Pub Date : 2023-10-31DOI: 10.26416/aler.7.3.2023.8791
Cristina Uţa, Sandra‑Iulia Moldovan, Laura Haidar, C. Panaitescu
Histamine intolerance, also referred to as enteral histaminosis or sensitivity to dietary histamine, is a disorder associated with an impaired ability to metabolize ingested histamine that was described at the beginning of the 21st century. Although interest in histamine intolerance has considerably grown in recent years, more scientific evidence is still required to help define, diagnose and clinically manage this condition. This article will provide an updated review on histamine intolerance, mainly focusing on its etiology and the existing diagnostic, differential diagnoses and treatment strategies.
{"title":"Histamine intolerance","authors":"Cristina Uţa, Sandra‑Iulia Moldovan, Laura Haidar, C. Panaitescu","doi":"10.26416/aler.7.3.2023.8791","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8791","url":null,"abstract":"Histamine intolerance, also referred to as enteral histaminosis or sensitivity to dietary histamine, is a disorder associated with an impaired ability to metabolize ingested histamine that was described at the beginning of the 21st century. Although interest in histamine intolerance has considerably grown in recent years, more scientific evidence is still required to help define, diagnose and clinically manage this condition. This article will provide an updated review on histamine intolerance, mainly focusing on its etiology and the existing diagnostic, differential diagnoses and treatment strategies.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139307790","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}
Pub Date : 2023-10-31DOI: 10.26416/aler.7.3.2023.8793
Sandra‑Iulia Moldovan, Laura Haidar, C. Panaitescu
Pollen-food allergy syndrome (PFAS) is an immediate allergic reaction mediated by immunoglobulin E. This reaction occurs due to cross-reactivity between pollen and food in patients with previous pollen sensitization. PFAS causes symptoms such as itching, hives or oedema, mainly occurring in the lips, orally and pharyngeal, therefore being often referred to as oral allergy syndrome. However, systemic reactions such as anaphylaxis have been described more frequently recently. This diversity in the degree of symptoms is related to the types of trigger foods and the characteristics of the allergens (Jeon et al., 2020).
花粉-食物过敏综合征（PFAS）是一种由免疫球蛋白 E 介导的直接过敏反应。PFAS 会引起瘙痒、荨麻疹或水肿等症状，主要发生在嘴唇、口腔和咽部，因此常被称为口腔过敏综合征。不过，过敏性休克等全身性反应最近出现得更为频繁。症状程度的多样性与诱发食物的类型和过敏原的特性有关（Jeon 等人，2020 年）。
{"title":"Pollen-food allergy syndrome (PFAS)","authors":"Sandra‑Iulia Moldovan, Laura Haidar, C. Panaitescu","doi":"10.26416/aler.7.3.2023.8793","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8793","url":null,"abstract":"Pollen-food allergy syndrome (PFAS) is an immediate allergic reaction mediated by immunoglobulin E. This reaction occurs due to cross-reactivity between pollen and food in patients with previous pollen sensitization. PFAS causes symptoms such as itching, hives or oedema, mainly occurring in the lips, orally and pharyngeal, therefore being often referred to as oral allergy syndrome. However, systemic reactions such as anaphylaxis have been described more frequently recently. This diversity in the degree of symptoms is related to the types of trigger foods and the characteristics of the allergens (Jeon et al., 2020).","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139306589","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}
Proton pump inhibitors (PPIs) are highly safe medicines, commonly used as first-line treatment for various digestive diseases. However, as the use of PPIs expands, hypersensitivity reactions (HSRs), including both immediate and delayed reactions, have become more prevalent. The most frequent HSR observed in patients treated with PPIs is anaphylaxis. Skin tests (prick and intradermal) followed by an oral challenge test are suggested for accurately diagnosing HSRs to PPIs, due to their high specificity. It is crucial to understand the patterns of cross-reactivity among different PPIs to establish a safe therapeutic option and evaluate alternative drugs within the same class. If the patient does not tolerate the available therapeutic options and no other equally effective chemically unrelated drugs are available, a desensitization protocol should be initiated to ensure continuous medical treatment.
