1,128 results
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2. Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)
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Roberto Berni Canani, Carlo Caffarelli, Mauro Calvani, Alberto Martelli, Laura Carucci, Tommaso Cozzolino, Patrizia Alvisi, Carlo Agostoni, Paolo Lionetti, and Gian Luigi Marseglia
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Adverse food reactions ,Food allergy ,Carbohydrates intolerance ,Lactose intolerance ,Anaphylaxis ,Component resolved diagnosis ,Pediatrics ,RJ1-570 - Abstract
Abstract Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.
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- 2022
- Full Text
- View/download PDF
3. Hypersensitivity reactions to chemotherapy: an EAACI Position Paper
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Patrizia Bonadonna, Emilio Alvarez-Cuesta, Adile Berna Dursun, Soledad Sanchez Sanchez, Mariana Castells, Josefina Cernadas, Mauro Pagani, Hamadi Sahar, Anca M. Chiriac, Ricardo Madrigal-Burgaleta, and Sevim Bavbek
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Drug ,medicine.medical_specialty ,Allergy ,media_common.quotation_subject ,medicine.medical_treatment ,Immunology ,Provocation test ,Drug allergy ,Antineoplastic Agents ,Disease ,Drug Hypersensitivity ,Neoplasms ,Humans ,Immunology and Allergy ,Medicine ,Intensive care medicine ,Anaphylaxis ,Skin Tests ,media_common ,Desensitization (medicine) ,business.industry ,medicine.disease ,Desensitization, Immunologic ,Position paper ,business - Abstract
Chemotherapeutic drugs have been widely used in the treatment of cancer disease for about 70 years. The development of new treatments has not hindered their use, and oncologists still prescribe them routinely, alone or in combination with other antineoplastic agents. However, all chemotherapeutic agents can induce hypersensitivity reactions (HSRs), with different incidences depending on the culprit drug. These reactions are the third leading cause of fatal drug-induced anaphylaxis in the United States. In Europe, deaths related to chemotherapy have also been reported. In particular, most reactions are caused by platinum compounds, taxanes, epipodophyllotoxins and asparaginase. Despite their prevalence and relevance, the ideal pathways for diagnosis, treatment and prevention of these reactions are still unclear, and practice remains considerably heterogeneous with vast differences from center to center. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology organized a task force to provide data and recommendations regarding the allergological work-up in this field of drug hypersensitivity reactions. This position paper aims to provide consensus on the investigation of HSRs to chemotherapeutic drugs and give practical recommendations for clinicians that treat these patients, such as oncologists, allergologists and internists. Key sections cover risk factors, pathogenesis, symptoms, the role of skin tests, in vitro tests, indications and contraindications of drug provocation tests and desensitization of neoplastic patients with allergic reactions to chemotherapeutic drugs. Statements, recommendations and unmet needs were discussed and proposed at the end of each section.
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- 2021
4. Frequency of allergic reactions in egg allergic patients after receiving the yellow fever vaccine.
- Author
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García-Paba MB, Aparicio C, Rodríguez M, Moreno S, and García E
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- Humans, Cross-Sectional Studies, Retrospective Studies, Vaccines, Anaphylaxis, Egg Hypersensitivity epidemiology, Egg Proteins adverse effects, Yellow Fever Vaccine adverse effects
- Abstract
Background: Immunization with live attenuated viral yellow fever vaccine (YFV) grants effective immunity in most cases, and is recommended and prioritized for residents and travelers of endemic countries. YFV is seldom administered to egg-allergic patients (EAP) since it is cultivated in embryonated chicken eggs and may contain residual egg proteins, being a problem for egg-allergic residents and travelers of endemic countries., Objective: Describe the frequency of allergic reactions after YFV administration in confirmed EAP from an allergy outpatient center in Bogotá, Colombia., Methods: An observational, retrospective, cross-sectional, and descriptive study was conducted from January 2017 to December 2019. EAP whose allergy was confirmed with a positive Skin Prick Test (SPT) and/or egg protein-specific IgE levels who hadn't received the YFV were included. Every patient had an SPT, severe EAP, and an additional Intradermal Test (IDT) done with the vaccine. If the vaccine SPT and IDT were negative, the YFV was administered as a single dose; if either were positive, the YFV was administered in graded doses. Statistical analysis was done in Stata16MP., Results: Seventy one patients were included, 24 (33.8%) of those had a history of egg anaphylaxis. All patients had negative YFV SPTs, and two of the five YVF IDTs were positive. Two patients, with previous egg-anaphylaxis, presented allergic reactions to the vaccine., Conclusions: YFV did not trigger allergic reactions in EAP without history of egg-anaphylaxis. With further research, safe single-dose vaccination to this population could be considered; however, patients with previous egg-anaphylaxis should be evaluated by an allergist before vaccination.
