Since December 2019, an outbreak of a novel coronavirus (SARS-CoV-2) infection causing COVID-19 disease has influenced the whole world Angiotensin converting enzyme 2 (ACE2) receptors on type 2 pneumocytes in humans were determined as the entry for SARS-CoV-2 Receptor binding and subsequently endocytosis of ACE2 diminish the cell membrane expression and also the function of ACE2 ACE2 is an enzyme involved in bradykinin metabolism Lys-des-Arg9-BK occured with enzymatic cleaving of Lys-BK derived from low molecular weight kininogen is inactivated by ACE2 in tissues and it is a vasodilator agent having its own receptor named bradykinin B1 Non-metabolized Lys-des-Arg9-BK can be the reason for tissue vasodilation and increased vascular permeability in the patients with COVID-19 Increased bradykinin levels in patients with hereditary angioedema with C1-INH deficiency (C1-INH-HAE) do not cause increased SARS-CoV-2 infection or more severe disease Although SARS-CoV-2 infection does not result in increased bradykinin levels, it can increase Lys-des-Arg9-BK levels
{"title":"COVID-19 Disease and Hereditary Angioedema","authors":"Aycan Aşık, N. Mete Gökmen","doi":"10.21911/AAI.562","DOIUrl":"https://doi.org/10.21911/AAI.562","url":null,"abstract":"Since December 2019, an outbreak of a novel coronavirus (SARS-CoV-2) infection causing COVID-19 disease has influenced the whole world Angiotensin converting enzyme 2 (ACE2) receptors on type 2 pneumocytes in humans were determined as the entry for SARS-CoV-2 Receptor binding and subsequently endocytosis of ACE2 diminish the cell membrane expression and also the function of ACE2 ACE2 is an enzyme involved in bradykinin metabolism Lys-des-Arg9-BK occured with enzymatic cleaving of Lys-BK derived from low molecular weight kininogen is inactivated by ACE2 in tissues and it is a vasodilator agent having its own receptor named bradykinin B1 Non-metabolized Lys-des-Arg9-BK can be the reason for tissue vasodilation and increased vascular permeability in the patients with COVID-19 Increased bradykinin levels in patients with hereditary angioedema with C1-INH deficiency (C1-INH-HAE) do not cause increased SARS-CoV-2 infection or more severe disease Although SARS-CoV-2 infection does not result in increased bradykinin levels, it can increase Lys-des-Arg9-BK levels","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41525074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronavirus disease 2019 (Covid 19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV 2) and causes lymphopenia, immunosuppression, inefficient T and B cell immunity, cytokine storm, and destructive tissue inflammation Since COVID 19 is a multi-system disease predominantly affecting the lungs, there is doubt on whether chronic lung diseases place patients at higher risk and SARS CoV2 leads to asthma exacerbation None of the studies have reported asthma or recurrent wheezing as a comorbidity or risk factor for Covid 19 in children up to now Notably, further studies are needed to explore the relationship between Covid 19 and asthma to improve clinical practice and decrease morbidity and mortality
{"title":"Childhood Asthma and Covid 19","authors":"Ö. Soyer","doi":"10.21911/AAI.561","DOIUrl":"https://doi.org/10.21911/AAI.561","url":null,"abstract":"Coronavirus disease 2019 (Covid 19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV 2) and causes lymphopenia, immunosuppression, inefficient T and B cell immunity, cytokine storm, and destructive tissue inflammation Since COVID 19 is a multi-system disease predominantly affecting the lungs, there is doubt on whether chronic lung diseases place patients at higher risk and SARS CoV2 leads to asthma exacerbation None of the studies have reported asthma or recurrent wheezing as a comorbidity or risk factor for Covid 19 in children up to now Notably, further studies are needed to explore the relationship between Covid 19 and asthma to improve clinical practice and decrease morbidity and mortality","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49384438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Montelukast is a leukotriene receptor antagonist that is used to treat allergy and asthma. It acts as a cysteinyl leukotriene receptor antagonist that blocks the action of leukotrienes and decreases inflammation. This agent is generally well tolerated in clinical practice. Although montelukast is generally considered as a safe drug, it can cause a few adverse drug reactions. In this case study, a rare side effect of montelukast that has been reported only twice before is presented. The importance of this case report is that the youngest patient who had ecchymosis due to the use of montelukast treatment is reported
{"title":"Ecchymosis: An Unexpected Side Effect of Montelukast","authors":"G. Eser, M. Berber, Hülya Ercan Sarıçoban","doi":"10.21911/aai.570","DOIUrl":"https://doi.org/10.21911/aai.570","url":null,"abstract":"Montelukast is a leukotriene receptor antagonist that is used to treat allergy and asthma. It acts as a cysteinyl leukotriene receptor antagonist that blocks the action of leukotrienes and decreases inflammation. This agent is generally well tolerated in clinical practice. Although montelukast is generally considered as a safe drug, it can cause a few adverse drug reactions. In this case study, a rare side effect of montelukast that has been reported only twice before is presented. The importance of this case report is that the youngest patient who had ecchymosis due to the use of montelukast treatment is reported","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48040636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.