{"title":"Hypersensitivity reactions induced by proton pump inhibitors: diagnostic and management strategies","authors":"Alexandra Tiţa, Roxana-Marcela Criseru, Ana-Maria-Andreea Ioan, Selda Ali, Roxana Silvia Bumbăcea","doi":"10.26416/aler.7.3.2023.8790","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8790","url":null,"abstract":"Proton pump inhibitors (PPIs) are highly safe medicines, commonly used as first-line treatment for various digestive diseases. However, as the use of PPIs expands, hypersensitivity reactions (HSRs), including both immediate and delayed reactions, have become more prevalent. The most frequent HSR observed in patients treated with PPIs is anaphylaxis. Skin tests (prick and intradermal) followed by an oral challenge test are suggested for accurately diagnosing HSRs to PPIs, due to their high specificity. It is crucial to understand the patterns of cross-reactivity among different PPIs to establish a safe therapeutic option and evaluate alternative drugs within the same class. If the patient does not tolerate the available therapeutic options and no other equally effective chemically unrelated drugs are available, a desensitization protocol should be initiated to ensure continuous medical treatment.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139309383","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}
Pub Date : 2023-10-31DOI: 10.26416/aler.7.3.2023.8788
Cătălina-Elena Lavric, C. Berghea
Since 2013, a total of nine allergenic sources of gibberellin-regulated protein (GRP) have been described in the literature. The first gibberellin-regulated protein considered to be an allergen was extracted from peach (Prunus persica) and was named Pru p 7. This article aims to provide an overview of the GRP’s characteristics, to emphasize their importance and relevance in clinical practice, and to bring to attention the methods of diagnosis and treatment proposed in the literature published to date. After certain fruit consumption in patients sensitized to GRP, it has been described the occurrence of allergic reactions of various degrees (oral allergy syndrome, up to severe anaphylactic reactions). This fact raises a series of questions regarding the clinical expression of this sensitization, but also confers a change of perspective in relation to fruit allergy. At this moment, it is not clear if the sensitization to food GRP is always a primary sensitization or if the sensitization to food GRP appears subsequent to sensitization to Cupresaceae pollen’s GRP. Pru p 7 is considered to be a potential marker of severity in case of sensitization to peach allergens. Furthermore, the presence of cofactors in GRP sensitized patients may induce systemic allergic reactions. The diagnosis of this type of allergy might be difficult, and the personalized treatment is not yet available.
{"title":"Clinical relevance of gibberellin-regulated protein","authors":"Cătălina-Elena Lavric, C. Berghea","doi":"10.26416/aler.7.3.2023.8788","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8788","url":null,"abstract":"Since 2013, a total of nine allergenic sources of gibberellin-regulated protein (GRP) have been described in the literature. The first gibberellin-regulated protein considered to be an allergen was extracted from peach (Prunus persica) and was named Pru p 7. This article aims to provide an overview of the GRP’s characteristics, to emphasize their importance and relevance in clinical practice, and to bring to attention the methods of diagnosis and treatment proposed in the literature published to date. After certain fruit consumption in patients sensitized to GRP, it has been described the occurrence of allergic reactions of various degrees (oral allergy syndrome, up to severe anaphylactic reactions). This fact raises a series of questions regarding the clinical expression of this sensitization, but also confers a change of perspective in relation to fruit allergy. At this moment, it is not clear if the sensitization to food GRP is always a primary sensitization or if the sensitization to food GRP appears subsequent to sensitization to Cupresaceae pollen’s GRP. Pru p 7 is considered to be a potential marker of severity in case of sensitization to peach allergens. Furthermore, the presence of cofactors in GRP sensitized patients may induce systemic allergic reactions. The diagnosis of this type of allergy might be difficult, and the personalized treatment is not yet available.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"217 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308765","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}
Pub Date : 2023-10-31DOI: 10.26416/aler.7.3.2023.8794
Sandra‑Cristina Munthiu
Meat allergy used to be considered a rare hypersensitivity reaction, but case reports of mammalian and poultry meat allergies became more common about 20 years ago. Allergies to pets such as cats (Felis domesticus) and dogs (Canis familiaris) are the second most common indoor allergic reactions in Western countries, affecting both adults and children. An important step in fur allergy diagnosis has been the introduction of molecular allergen-based diagnosis, which offers new opportunities for improved allergen characterization. An example of these new characterizations is the meat reactions of patients suffering from pork-cat syndrome. Patients with this syndrome sensitized to albumin from animal epithelia report symptoms after eating pork because there is cross-reactivity to albumins from different species. The management of a patient with an allergic condition to fur-bearing animals includes a detailed history of exposure to relevant allergens, the effect of exposure on symptoms and subsequent recommendations for controlled exposure, and in the case of pig-cat syndrome, the patient can tolerate well-cooked red meat, but not the insufficiently prepared one.