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- 2023
- Full Text
- View/download PDF
5. The role of mobile health technologies in allergy care: An EAACI position paper
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Jean Bousquet, Jean-Christoph Roger J-P Caubet, James Gardner, Ralph Mösges, Simon Blank, Dermot Ryan, Alla Nakonechna, Daniel Perez-Formigo, Markus Ollert, Ignacio Esteban-Gorgojo, Ileana Ghiordanescu, Darío Antolín-Amérigo, Giovanni Battista Pajno, Jörn Wittmann, Jeroen Buters, Elisa Boni, Constantinos Pitsios, Karin Hoffmann-Sommergruber, Knut Brockow, Philippe Gevaert, Uwe Berger, Harmieke van Os-Medendorp, Matteo Bonini, Tania Elliott, Peter Hellings, Jennifer Shih, Marina Atanaskovic-Markovic, Salvatore Tripodi, Michael S. Blaiss, Stephanie Dramburg, A. Fusun Kalpaklioglu, Ioana Agache, Oliver Pfaar, Lauri-Ann Van der Poel, João Fonseca, Christian Apfelbacher, Ozlem Cavkaytar, Gilda Varricchi, Jose Oteros, S. Sanchez-Garcia, Farid Marmouz, Alberto Alvarez-Perea, Victoria Cardona, Ángela Meijide Calderón, Paolo Maria Matricardi, Michael Rudenko, Catalina Panaitescu, Margitta Worm, KKÜ, Ear, Nose and Throat, Kırıkkale Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kalpaklıoğlu, A. Fusun, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Hospital General Universitario 'Gregorio Marañón' [Madrid], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), University of Regensburg, University of Belgrade [Belgrade], Medizinische Universität Wien = Medical University of Vienna, Augusta University - Medical College of Georgia, University System of Georgia (USG), Center of Allergy & Environment (CK-CARE, ZAUM), Helmholtz-Zentrum München (HZM), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Royal Brompton Hospital, Fondazione 'Policlinico Universitario A. Gemelli' [Rome], Università cattolica del Sacro Cuore [Roma] (Unicatt), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Technical University of Munich (TUM), Vall d'Hebron University Hospital [Barcelona], Geneva University Hospital (HUG), Istanbul Medeniyet University [Istanbul, Turquie] (IMU), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU), General Hospital of Villalba [Madrid], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto, Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Great North Children's Hospital, Partenaires INRAE, Newcastle University [Newcastle], Ghent University Hospital, Emergency University Hospital Elias, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Kirikkale, Hopital Réné Dubos, University of Vigo [ Pontevedra], University Hospital of Cologne [Cologne], Clinical Research International Ltd., Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool Hope University, Luxembourg Institute of Health (LIH), University of Southern Denmark (SDU), University of Messina, Romanian Primary Care Respiratory Group (RespiRo), Hospital Universitario de Torrejón, Univ Politecn Madrid, Ctr Tecnol Biomed, Pozuelo De Alarcon 28223, Madrid, Spain, Philipps Universität Marburg, University of Cyprus (UCY), Centre Harley Street Allergy Clinic, Centre of Medical Informatics [Edinburgh, UK] (Usher Institute of Population Health Sciences and Informatics), University of Edinburgh, Hospital Infantil Universitario Niño Jesús [Madrid, Spain] (HIUNJ), Institute of Health Carlos III, Emory University School of Medicine, Emory University [Atlanta, GA], Policlinico Casilino (Ospedale Policlinico Casilino), Medical Physics Department,Guy's and St Thomas'NHS Foundation Trust, London, UK, Medical Physics Department, London, UK, Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust-Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust, University Medical Center [Utrecht], 'Federico II' University of Naples Medical School, Transilvania University of Brasov, Helmholtz Zentrum München = German Research Center for Environmental Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Universidade do Porto = University of Porto, Philipps Universität Marburg = Philipps University of Marburg, University of Cyprus [Nicosia] (UCY), Hospital Infantil Universitario Niño Jesús (HIUNJ), Salvy-Córdoba, Nathalie, Matricardi, Paolo Maria, Dramburg, Stephanie, Alvarez-Perea, Alberto, Antolín-Amérigo, Darío, Apfelbacher, Christian, Atanaskovic-Markovic, Marina, Berger, Uwe, Blaiss, Michael S, Blank, Simon, Boni, Elisa, Bonini, Matteo, Bousquet, Jean, Brockow, Knut, Buters, Jeroen, Cardona, Victoria, Caubet, Jean-Christoph, Cavkaytar, Özlem, Elliott, Tania, Esteban-Gorgojo, Ignacio, Fonseca, Joao A, Gardner, Jame, Gevaert, Philippe, Ghiordanescu, Ileana, Hellings, Peter, Hoffmann-Sommergruber, Karin, Kalpaklioglu, A Fusun, Marmouz, Farid, Meijide Calderón, Ángela, Mösges, Ralph, Nakonechna, Alla, Ollert, Marku, Oteros, José, Pajno, Giovanni, Panaitescu, Catalina, Perez-Formigo, Daniel, Pfaar, Oliver, Pitsios, Constantino, Rudenko, Michael, Ryan, Dermot, Sánchez-García, Silvia, Shih, Jennifer, Tripodi, Salvatore, Van der Poel, Lauri-Ann, van Os-Medendorp, Harmieke, Varricchi, Gilda, Wittmann, Jörn, Worm, Margitta, Agache, Ioana, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
