Asia Pacific Allergy最新文献

Bee pollen is becoming an increasingly popular health supplement worldwide due to its many therapeutic applications. Thirteen cases of anaphylaxis to bee pollen consumption have been published to date, with plant pollen of the Compositae family being the most frequently implicated allergen. We present the first known paediatric case of bee pollen anaphylaxis in Australia involving a 15-year-old boy who had a strongly positive skin prick test to the bee pollen consumed where exercise was a possible co-factor. Our patient had a history of allergic rhinitis like most earlier cases. Our patient also had a strongly positive skin prick test to overseas-sourced bee pollen despite no relevant travel history, indicating the likelihood of a common pollen grain or cross-allergenicity of pollen grains found within both bee pollens. Our case reinforces the importance of a careful dietary history including health supplements when assessing for anaphylaxis.

Background: Early introduction of allergenic foods is recommended to reduce the risk of developing food allergies, but it is unclear whether recommendations are being followed.

Objective: We examine patterns of allergenic food introduction in inner-city children enrolled in an academic pediatric practice in the greater Los Angeles area.

Methods: This was a prospective study with patients ages 12 to 24 months recruited from the pediatrics continuity clinic at an inner-city tertiary medical center in the greater Los Angeles area. Caregivers were asked via anonymous surveys about their child's history of atopic diseases and at what age they first introduced egg, soy, wheat, peanut, tree nuts, fish, shrimp, and shellfish into their child's diet.

Results: Two hundred caregivers responded to the survey. The average age of introduction of egg was 9.2 months, soy 10 months, wheat 9.3 months, peanut 10.5 months, tree nuts 10.9 months, fish 10.9 months, shrimp 11.3 months, and shellfish 11.5 months. Between ages 4-11 months, 65.3% of children were introduced egg, 19.1% soy, 55.8% wheat, 28.6% peanut, 17.1% tree nuts, 28.1% fish, 13.6% shrimp, and 7.0% shellfish. By age 24 months, 92% of children were introduced egg, 37.7% soy, 85.4% wheat, 67.3% peanut, 47.7% tree nuts, 67.8% fish, 48.2% shrimp, and 30.2% shellfish. Of the 14 children with eczema or egg allergy, 26.1% were introduced peanut by age 4-6 months and 50% by age 4-11 months.

Conclusion: Despite recommendations, inner-city caregivers may not be introducing allergenic foods in a timely manner to their children.

Background: Medically unexplained physical symptoms are a well-recognized problem and, in some cases, there is a well-established relationship between behavior and psychopathological disturbances. However, the association between drug hypersensitivity reactions and psychoactive disorders stills under discussion.

Objective: Our main goal was to establish if there is an association between self-reported drug hypersensitivity reaction and psychopathology with need for psychoactive drug consumption.

Methods: Retrospective study of adult patients evaluated in a first Immunoallergology appointment because of self-reported drug hypersensitivity over 1 year and register of data concerning psychoactive drugs use. Compare the study group with patients observed for allergic respiratory disease along the same year.

Results: The study group included 70 patients that referred a total of 92 self-reported drug hypersensitivity reactions. Twenty-nine (41.4%) were under treatment with psychoactive drugs: 20 (70%) were treated with anxiolytics, 13 (18.6%) with antidepressants, 15 (21.4%) with sedatives, and 1 (1.4%) with antipsychotics. The control group included 160 patients and 38 patients (23.8%) were under treatment with psychoactive drugs: 31 (19.4%) where treated with antidepressants, 29 (18.1%) with anxiolytics, and 3 (1.9%) with sedatives. The use of psychoactive drugs in the study group is higher than in the control group (p = 0.007), the difference is especially important for sedative drugs (p < 0.001). Besides a higher use of psychoactive drugs, the study group also has a higher frequency of use of several psychoactive drug (p = 0.002).

Conclusion: Patients with a self-report drug hypersensitivity have more tendency to be under treatment with psychoactive drugs and could have more tendency to somatization. Personality traces and psychopathology must be taken into account during an allergy workup.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions, most commonly triggered by medications, characterized by extensive necrosis and detachment of the epidermis.

Objective: We investigated the differences in clinical characteristics of drug-induced SJS/TEN depending on the type of drug in a single center.

Methods: The relevance of sex, age, culprit drugs, clinical features, courses, treatment options, and follow-up results were retrospectively evaluated in patients diagnosed with drug-induced SJS/TEN at Pusan National University Hospital between 2008 and 2019.

Results: Ninety-two patients with a mean age of 58.7 ± 20.2 years (range, 10-93 years) were included in the study. Those aged 60-80 years accounted for the largest number of patients (42.4%). Patients with drug-induced SJS/TEN comprised 40 women (43.5%) and 52 men (56.5%). We categorized drug-induced SJS/TEN cases by culprit drugs into 6 groups: antibiotics, allopurinol, antiepileptic (AED), nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and other drugs. The rate of NSAID-induced disease significantly increased from SJS to TEN (p = 0.016). Among the patients in the NSAID group, the proportion of TEN (40%) was higher than that in the other groups (p = 0.021). The mean body surface area was significantly lower in the AED group than in the non-AED groups (7.1 ± 9.8 vs. 23.1 ± 27.3, p = 0.020) and higher in the NSAID group than in the non-NSAID groups (47.5 ± 39.5 vs. 15.7 ± 20.0, p = 0.010).

Conclusion: This study showed that the clinical characteristics of each causative drug group may be different in drug-induced SJS/TEN. Our findings may help clinicians better understand drug-induced SJS/TEN.