{"title":"Pork-cat syndrome","authors":"Sandra‑Cristina Munthiu","doi":"10.26416/aler.7.3.2023.8794","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8794","url":null,"abstract":"Meat allergy used to be considered a rare hypersensitivity reaction, but case reports of mammalian and poultry meat allergies became more common about 20 years ago. Allergies to pets such as cats (Felis domesticus) and dogs (Canis familiaris) are the second most common indoor allergic reactions in Western countries, affecting both adults and children. An important step in fur allergy diagnosis has been the introduction of molecular allergen-based diagnosis, which offers new opportunities for improved allergen characterization. An example of these new characterizations is the meat reactions of patients suffering from pork-cat syndrome. Patients with this syndrome sensitized to albumin from animal epithelia report symptoms after eating pork because there is cross-reactivity to albumins from different species. The management of a patient with an allergic condition to fur-bearing animals includes a detailed history of exposure to relevant allergens, the effect of exposure on symptoms and subsequent recommendations for controlled exposure, and in the case of pig-cat syndrome, the patient can tolerate well-cooked red meat, but not the insufficiently prepared one.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308240","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}
Shellfish allergy is one of the most common food allergies, with an estimated prevalence of 3% in the general population. Crustaceans and mollusks are part of this food category, being capable of immunologic hypersensitivity reactions (IgE-mediated, as well as non-IgE-mediated), but also non-immunologic reactions, based on intoxication with certain neurotoxins from contaminated seafood, in which neurological but also gastrointestinal symptoms predominate. The clinical picture in IgE-mediated hypersensitivity reactions can vary in severity, from mild reactions such as oral allergy syndrome to severe reactions such as anaphylaxis. Among the delayed, non-IgE mediated reactions, we can identify food protein-induced enterocolitis syndrome, food protein-induced enteropathy and food protein-induced allergic proctocolitis, which mainly involve gastrointestinal symptoms. Over the past decades, the knowledge gained regarding the characteristics of different allergens has improved the diagnostic approach. Thus, for an accurate diagnosis of seafood-induced allergy, a thorough history, along with skin prick testing and specific IgE dosing are essential, and when these are insufficient, an oral challenge test can disentangle causality.
{"title":"Shellfish allergy – diagnostic approach","authors":"Denisa-Mihaela Nedelcu, Ancuţa-Mădălina Nedelcu, C. Budică, Selda Ali, Roxana Silvia Bumbăcea","doi":"10.26416/aler.7.3.2023.8792","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8792","url":null,"abstract":"Shellfish allergy is one of the most common food allergies, with an estimated prevalence of 3% in the general population. Crustaceans and mollusks are part of this food category, being capable of immunologic hypersensitivity reactions (IgE-mediated, as well as non-IgE-mediated), but also non-immunologic reactions, based on intoxication with certain neurotoxins from contaminated seafood, in which neurological but also gastrointestinal symptoms predominate. The clinical picture in IgE-mediated hypersensitivity reactions can vary in severity, from mild reactions such as oral allergy syndrome to severe reactions such as anaphylaxis. Among the delayed, non-IgE mediated reactions, we can identify food protein-induced enterocolitis syndrome, food protein-induced enteropathy and food protein-induced allergic proctocolitis, which mainly involve gastrointestinal symptoms. Over the past decades, the knowledge gained regarding the characteristics of different allergens has improved the diagnostic approach. Thus, for an accurate diagnosis of seafood-induced allergy, a thorough history, along with skin prick testing and specific IgE dosing are essential, and when these are insufficient, an oral challenge test can disentangle causality.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139309322","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}
Pub Date : 2023-10-31DOI: 10.26416/aler.7.3.2023.8789
Mădălina Coman-Stanemir, C. Berghea
Non-steroidal anti-inflammatory drug exacerbated respiratory disease (N-ERD) is predominantly encountered in adults and rarely documented and less well-defined clinically and epidemiologically in children. The cause remains unclear, with the main pathogenic mechanism being represented by a decrease in prostaglandin E2 production, increased production of cysteinyl-leukotrienes, and eosinophilic inflammation. N-ERD symptoms in the pediatric population are similar to those in adults: chronic eosinophilic rhinosinusitis with nasal polyps, asthma and respiratory symptoms upon aspirin/NSAID administration, but they can initially present with gastrointestinal or cutaneous symptoms or be more subtle, making early diagnosis difficult and requiring rigorous differential diagnosis. Pediatric onset of N-ERD should be considered by specialists when faced with cases of asthma associated with chronic rhinosinusitis and nasal polyps. Studies involving a larger number of patients are needed to determine the frequency of non-steroidal anti-inflammatory drug hypersensitivity in children with asthma and to establish the evolutionary and therapeutic characteristics of this patient category.