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0301 basic medicine ,MESH: Drug Hypersensitivity ,MESH: Asthma ,Allergy ,MESH: Chronic Urticaria ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,immunoglobulin E ,0302 clinical medicine ,Immunology and Allergy ,Chronic Urticaria ,Position paper ,Disease management (health) ,MESH: Desensitization, Immunologic ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,mHealth ,Self-management ,ddc:618 ,Health technology ,Disease Management ,allergen-immunotherapy ,Mobile Applications ,Telemedicine ,EAACI ,allergy ,digital health ,mobile health technology ,position paper ,3. Good health ,Dermatitis, Allergic Contact ,biomarker ,MESH: Mobile Applications ,Psychology ,allergic rhiniti ,Digital health ,Food Hypersensitivity ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,allergen ,molecular allergology ,Immunology ,Internet privacy ,component-resolved-diagnosi ,Context (language use) ,Mobile health technology ,MESH: Disease Management ,Dermatitis, Atopic ,Drug Hypersensitivity ,03 medical and health sciences ,[SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Dermatitis, Allergic Contact ,IgE test ,MESH: Dermatitis, Atopic ,Humans ,Mobile technology ,Anaphylaxis ,Physician-Patient Relations ,[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Humans ,business.industry ,Rhinitis, Allergic, Seasonal ,MESH: Rhinitis, Allergic, Seasonal ,asthma ,molecular spreading ,[SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology ,diagnostic algorithm ,MESH: Anaphylaxis ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,Digital Health ,Eaaci ,Mobile Health Technology ,Position Paper ,MESH: Telemedicine ,MESH: Food Hypersensitivity ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,MESH: Physician-Patient Relations ,business ,[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology - Abstract
Oteros, Jose/0000-0002-9369-8633; Fonseca, Joao Almeida/0000-0002-0887-8796; Alvarez-Perea, Alberto/0000-0001-7417-7309; Oteros, Jose/0000-0002-9369-8633; Gevaert, Philippe/0000-0002-1629-8468; Antolin, Dario/0000-0001-5699-4022; Apfelbacher, Christian/0000-0003-3805-8219; Buters, Jeroen/0000-0003-3581-5472; Berger, Uwe E./0000-0002-9265-2131; Blank, Simon/0000-0002-5649-1078; Cardona, Victoria/0000-0003-2197-9767; Dramburg, Stephanie/0000-0002-9303-3260 WOS: 000486665800001 PubMed: 31230373 Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.
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- 2020
6. White paper on peanut allergy- part1: Epidemiology, burden of disease, health economic aspects
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Hans F. Merk, Christian Vogelberg, Natalija Novak, Sven Becker, Katja Nemat, Thomas Spindler, Eckard Hamelmann, Michael Gerstlauer, Adam Chaker, Randolf Brehler, Torsten Zuberbier, Norbert Mülleneisen, Thomas Fuchs, Kirsten Beyer, Holger Wrede, Wolfgang Czech, Wolfgang Wehrmann, Tobias Ankermann, Ludger Klimek, Sebastian Schmidt, Kirsten Jung, Andrea Bauer, Wolfgang Schlenter, Katharina Blumchen, Uta Rabe, Lars Lange, Johannes Ring, and Thilo Jakob
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Burden of disease ,medicine.medical_specialty ,Allergy ,Review ,Food allergy ,Anaphylaxis ,Oral immunotherapy ,COVID-19 ,Children ,business.industry ,Peanut allergy ,food and beverages ,Allergen avoidance ,medicine.disease ,ddc ,White paper ,Environmental health ,Epidemiology ,medicine ,Immunology and Allergy ,ddc:610 ,business - Abstract
Peanuts are Leguminosae, commonly known as the legume or pea family, and peanut allergy is among the most common food allergies and the most common cause of fatal food reactions and anaphylaxis.The prevalence of peanut allergy increased 3.5-fold over the past two decades reaching 1.4–2% in Europe and the United States. The reasons for this increase in prevalence are likely multifaceted. Sensitization via the skin appears to be associated with the development of peanut allergy and atopic eczema in infancy is associated with a high risk of developing peanut allergy.Until recently, the only possible management strategy for peanut allergy was strict allergen avoidance and emergency treatment including adrenaline auto-injector in cases of accidental exposure and reaction.This paper discusses the various factors that impact the risks of peanut allergy and the burden of self-management on peanut-allergic children and their caregivers.