{"title":"Aerosol Medication Use in COVID-19 Pandemic","authors":"M. Topel, K. Aksu","doi":"10.21911/aai.539","DOIUrl":"https://doi.org/10.21911/aai.539","url":null,"abstract":"Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43915282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Aytekin, Fatih Çölkesen, Eray Yıldız, Ş. Arslan, A. Çalışkaner
Objective: Common variable immunodeficiency (CVID) is a relatively frequent primary immunodeficiency disorder characterized by impaired B cell differentiation with hypogammaglobulinemia in the European Society for Immunodeficiencies (ESID) registry system. Increased inflammatory cytokines, prolonged and/or recurrent infections, gastrointestinal complications, and anti-inflammatory medications are risk factors for diminished bone mineral density (BMD) in CVID patients. Materials and Methods: The study group included 32 patients with CVID (19 males and 13 females; mean age: 37.33 ± 13.70 years, 40.6% female), who had been followed up on a regular basis for a period of four years. The patients were categorized into two groups according to their BMD: low BMD and normal BMD. Results: Seventeen patients (8 females and 9 males) had normal BMD (mean age 34.94 ± 11.41 years, 47.1% female) and fifteen patients (5 females and 10 males) had low BMD (mean age 40.03 ± 15.87 years, 33.3% female). In the low BMD group, three patients had osteoporosis and 12 patients had osteopenia. Univariate regression analysis revealed that lymphopenia (odds ratio, OR:6.562, 95% confidence interval, CI: 1.095-39.324, p=0.039) was significantly associated with low BMD. Multivariate regression analysis showed that higher alkaline phosphatase (ALP) levels (OR:1.017, 95% CI 1.001-1.033, p=0.041), lymphopenia (OR:11.028, 95% CI 1.326-91.709, p=0.026), and lower folic acid levels (OR:1.284, 95% CI 1.007-1.637, p=0.043) were also independent predictors for low BMD. Conclusion: Even with some limitations such as the small number for the study population, a single center experience, and a crosssectional design, we recommend that clinical immunologists should be alert for diminished BMD in CVID patients, especially those with low folic acid and high ALP levels and lymphopenia.