{"title":"Non-steroidal anti-inflammatory drug exacerbated respiratory disease (N-ERD) in the pediatric population","authors":"Mădălina Coman-Stanemir, C. Berghea","doi":"10.26416/aler.7.3.2023.8789","DOIUrl":"https://doi.org/10.26416/aler.7.3.2023.8789","url":null,"abstract":"Non-steroidal anti-inflammatory drug exacerbated respiratory disease (N-ERD) is predominantly encountered in adults and rarely documented and less well-defined clinically and epidemiologically in children. The cause remains unclear, with the main pathogenic mechanism being represented by a decrease in prostaglandin E2 production, increased production of cysteinyl-leukotrienes, and eosinophilic inflammation. N-ERD symptoms in the pediatric population are similar to those in adults: chronic eosinophilic rhinosinusitis with nasal polyps, asthma and respiratory symptoms upon aspirin/NSAID administration, but they can initially present with gastrointestinal or cutaneous symptoms or be more subtle, making early diagnosis difficult and requiring rigorous differential diagnosis. Pediatric onset of N-ERD should be considered by specialists when faced with cases of asthma associated with chronic rhinosinusitis and nasal polyps. Studies involving a larger number of patients are needed to determine the frequency of non-steroidal anti-inflammatory drug hypersensitivity in children with asthma and to establish the evolutionary and therapeutic characteristics of this patient category.","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308155","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}
Pub Date : 2023-01-01DOI: 10.26416/aler.7.2.2023.8194
Sabina-Loredana Corcea, Roxana Silvia Bumbăcea, Selda Ali, O. Coman
{"title":"Update on prospective markers of treatment response with omalizumab in chronic spontaneous urticaria","authors":"Sabina-Loredana Corcea, Roxana Silvia Bumbăcea, Selda Ali, O. Coman","doi":"10.26416/aler.7.2.2023.8194","DOIUrl":"https://doi.org/10.26416/aler.7.2.2023.8194","url":null,"abstract":"","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73895114","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}
Pub Date : 2023-01-01DOI: 10.26416/aler.7.2.2023.8200
Sandra‑Cristina Munthiu, C. Berghea
{"title":"Selection and significance of haptens in patch testing with contact allergens in patients with atopic eczema","authors":"Sandra‑Cristina Munthiu, C. Berghea","doi":"10.26416/aler.7.2.2023.8200","DOIUrl":"https://doi.org/10.26416/aler.7.2.2023.8200","url":null,"abstract":"","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72988595","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}
Pub Date : 2023-01-01DOI: 10.26416/aler.7.2.2023.8193
A. Nedelcu, Denisa-Mihaela Nedelcu, C. Budică, Selda Ali, Roxana Silvia Bumbăcea
{"title":"Updates in the management of fish allergy","authors":"A. Nedelcu, Denisa-Mihaela Nedelcu, C. Budică, Selda Ali, Roxana Silvia Bumbăcea","doi":"10.26416/aler.7.2.2023.8193","DOIUrl":"https://doi.org/10.26416/aler.7.2.2023.8193","url":null,"abstract":"","PeriodicalId":7524,"journal":{"name":"Alergologia","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73593066","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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