- Published
- 2021
7. Primary, secondary and tertiary prevention of food allergy: current practices and future directions.
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Cronin C, Salzberg N, Woon Y, and Wurttele JT
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- Infant, Child, Female, Pregnancy, Humans, Child, Preschool, Tertiary Prevention, Breast Feeding, Diet methods, Allergens, Arachis, Anaphylaxis prevention & control, Food Hypersensitivity epidemiology
- Abstract
The incidence of food allergies has risen around the globe, and experts have been exploring methods of preventing such allergies in young children to ease the burden of disease and reduce the morbidity and mortality caused by anaphylaxis to food allergens. Such preventative measures can be categorised as primary, secondary and tertiary prevention, which are discussed in detail in this review. Primary prevention is defined as the prevention of becoming sensitised towards specific allergens. The evidence suggests that avoiding common allergenic foods during pregnancy and breastfeeding is not protective against food allergies, and guidelines recommend weaning from 4 to 6 months of age, with recent studies supporting the early introduction of peanuts at 4 months to prevent peanut allergy. Secondary prevention targets patients who are already sensitised and aims to halt the progression of sensitisation, with evidence for high rates of success and safety in trials of early introduction to milk and peanuts using oral immunotherapy in sensitised infants. Tertiary allergy prevention focuses on reducing the risk of a patient having anaphylaxis, with oral immunotherapy being the most common method of promoting tolerance in allergic children. Several studies have demonstrated successful reintroduction for milk, egg and peanut; however, no such guidelines are recommended for other foods. Finally, dietary advancement therapy in the form of milk and egg ladders has been employed as a method of primary, secondary and tertiary prevention of allergies, particularly in Ireland, the UK and Canada.
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- 2024
- Full Text
- View/download PDF
8. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions
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Didier G. Ebo, Ingrid Terreehorst, Susanna Voltolini, Tomaz Garcez, Peter Kopač, Jose Julio Laguna, Paul-Michel Mertes, Pascale Dewachter, Kathrin Scherer, Lene H. Garvey, Anca Mirela Chiriac, Ear, Nose and Throat, and AII - Inflammatory diseases
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0301 basic medicine ,Hypersensitivity, Immediate ,Premedication ,Severity of Illness Index ,antibiotics ,alergija in imunologija -- diagnostika ,opioid analgesics ,0302 clinical medicine ,opioidni analgetiki ,Immunology and Allergy ,opioidi ,Incidence ,Disease Management ,preobčutljivost za zdravila -- diagnostika ,anafilaksija ,Phenotype ,Disease Susceptibility ,medicine.medical_specialty ,udc:616.097:(615.211+615.216.2) ,non-steroidal opioids ,Immunology ,anesthesia ,anti-inflammatory agents ,anestezija ,Diagnosis, Differential ,03 medical and health sciences ,allergy and immunology -- diagnosis ,antibakterijska sredstva ,anti-bacterial agents ,anesthetics ,medicine ,anaphylaxis ,Humans ,anestetiki ,nesteroidna protivnetna sredstva ,Intensive care medicine ,Perioperative Period ,Skin Tests ,drug hypersensitivity -- diagnosis ,Task force ,business.industry ,Diagnostic Tests, Routine ,Perioperative ,Immunoglobulin E ,030104 developmental biology ,030228 respiratory system ,Position paper ,Allergists ,Human medicine ,business ,antibiotiki - Abstract
Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate-type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.
- Published
- 2020
9. ARIA-EAACI statement on severe allergic reactions to COVID-19 vaccines -- an EAACI-ARIA Position Paper
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Ruby Pawankar, Giorgio Walter Canonica, Eva Untersmayr, Torsten Zuberbier, Margitta Worm, Marek Jutel, Mübeccel Akdis, Stefano Del Giacco, Ioana Agache, Ludger Klimek, María José Torres, Anna Bedbrook, Mohamed H. Shamji, Jean Bousquet, Johannes Ring, Liam O'Mahony, and Cezmi A. Akdis
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medicine.medical_specialty ,Allergy ,business.industry ,medicine.disease ,Herd immunity ,Vaccination ,Health care ,medicine ,Position paper ,Medical history ,Intensive care medicine ,business ,Adverse effect ,Anaphylaxis - Abstract
Coronavirus disease 2019 (COVID-19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as the exclusion of all these patients from vaccination may have a significant impact on reaching the goal of population immunity. Health care practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognise and treat anaphylaxis properly with the ability to administer adrenaline. A mandatory observation period after vaccine administration of at least 15 minutes for all individuals should be followed. The current guidelines, which exclude patients with severe allergies from vaccination with BNT162b2, should be re-evaluated after more information and experience with the new vaccine develops.
- Published
- 2020
10. ARIA‐EAACI statement on severe allergic reactions to COVID‐19 vaccines – An EAACI‐ARIA Position Paper
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Ioana Agache, Eva Untersmayr, Torsten Zuberbier, Jean Bousquet, Karin Hoffmann-Sommergruber, Mübeccel Akdis, María José Torres, Stefano Del Giacco, Cezmi A. Akdis, G. Walter Canonica, Anna Bedbrook, Ludger Klimek, Marek Jutel, Edward F. Knol, Margitta Worm, Tomas Chivato, Mohamed H. Shamji, Johannes Ring, Jürgen Schwarze, Liam O'Mahony, University of Zurich, and Klimek, Ludger
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0301 basic medicine ,Allergy ,medicine.medical_specialty ,COVID-19 Vaccines ,Immunology ,Population ,610 Medicine & health ,Herd immunity ,03 medical and health sciences ,0302 clinical medicine ,10183 Swiss Institute of Allergy and Asthma Research ,medicine ,Humans ,Immunology and Allergy ,Medical history ,education ,Intensive care medicine ,Adverse effect ,BNT162 Vaccine ,Asthma ,Vaccines ,2403 Immunology ,education.field_of_study ,SARS-CoV-2 ,business.industry ,COVID-19 ,medicine.disease ,Vaccination ,030104 developmental biology ,030228 respiratory system ,2723 Immunology and Allergy ,business ,Anaphylaxis - Abstract
Coronavirus disease 2019 (COVID-19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as the exclusion of all these patients from vaccination may have a significant impact on reaching the goal of population immunity. Health care practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognise and treat anaphylaxis properly with the ability to administer adrenaline. A mandatory observation period after vaccine administration of at least 15 minutes for all individuals should be followed. The current data has not shown any higher risk for patients suffering from allergic rhinitis or asthma and this message should be clearly stated by physicians to give our patients trust. The benefit of the vaccination clearly outweighs the risk of severe COVID-19 development including the more than 30% of the population suffering from allergic diseases.