{"title":"Bone Metabolism Alterations in Patients with Common Variable Immune Deficiency: A Retrospective Cohort Study","authors":"G. Aytekin, Fatih Çölkesen, Eray Yıldız, Ş. Arslan, A. Çalışkaner","doi":"10.21911/aai.501","DOIUrl":"https://doi.org/10.21911/aai.501","url":null,"abstract":"Objective: Common variable immunodeficiency (CVID) is a relatively frequent primary immunodeficiency disorder characterized by impaired B cell differentiation with hypogammaglobulinemia in the European Society for Immunodeficiencies (ESID) registry system. Increased inflammatory cytokines, prolonged and/or recurrent infections, gastrointestinal complications, and anti-inflammatory medications are risk factors for diminished bone mineral density (BMD) in CVID patients. Materials and Methods: The study group included 32 patients with CVID (19 males and 13 females; mean age: 37.33 ± 13.70 years, 40.6% female), who had been followed up on a regular basis for a period of four years. The patients were categorized into two groups according to their BMD: low BMD and normal BMD. Results: Seventeen patients (8 females and 9 males) had normal BMD (mean age 34.94 ± 11.41 years, 47.1% female) and fifteen patients (5 females and 10 males) had low BMD (mean age 40.03 ± 15.87 years, 33.3% female). In the low BMD group, three patients had osteoporosis and 12 patients had osteopenia. Univariate regression analysis revealed that lymphopenia (odds ratio, OR:6.562, 95% confidence interval, CI: 1.095-39.324, p=0.039) was significantly associated with low BMD. Multivariate regression analysis showed that higher alkaline phosphatase (ALP) levels (OR:1.017, 95% CI 1.001-1.033, p=0.041), lymphopenia (OR:11.028, 95% CI 1.326-91.709, p=0.026), and lower folic acid levels (OR:1.284, 95% CI 1.007-1.637, p=0.043) were also independent predictors for low BMD. Conclusion: Even with some limitations such as the small number for the study population, a single center experience, and a crosssectional design, we recommend that clinical immunologists should be alert for diminished BMD in CVID patients, especially those with low folic acid and high ALP levels and lymphopenia.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41786582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is a rare, idiosyncratic, life-threatening drug reaction with a variety of clinical manifestations including symptoms of fever higher than 38.5 oC, pruritic maculopapular or erythematous eruption, hematologic abnormalities, lymphadenopathy, and multiorgan involvement. Its incidence ranges from 1 in 1000 to 1 in 10,000 drug exposures, and it has an estimated mortality rate of up to 10%. To date, many drugs have been reported to cause DRESS syndrome, but the most common ones are the anticonvulsants and sulfonamides, although the pathogenesis is not clearly understood. Deficiency or defects in the epoxide hydroxylase enzyme, which detoxifies the metabolites of aromatic anticonvulsants, an insufficiency in the detoxification of the drug leading to reactive metabolites which may trigger immunologic reactions, predispositions due to some HLA alleles, and reactivation of herpes viruses are suggested to play a role in the pathogenesis. The latent period varies from two to six weeks. Hematologic, hepatic, renal, cardiac, pulmonary, neurologic, gastrointestinal and endocrine involvement; and hemophagocytic syndrome can be seen during the clinical course of DRESS syndrome. The long term sequels of DRESS syndrome include hepatic, renal and adrenal failure; diabetes mellitus type 1 and type 2, Graves disease, autoimmune hemolytic anemia, lupus, systemic sclerosis, and autoimmune enteropathy. Diagnosis of DRESS syndrome is difficult to establish, and requires a high degree of initial clinical suspicion and ruling out of other etiologies. The most important step in the management of DRESS syndrome is early diagnosis and prompt withdrawal of the offending drug. In cases with organ involvement, systemic corticosteroid treatment is required. In serious and steroid-resistant cases, using more potent immunosuppressive agents or intravenous immunoglobulin treatments may be required.
