Revue francaise d'allergologie et d'immunologie clinique最新文献

Allergic conditions account for a large proportion of chronic diseases. Here, the presenting complaints of patients with allergic diseases seen in consultation with three general practitioners are compared with published epidemiologic data. Questionnaires from 346 patients (mean age 36.3 years, 213 women:133 men) were available for analysis. There was no statistically significant difference between the allergy as seen by the patients and that observed by the doctor (28.9% versus 35.3%, P = 0.09). Seventy-six percent of the allergic patients said that they had previously consulted their generalist for this problem. Forty-two percent reported a positive family history of allergy (63% of the allergic patients versus 33.3% of the nonallergic patients, P < 0.001). Allergic rhinitis was the most frequent complaint, reported by 19.8% of the patients, followed by conjunctivitis (14.4%), eczema (11.9%), asthma (7.6%), urticaria (5.8%), and angioedema (3.2%). For each of these complaints, the doctor's evaluation was practically identical. Food allergy, all complaints included, was claimed by 4% of the patients but food allergy was recognized by only 0.3% of the doctors. Drug allergy was reported by 10.8% of the patients and recognized as such by 7.8% of the doctors. In conclusion, the results of this study on allergic complaints reported by patients seen in general practice demonstrate no overvaluation of these complaints by the patients. These results are difficult to compare with published data, which are disparate.

The relationship between asthma, asthmatics and sport is somewhat complex, yet physical activity is necessary for the healthy development of children. Certain questions can be raised regarding asthmatics, for example, can sport trigger asthma? This is particularly the case for children. When used within a well-conducted physiotherapy programme for asthmatics, sport is a good means of reintroducing a normal physical activity. It is difficult for asthmatics to reach a high level in sport and the prescription of medication is often required. However, drugs must comply with the anti-doping regulations. Furthermore, when physical training is extremely intense, athletes can suffer from bronchial hyperreactivity, a type of bronchial irritation, and even from asthma.

The author discusses a number of new points in allergology, listed in alphabetical order : dust mite eviction (a new debatable meta-analysis) ; hidden food allergens (their high frequency) ; cetuximab (severe episodes of anaphylaxis) ; chlorine, asthma and allergies (how they are related requires discussion) ; emotions and allergies ; allergy to Harmonia axyridis (consequences of the ecological fight against insects in agriculture) ; stress and allergies (a question that has been debated) ; and eating disorders (a consequence of the increase in food allergy frequency). Although the choice of these topics may reflect the author’s subjective point of view, they nevertheless echo the diversity of today’s topics in allergology.

To evaluate whether fine air particles could be involved in the occurrence of atopy and allergic diseases, we performed a cross-sectional epidemiological survey involving primary schoolchildren living in six French towns with contrasted air pollution levels. Air pollution was measured during a week in the schoolyards and by standard air monitoring networks. Children get an examination in school looking for atopic dermatitis and bronchial hyperresponsiveness assessed by a standardized run test. Besides, parents or guardians provided past medical history and environmental data, especially on passive smoking. Overall, 5338 children, aged 10.4 (± 0.7) years, coming from 108 different schools and 401 different classes were included in the survey. Taking into account potential confounders, high exposure to proximity PM_2.5 was linked to a higher-point prevalence of atopic dermatitis and hyperresponsiveness, to a higher cumulative prevalence of allergic asthma and a higher sensitization rate to common indoor allergens. Thus, these data suggest that chronic exposure to urban fine particles could be a risk factor for atopy, hyperresponsiveness and asthma.

Patent blue and isosulfan blue dyes are currently used during sentinel lymph node biopsy. They can cause allergic reactions that can be relatively severe. Here we report the case of a patient who experienced a grade IV anaphylactic reaction, with tracheal obstruction that required three interventions. Skin tests done later confirmed allergy to patent blue dye; the tests induced a small syndrome reaction. Surgical personnel who use patent blue dye should be made aware of the risk of allergic reactions, sometimes severe, to this dye.

The celiaque disease is an autoimmune chronic inflammatory enteropathy caused by a food antigen the gliadin of gluten. The diagnosis of the disease is based on clinical, serological and histological features. The clinical forms are very variable. The most common signs are abdominal pain, chronic diarrhea, weight loss, bone diseases, anemia and asthaenia. Serologically, antiendomysium antibodies and antitransglutaminase antibodies allow, when they are positive, to confirm the clinical suspicion and to decide on a biopsy of small intestine. Histologically, biopsies of small intestine are indicated when the serological tests are positive. They alone can confirm the diagnosis. In The adult, they are necessarilly performed before a gluten-free diet (GFD). In childhood, biopsy is discussed because of the risks associated with general anesthesia. In the adult, the treatment is based on a GFD all life long. In childhood, the GFD can be interrupted after puberty. The observance of treatment is evaluated by the research of antibodies having served for the diagnosis.