- Published
- 2021
11. Increasing emergency department visits for anaphylaxis in very early childhood: A canary in the coal mine.
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Rueter K, Moseley N, Ta B, Bear N, Borland ML, and Prescott SL
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- Infant, Child, Child, Preschool, Humans, Retrospective Studies, Epinephrine therapeutic use, Emergency Service, Hospital, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Anaphylaxis etiology, Food Hypersensitivity epidemiology
- Abstract
Aim: The incidence of anaphylaxis is increasing globally in tandem with changing environmental and lifestyle factors. There is very limited data on very early childhood presentations. We aim to assess changes in rates, characteristics and management of infant anaphylaxis in a paediatric ED over a 15-year period., Methods: We conducted a retrospective study of children <2 years of age who presented with verified anaphylaxis comparing cases in years 2003-2007 with those in 2013-2017. Standardised information was collected on demographics, clinical presentation, management and triggers., Results: Manually confirmed anaphylaxis rates in <2 year olds increased from 3.6 to 6.2 per 10
4 population (OR 1.7, 95% CI: 1.3-2.7; p < 0.001) with the greatest increase in <1 year olds. Anaphylaxis severity increased between 2003-2007 and 2013-2017 (OR 2.3, 95% CI: 1.2-4.3; p = 0.018). Failure to administer adrenaline was reduced in 2013-2017 (p = 0.007). Food was the leading anaphylaxis trigger (97.85%)., Conclusion: This is the first study to suggest an increase in the incidence and severity of ED anaphylaxis presentations in children aged <2 years. Increased awareness of specific characteristics in this age group is required to facilitate timely recognition and optimal management. Further large-scale studies are warranted to understand underlying environmental drivers and find prevention strategies to reduce the burden of disease., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)- Published
- 2023
- Full Text
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12. Diagnosis and management of drug-induced anaphylaxis in children: An EAACI position paper
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Claude Ponvert, Marina Atanaskovic-Markovic, Josefina Cernadas, Ingrid Terreehorst, Mona Kidon, Jean-Christoph Roger J-P Caubet, Eva Rebelo Gomes, Semanur Kuyucu, George Du Toit, and Francesca Mori
- Subjects
Drug ,medicine.medical_specialty ,media_common.quotation_subject ,Immunology ,Provocation test ,Drug allergy ,Immunoglobulin E ,Diagnosis, Differential ,Drug Hypersensitivity ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Medical prescription ,Intensive care medicine ,Child ,Anaphylaxis ,media_common ,Skin Tests ,biology ,business.industry ,Public health ,medicine.disease ,3. Good health ,030228 respiratory system ,Desensitization, Immunologic ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,biology.protein ,Position paper ,business - Abstract
Drug hypersensitivity reactions (DHR) constitute a major and common public health problem, particularly in children. One of the most severe manifestations of DHR is anaphylaxis, which might be associated with a life-threatening risk. During those past decades, anaphylaxis has received particularly a lot of attention and international consensus guidelines have been recently published. Whilst drug-induced anaphylaxis is more commonly reported in adulthood, less is known about the role of drugs in pediatric anaphylaxis. Betalactam antibiotics and non-steroidal anti-inflammatory drugs are the most commonly involved drugs, probably related to high prescription rates. Diagnosis relies on the recognition of symptoms pattern and is based on complete allergic workup, particularly including skin tests and/or specific IgE. However, the real diagnostic value of those tests to diagnose immediate reactions in children remains not well defined for a significant number of the drugs. Generally, a drug provocation test is discussed to confirm or exclude an immediate-onset drug-induced hypersensitivity. Although avoidance of the incriminated drug (and related drug) is the rule, rapid desensitization is useful in selected subgroups of patients. There is a need for large, multicentric studies, to evaluate the real diagnostic value of the currently available skin tests. Moreover there is also a need to develop new diagnostic tests in the future to improve the management of these children.