{"title":"Dress Syndrome","authors":"S. Bahçeci, Demet Can","doi":"10.21911/aai.444","DOIUrl":"https://doi.org/10.21911/aai.444","url":null,"abstract":"Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is a rare, idiosyncratic, life-threatening drug reaction with a variety of clinical manifestations including symptoms of fever higher than 38.5 oC, pruritic maculopapular or erythematous eruption, hematologic abnormalities, lymphadenopathy, and multiorgan involvement. Its incidence ranges from 1 in 1000 to 1 in 10,000 drug exposures, and it has an estimated mortality rate of up to 10%. To date, many drugs have been reported to cause DRESS syndrome, but the most common ones are the anticonvulsants and sulfonamides, although the pathogenesis is not clearly understood. Deficiency or defects in the epoxide hydroxylase enzyme, which detoxifies the metabolites of aromatic anticonvulsants, an insufficiency in the detoxification of the drug leading to reactive metabolites which may trigger immunologic reactions, predispositions due to some HLA alleles, and reactivation of herpes viruses are suggested to play a role in the pathogenesis. The latent period varies from two to six weeks. Hematologic, hepatic, renal, cardiac, pulmonary, neurologic, gastrointestinal and endocrine involvement; and hemophagocytic syndrome can be seen during the clinical course of DRESS syndrome. The long term sequels of DRESS syndrome include hepatic, renal and adrenal failure; diabetes mellitus type 1 and type 2, Graves disease, autoimmune hemolytic anemia, lupus, systemic sclerosis, and autoimmune enteropathy. Diagnosis of DRESS syndrome is difficult to establish, and requires a high degree of initial clinical suspicion and ruling out of other etiologies. The most important step in the management of DRESS syndrome is early diagnosis and prompt withdrawal of the offending drug. In cases with organ involvement, systemic corticosteroid treatment is required. In serious and steroid-resistant cases, using more potent immunosuppressive agents or intravenous immunoglobulin treatments may be required.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43439599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Aytekin, Eray Yıldız, Fatih Çölkesen, Ş. Arslan, A. Çalışkaner
Objective: Common Variable Immune Deficiency (CVID) is a heterogeneous immune disorder characterized by impaired and/or inadequate B cell differentiation with hypogammaglobulinemia. It is characterized by frequent and recurrent respiratory infections, autoimmune disorders, chronic lung diseases, granulomatous diseases, and increased risk for lymphoid malignancies. Materials and Methods: The medical records of 47 patients (22 females, 25 males) who had been followed up at our clinic and had sufficient data in their files were retrospectively reviewed. Patients were diagnosed with CVID according to the ESID (European Society for Immunodeficiency) criteria. Results: The median age of the patients was 32 (19-65) years. The most frequent clinical presentation of the patients was with recurrent upper respiratory infections (46%), pneumonia (29.8%), otitis media (23.4%) and chronic sinusitis (17%). During the follow-up period, 17 patients (36.8%) developed autoimmune complications, 14 (29.8%) of whom had autoimmune cytopenia. A total of 26 patients (55.3%) had bronchiectasis confirmed with computed tomography of the thorax. Lymphopenia was detected in 13 patients (27.7%). The median immunoglobulin level at the time of diagnosis was IgG 2.77 (0.33-6.90) g/L, IgM 0.31 (0.06-5.99) g/L, and IgA 0.25 (0.01- 5.02) g/L. Conclusion: CVID is very heterogeneous in terms of both clinical and laboratory features. Moreover, it is more common than expected, particularly in adulthood. The centers dealing with CVID should share their experiences in order to increase awareness among physicians.
{"title":"Five Years of Experience in a Single Center: Retrospective Analysis of Adult Patients with Common Variable Immunodeficiency","authors":"G. Aytekin, Eray Yıldız, Fatih Çölkesen, Ş. Arslan, A. Çalışkaner","doi":"10.21911/aai.504","DOIUrl":"https://doi.org/10.21911/aai.504","url":null,"abstract":"Objective: Common Variable Immune Deficiency (CVID) is a heterogeneous immune disorder characterized by impaired and/or inadequate B cell differentiation with hypogammaglobulinemia. It is characterized by frequent and recurrent respiratory infections, autoimmune disorders, chronic lung diseases, granulomatous diseases, and increased risk for lymphoid malignancies. Materials and Methods: The medical records of 47 patients (22 females, 25 males) who had been followed up at our clinic and had sufficient data in their files were retrospectively reviewed. Patients were diagnosed with CVID according to the ESID (European Society for Immunodeficiency) criteria. Results: The median age of the patients was 32 (19-65) years. The most frequent clinical presentation of the patients was with recurrent upper respiratory infections (46%), pneumonia (29.8%), otitis media (23.4%) and chronic sinusitis (17%). During the follow-up period, 17 patients (36.8%) developed autoimmune complications, 14 (29.8%) of whom had autoimmune cytopenia. A total of 26 patients (55.3%) had bronchiectasis confirmed with computed tomography of the thorax. Lymphopenia was detected in 13 patients (27.7%). The median immunoglobulin level at the time of diagnosis was IgG 2.77 (0.33-6.90) g/L, IgM 0.31 (0.06-5.99) g/L, and IgA 0.25 (0.01- 5.02) g/L. Conclusion: CVID is very heterogeneous in terms of both clinical and laboratory features. Moreover, it is more common than expected, particularly in adulthood. The centers dealing with CVID should share their experiences in order to increase awareness among physicians.