAE type III who experienced recurrent acute abdominal pain after starting low-dose estrogen therapy. Genetic analysis by Sanger sequencing led to the identification of a recurrent heterozygous missense variant c.988A>G (p.K330E) in the plasminogen (PLG) gene of the patient. This variant was previously found in her elder sister who also had the disease. She was treated with tranexamic acid as a long-term prophylactic. Her attacks did not increase during her pregnancy. We managed the patient with intravenous injection of C1-INH preparation before and after delivery. As the frequency of attacks increased after delivery and after the resumption of menstruation, the dose of tranexamic acid was increased, and a subcutaneous injection of lanadelumab was started.While the severity of attacks reduced, she experienced the attacks once or twice a month. After switching from lanadelumab to twice-weekly subcutaneous injections of C1-inhibitor (C1-INH), she had no attacks requiring additional treatment, although she had several minor attacks. To establish appropriate treatment for HAE type III, accumulation of cases, determination of the causative gene in each case, and elucidation of the pathology are warranted.

Background: Although the prevalence of cedar pollinosis (CP) is increasing in Japan, some patients self-medicate with over-the-counter drugs after medical diagnosis, making it difficult for healthcare providers to grasp the actual situation. The aim of this study was to clarify the actual conditions of CP patients and assess the current status of sublingual immunotherapy (SLIT).

Methods: We conducted a nationwide Internet survey of adult patients with CP.

Results: A total of 5543 participants (mean age 45.4 years) self-reported having CP. Of these, 58.0% had received a physician's diagnosis, and 20.2% had not undergone allergy testing. In terms of severity, 14.8% were classified as "most severe" and 17.5% as "severe." Regarding treatment, 39.4% used over-the-counter medications and 38.3% visited medical institutions. The most frequently reported treatment-related issue was cost (36.2%). Additionally, 42.0% of patients were unaware of cedar SLIT.

Conclusion: Our survey revealed that approximately 20% of CP-diagnosed patients had not undergone testing. Awareness of SLIT was insufficient, indicating a need for greater dissemination of information about treatment options for CP.

Allergies to walnuts and cashew nuts are on the rise, and walnuts have been required to be labeled as a specific ingredient since March 2023, and labeling requirements are exempt for face-to-face sales. It is expected that the mandatory labeling of cashew nuts will be implemented within the fiscal year 2025. Here, we report two cases in which patients developed anaphylaxis despite heeding cautions regarding the mixing of nuts. Case 1: A child with apprehension about a walnut allergy developed symptoms of anaphylaxis after purchasing and consuming a "peanut cream bread" directly from a store. At a later date, an inquiry with the store revealed that the cream had been mixed with walnut paste. Case 2: A child with a history of anaphylaxis due to cashew nuts experienced symptoms of anaphylaxis after consuming curry bread bought directly from a store, although the child had inquired about the use of cashew nuts and had been reassured that it was all right. At a later date, an inquiry made to the distributor's headquarters revealed that the product did indeed contain cashew nuts. For children with nut allergies, it is important to not only instruct them to check the ingredient labels and store counters but also provide more specific guidance about foodstuffs that may possibly contain such allergens.