- Published
- 2018
13. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper
- Author
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Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, and University of Helsinki
- Subjects
food allergy ,Respiratory Medicine and Allergy ,PEANUT ALLERGY ,CHILDREN ,COWS MILK ,ORAL IMMUNOTHERAPY ,DIAGNOSIS ,SESAME ,EXERCISE-INDUCED ANAPHYLAXIS ,nutrition ,3121 General medicine, internal medicine and other clinical medicine ,ADOLESCENTS ,TESTS ,anaphylaxis ,CHALLENGE ,Lungmedicin och allergi - Abstract
Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
- Published
- 2022
14. Drug allergy passport and other documentation for patients with drug hypersensitivity - An ENDA/EAACI Drug Allergy Interest Group Position Paper
- Author
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Jose Julio Laguna, Gianfranco Calogiuri, Sigurveig T. Sigurdardottir, Alla Nakonechna, A. Romano, Josefina Cernadas, J. N. G. Oude Elberink, Violeta Kvedariene, Marina Atanaskovic-Markovic, L. Sedlackova, Eva Rebelo Gomes, H. Rockmann, B Schnyder, Andreas J. Bircher, Lene Heise Garvey, Cristiano Caruso, Torgeir Storaas, Martine Grosber, Javier Fernández, J. Ring, Patrizia Bonadonna, Holger Mosbech, Paula Kauppi, M. Gotua, B. M. Bilo, Pascal Demoly, Anca Mirela Chiriac, Ravishankar Sargur, GJ Burbach, Joanna Makowska, Sevim Bavbek, Ingrid Terreehorst, Mihaela Zidarn, M. Blanca, J. Gooi, N. G. Papadopolous, Knut Brockow, Werner Aberer, Gülfem Çelik, M.J. Torres, Paediatric Pulmonology, Ear, Nose and Throat, Surgical clinical sciences, Skin function and permeability, and Groningen Research Institute for Asthma and COPD (GRIAC)
- Subjects
Drug ,medicine.medical_specialty ,Pediatrics ,media_common.quotation_subject ,Immunology ,Drug allergy ,Health Smart Cards ,CHILDREN ,Documentation ,DIAGNOSIS ,documentation ,Drug Hypersensitivity ,EVENTS ,drug allergy ,drug hypersensitivity ,education ,prevention ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,HISTORY ,MANAGEMENT ,Humans ,Immunology and Allergy ,Medicine ,Medical history ,MEDICATION ERRORS ,030212 general & internal medicine ,Medical prescription ,Intensive care medicine ,PRESCRIBER ORDER ENTRY ,GENERAL-CONSIDERATIONS ,media_common ,ANAPHYLAXIS ,PENICILLIN ,business.industry ,Risk factor (computing) ,medicine.disease ,3. Good health ,Europe ,030228 respiratory system ,Position paper ,business ,Anaphylaxis - Abstract
The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
- Published
- 2016
15. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food: A first step in an initiative to better inform patients and avoid fatal allergic reactions, A GA²LEN position paper
- Author
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Giovanni Battista Pajno, Stefan Wöhrl, Sasho Stoleski, Caroline Nilsson, Mary Jane Marchisotto, Ronald van Ree, Carina Venter, Anna Nowak-Wegrzyn, Montserrat Fernandez-Rivas, Akio Tanaka, Barbara Rogala, Benjamin Kendziora, Michihiro Hide, Stefano Del Giacco, Katarina Stevanovic, Dragan Mijakoski, Enrico Heffler, Nikolaos G. Papadopoulos, Werner Aberer, Antoine Deschildre, Lisa A. Beck, Kate Grimshaw, M. Gotua, Torsten Zuberbier, Hugh A. Sampson, Marek Jutel, Mikela Odemyr, Carlo Lombardi, Erkka Valovirta, Antonella Cianferoni, Nicolette W. de Jong, Jovanka Karadzinska Bislimovska, Michael J. Cork, Christer Janson, Karin Hoffmann-Sommergruber, Gianenrico Senna, Jean Bousquet, Michael Makris, Carsten Bindslev-Jensen, Tamara Dörr, Joan Bartra, Ana Todo-Bom, Mika J. Mäkelä, Ulf Darsow, Margitta Worm, Richard Loh, Rosan Meyer, Giampaolo Ricci, Roy Gerth van Wijk, Audrey Dunn Galvin, Joaquim Mullol, M Alvaro, Alessandro Fiocchi, Zuotao Zhao, Stefania Arasi, Marta Ferrer, Norito Katoh, Philippe Bégin, Brigita Sitkauskiene, Sushil Paudel, Knut Brockow, Johannes Ring, Edward F. Knol, Susanne Lau, Gary W.K. Wong, Jordan Minov, Cristoforo Incorvaia, Marcus Maurer, Hasan Arshad, Fatih A Topal, Bright I Nwaru, Hania Szajewska, Andrew Bush, Tamar Kinaciyan, Adnan Custovic, Elizabeth Angier, O M Kurbacheva, Diana Deleanu, Harald Renz, Peter Smith, Motohiro Ebisawa, J. Grünhagen, Swen Malte John, Carla P. Jones, Barbara Ballmer-Weber, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
- Subjects
Food industry ,Eggs ,Immunology ,Provocation test ,Declaration ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Food allergy ,Food Labeling ,Environmental health ,anaphylaxis ,Immunology and Allergy ,Medicine ,Ingestion ,Animals ,Humans ,SDG 2 - Zero Hunger ,030304 developmental biology ,2. Zero hunger ,0303 health sciences ,Meal ,food allergy ,business.industry ,digestive, oral, and skin physiology ,Allergens ,medicine.disease ,3. Good health ,nutrition ,030228 respiratory system ,Food processing ,business ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit ,Food Hypersensitivity - Abstract
Background\ud \ud Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin.\ud \ud \ud \ud Methods\ud \ud MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results.\ud \ud \ud \ud Results\ud \ud In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds.\ud \ud \ud \ud Conclusion\ud \ud Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