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46755296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Highlight the asthma situation in this pandemic. Describe the safety aspects of patients and health professionals. Discuss its severity, control, risk factors, therapeutic management of chronic disease and its exacerbations. Methods: Data were collected from the scientific literature on the topic asthma in the context of the COVID-19 pandemic. A search was performed in PubMed databases, using the descriptors: asthma, coronavirus infections, pandemics, risk factors, drug therapy and spirometry. Results: Asthma has not been identified as a significant risk factor for severe COVID-19 disease, perhaps due to the lower expression of angiotensin-converting enzyme receptors in atopic asthma. Groups were identified, among severe asthmatics, with greater expression of these receptors. Conclusions: Nebulizers should be avoided, spacers should not be shared and spirometry or peak expiratory flow measurement is not recommended. All asthmatics should be maintained on inhaled corticosteroids. Short-acting beta2-agonist only treatment is not recommended from the age of 12. As-needed low dose inhaled corticosteroid with formoterol is the prefered reliever for this age group and can be offered together on the same device. From 6 to 11-years-old, reliever medication should preferably be short-acting beta2-agonists, associated with low dose inhaled corticosteroids and applied in separate devices. In severe asthma, tiotropium should precede the indication of the immunobiological and this, when in use, should not be interrupted.
{"title":"Asthma and COVID-19","authors":"E. Çelebioğlu","doi":"10.21911/aai.531","DOIUrl":"https://doi.org/10.21911/aai.531","url":null,"abstract":"Objectives: Highlight the asthma situation in this pandemic. Describe the safety aspects of patients and health professionals. Discuss its severity, control, risk factors, therapeutic management of chronic disease and its exacerbations. Methods: Data were collected from the scientific literature on the topic asthma in the context of the COVID-19 pandemic. A search was performed in PubMed databases, using the descriptors: asthma, coronavirus infections, pandemics, risk factors, drug therapy and spirometry. Results: Asthma has not been identified as a significant risk factor for severe COVID-19 disease, perhaps due to the lower expression of angiotensin-converting enzyme receptors in atopic asthma. Groups were identified, among severe asthmatics, with greater expression of these receptors. Conclusions: Nebulizers should be avoided, spacers should not be shared and spirometry or peak expiratory flow measurement is not recommended. All asthmatics should be maintained on inhaled corticosteroids. Short-acting beta2-agonist only treatment is not recommended from the age of 12. As-needed low dose inhaled corticosteroid with formoterol is the prefered reliever for this age group and can be offered together on the same device. From 6 to 11-years-old, reliever medication should preferably be short-acting beta2-agonists, associated with low dose inhaled corticosteroids and applied in separate devices. In severe asthma, tiotropium should precede the indication of the immunobiological and this, when in use, should not be interrupted.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44790967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 15-year-old male patient presented with complaints of erythema, urticaria and burning on the hands, feet and trunk after contact with cold objects, liquids and/or air for the last two-years. There was no mucosal site involvement and no associated symptoms. The physical examination was normal. The cold provocation test was positive. Biochemistry, hemogram, ESR, CRP, urine analysis, stool examination, latex specific IgE, RF, ANA, skin prick test with common aeroallergens including dust mites, yeasts, animal allergens, various tree and grass pollens, and the serum specific IgE, C3, C4, thyroid function tests, cryoglobulins, cold agglutinins, HIV and HBsAg testing demonstrated normal/negative results. The total IgE level was 5.520 IU/ml in the beginning but decreased to 2.150 IU/ml after 15 months. Due to chronicity of his symptoms and the lack of a triggering factor other than cold, he was diagnosed with type I cold contact urticaria (CCU). Despite using different antihistamines for 10 months, his have persisted. With the use of subcutaneous omalizumab at the dose of 300 mg/month, the symptoms were under control after 3 months (urticaria activity score and Omalizumab was well tolerated. and particularly the severe form (type III) has a considerable effect on the quality of no to been there is no biomarker to predict the response to omalizumab. This case report shows that omalizumab could be useful for the CCU patients.
{"title":"Chronic (Cold) Contact Urticaria Treated Successfully with Anti-IgE (Omalizumab)","authors":"Ö. Özdemir","doi":"10.21911/AAI.455","DOIUrl":"https://doi.org/10.21911/AAI.455","url":null,"abstract":"A 15-year-old male patient presented with complaints of erythema, urticaria and burning on the hands, feet and trunk after contact with cold objects, liquids and/or air for the last two-years. There was no mucosal site involvement and no associated symptoms. The physical examination was normal. The cold provocation test was positive. Biochemistry, hemogram, ESR, CRP, urine analysis, stool examination, latex specific IgE, RF, ANA, skin prick test with common aeroallergens including dust mites, yeasts, animal allergens, various tree and grass pollens, and the serum specific IgE, C3, C4, thyroid function tests, cryoglobulins, cold agglutinins, HIV and HBsAg testing demonstrated normal/negative results. The total IgE level was 5.520 IU/ml in the beginning but decreased to 2.150 IU/ml after 15 months. Due to chronicity of his symptoms and the lack of a triggering factor other than cold, he was diagnosed with type I cold contact urticaria (CCU). Despite using different antihistamines for 10 months, his have persisted. With the use of subcutaneous omalizumab at the dose of 300 mg/month, the symptoms were under control after 3 months (urticaria activity score and Omalizumab was well tolerated. and particularly the severe form (type III) has a considerable effect on the quality of no to been there is no biomarker to predict the response to omalizumab. This case report shows that omalizumab could be useful for the CCU patients.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48797757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Aytekin, S. Fındık, Fatih Çölkesen, Eray Yıldız, A. Çalışkaner
Systemic Mastocytosis (SM) is one of the subtypes of mast cell disorders. Patients with SM suffer from flushing, abdominal cramps and hypotension. It may also cause unexplained and recurrent anaphylactic episodes sometimes. The secretion of mediators can be triggered by various factors. Non-steroidal anti-inflammatory drugs (NSAIDs) are extensively used for their analgesic, antipyretic and anti-inflammatory properties, and they are one of the most commonly prescribed drugs in the world. On the other hand, they may cause a group of adverse reactions, ranging from mild reactions like gastritis to life-threatening allergic reactions like anaphylaxis. In this paper, we report a patient who had multiple severe adverse reactions against NSAIDs and was referred to our clinic to find a safe alternative NSAID. She was eventually diagnosed with Indolent SM (ISM) when she was evaluated with all of her systemic complaints and symptoms.
{"title":"An Indolent Cause of Recurrent Anaphylaxis with NSAIDs: Systemic Mastocytosis","authors":"G. Aytekin, S. Fındık, Fatih Çölkesen, Eray Yıldız, A. Çalışkaner","doi":"10.21911/AAI.447","DOIUrl":"https://doi.org/10.21911/AAI.447","url":null,"abstract":"Systemic Mastocytosis (SM) is one of the subtypes of mast cell disorders. Patients with SM suffer from flushing, abdominal cramps and hypotension. It may also cause unexplained and recurrent anaphylactic episodes sometimes. The secretion of mediators can be triggered by various factors. Non-steroidal anti-inflammatory drugs (NSAIDs) are extensively used for their analgesic, antipyretic and anti-inflammatory properties, and they are one of the most commonly prescribed drugs in the world. On the other hand, they may cause a group of adverse reactions, ranging from mild reactions like gastritis to life-threatening allergic reactions like anaphylaxis. In this paper, we report a patient who had multiple severe adverse reactions against NSAIDs and was referred to our clinic to find a safe alternative NSAID. She was eventually diagnosed with Indolent SM (ISM) when she was evaluated with all of her systemic complaints and symptoms.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41913164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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