- Published
- 2021
16. EAACI/ENDA Position Paper: Diagnosis and management of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) in children and adolescents
- Author
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Ingrid Terreehorst, Jean-Christoph Roger J-P Caubet, Chiang Wen Chin, Eva Rebelo Gomes, Natalia Blanca-López, Claude Ponvert, Luciana Kase Tanno, Marina Atanaskovic-Markovic, Ozge Soyer, Miguel Blanca, Francesca Mori, Mona Kidon, Ear, Nose and Throat, and AII - Inflammatory diseases
- Subjects
Male ,Allergy ,Anti-Inflammatory Agents ,Desensitization ,0302 clinical medicine ,Risk Factors ,Immunology and Allergy ,030212 general & internal medicine ,Child ,media_common ,ddc:618 ,Anti-Inflammatory Agents, Non-Steroidal ,3. Good health ,Child, Preschool ,Practice Guidelines as Topic ,Female ,Immunologic/methods ,medicine.drug ,Drug ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Immunology ,Drug allergy ,Cross Reactions ,Non-Steroidal/immunology/therapeutic use ,Drug Hypersensitivity ,03 medical and health sciences ,Internal medicine ,medicine ,Animals ,Humans ,Antipyretic ,Anaphylaxis/diagnosis/etiology/therapy ,Preschool ,Allergens/immunology/therapeutic use ,Anaphylaxis ,Expert Testimony ,Skin Tests ,business.industry ,Drug Hypersensitivity/diagnosis/therapy ,Allergens ,medicine.disease ,030228 respiratory system ,Non steroidal anti inflammatory ,Desensitization, Immunologic ,Pediatrics, Perinatology and Child Health ,Interest group ,Position paper ,business ,Pediatric population - Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in the pediatric population as antipyretics/analgesics and anti-inflammatory medications. Hypersensitivity (HS) reactions to NSAID in this age group, while similar to adults, have unique diagnostic and management issues. Although slowly accumulating, published data in this age group are still relatively rare and lacking a unifying consensus. This work is a summary of current knowledge and consensus recommendations utilizing both published data and expert opinion from the European Network of Drug Allergy (ENDA) and the Drug Hypersensitivity interest group in the European Academy of Allergy and Clinical Immunology (EAACI). This position paper summarizes diagnostic and management guidelines for children and adolescents with NSAIDs hypersensitivity.
- Published
- 2018
17. Papers On Anaphylaxis
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Dixon, W. E., Woodhead, G. Sims, Thiele, F. H., Embleton, Dennis, and Goodall, E. W.
- Published
- 1913
18. Vaccination and allergy: EAACI position paper, practical aspects
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Knut Brockow, Lennart Nilsson, Susanne Lau, Jean-Christoph Roger J-P Caubet, Eva Netterlid, Chrysanthi Skevaki, Victoria Cardona, Johan Alm, Eva Rebelo Gomes, Jann Storsaeter, Aziz Sheikh, Giovanna Zanoni, Ingrid Terreehorst, Maria C. Jenmalm, and Jürgen Schwarze
- Subjects
medicine.medical_specialty ,Allergy ,Respiratory Medicine and Allergy ,Immunology ,adverse event ,Disease ,adjuvant ,allergy ,anaphylaxis ,vaccination ,Allergic sensitization ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Hypersensitivity ,medicine ,Humans ,Immunology and Allergy ,Child ,Preschool ,Hypersensitivity/etiology/immunology ,Adverse effect ,Intensive care medicine ,Anaphylaxis ,Lungmedicin och allergi ,Vaccines ,Vaccines/adverse effects/immunology ,ddc:618 ,Anaphylaxis/immunology ,business.industry ,Public health ,Vaccination ,Infant ,Vaccination/adverse effects ,medicine.disease ,030228 respiratory system ,Immunization ,Child, Preschool ,Adverse events ,Pediatrics, Perinatology and Child Health ,business - Abstract
Immunization is highly effective in preventing infectious diseases and therefore an indispensable public health measure. Allergic patients deserve access to the same publicly recommended immunizations as nonallergic patients unless risks associated with vaccination outweigh the gains. Whereas the number of reported possible allergic reactions to vaccines is high, confirmed vaccine-triggered allergic reactions are rare. Anaphylaxis following vaccination is rare, affecting less than 1/100,000, but can occur in any patient. Some patient groups, notably those with a previous allergic reaction to a vaccine or its components, are at heightened risk of allergic reaction and require special precautions. Allergic reactions, however, may occur in patients without known risk factors and cannot be predicted by currently available tools. Unwarranted fear and uncertainty can result in incomplete vaccination coverage for children and adults with or without allergy. In addition to concerns about an allergic reaction to the vaccine itself, there is fear that routine childhood immunization may promote the development of allergic sensitization and disease. Thus, although there is no evidence that routine childhood immunization increases the risk of allergy development, such risks need to be discussed. This article is protected by copyright. All rights reserved.
- Published
- 2017
19. Food allergy in adolescents: validation of the food allergy independent measure and the EuroPrevall food allergy quality of life questionnaire into Spanish.
- Author
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Jang DT, Ibáñez L, Buendía E, Sabido MP, Ester B, María N, Blanca S, Sonia U, Antonio N, and Ángel M
- Subjects
- Humans, Adolescent, Quality of Life, Surveys and Questionnaires, Immunoglobulin E, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology
- Abstract
Background: Different questionnaires have been developed globally to assess and compare the impact of food allergy on the quality of life. The aim of this study was to validate a Spanish translation of the Food Allergy Independent Measure (FAIM) and the EuroPrevall Food Allergy-Quality of Life Questionnaire-Teenage Form (FAQLQ-TF) for adolescents aged 13-17 years., Methods: Sixty adolescents diagnosed with immunoglobulin E-mediated allergy to food completed the questionnaires. Cronbach's alpha was used to assess internal consistency; correlation between FAQLQ-TF and FAIM was used to test construct validity. The discriminant validity was evaluated by comparison with the number of offending foods, the perceived impact on social life, the diagnosis of anaphylaxis, and the previous prescription of adrenaline auto--injectors (AAI)., Results: No question fulfilled criteria to be removed from the questionnaire. For FAIM, Cronbach's alpha = 0.763, and for the four domains of FAQLQ-TF, Cronbach's alpha = 0.797-0.847. A significant correlation existed between FAQLQ-TF and FAIM, and of both of them with anaphylaxis and the prescription of AAI (P ˂ 0.05 for all comparisons)., Conclusions: This Spanish translation of FAIM and FAQLQ-TF for adolescents had good internal consistency and construct validity as well as ability to discriminate patients according to the number of foods to avoid, impact on social life, diagnosis of anaphylaxis, and AAI prescription.
- Published
- 2023
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- View/download PDF
20. Peach extract induces systemic and local immune responses in an experimental food allergy model.
- Author
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Steigerwald H, Krause M, Gonzalez-Menendez I, Quintanilla-Martinez L, Vieths S, Scheurer S, Albrecht M, and Blanco-Pérez F
- Subjects
- Humans, Mice, Animals, Antigens, Plant, Immunoglobulin E, Mice, Inbred CBA, Allergens, Immunoglobulin G, Immunity, Plant Extracts pharmacology, Plant Proteins, Prunus persica adverse effects, Food Hypersensitivity, Anaphylaxis
- Abstract
Peach allergy is among the most frequent food allergies in the Mediterranean area, often eliciting severe anaphylactic reactions in patients. Due to the risk of severe symptoms, studies in humans are limited, leading to a lack of therapeutic options. This study aimed to develop a peach allergy mouse model as a tool to better understand the pathomechanism and to allow preclinical investigations on the development of optimized strategies for immunotherapy. CBA/J mice were sensitized intraperitoneally with peach extract or PBS, using alum as adjuvant. Afterwards, extract was administered intragastrically to involve the intestinal tract. Allergen provocation was performed via intraperitoneal injection of extract, measuring drop of body temperature as main read out of anaphylaxis. The model induced allergy-related symptoms in mice, including decrease of body temperature. Antibody levels in serum and intestinal homogenates revealed a Th2 response with increased levels of mMCPT-1, peach- and Pru p 3-specific IgE, IgG1 and IgG2a as well as increased levels of IL-4 and IL-13. FACS analysis of small intestine lamina propria revealed increased amounts of T cells, neutrophils and DCs in peach allergic mice. These data suggest the successful establishment of a peach allergy mouse model, inducing systemic as well as local gastrointestinal reactions., (© 2023. The Author(s).)
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- 2023
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21. A case of severe anaphylaxis after Ropalidia marginata (a paper wasp) sting in Sri Lanka
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Ariaranee Gnanathasan, E. W. R. A. Witharana, S. K. J. Wijesinghe, S.C.L. Kadahetti, and W. A. I. P. Karunaratne
- Subjects
Paper wasp ,Characteristics of common wasps and bees ,Zoology ,General Medicine ,Hymenoptera ,Biology ,medicine.disease ,biology.organism_classification ,Sting ,Nest ,medicine ,Nuisance ,Anaphylaxis ,Ropalidia marginata - Abstract
Introduction: Ants, bees and wasps are insects in Order Hymenoptera. Victims of Hymenoptera sting can present with nuisance pain to more severe form of anaphylaxis [1]. Ropalidia marginata (Kaladuruwa) is the most common social wasp of Peninsula of India [2]. Traditional medication is a common practice in rural Sri Lanka for insect sting. Nest of the Ropalidia marginata is crushed and mixed with water to make a paste which is applied on the painful area over the stinging site of paper wasp as a common traditional treatment.Although there are many cases of allergic reactions after wasp sting, the individual species of Ropalidia marginata causing severe anaphylaxis is not reported. We report a school boy presented with severe anaphylaxis after this paper wasp sting in Deniyaya, Sri Lanka.
- Published
- 2015
22. A new classification option for NSAID hypersensitivity: Kalyoncu classification.
- Author
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Özdemir E, Damadoğlu E, Karakaya G, and Kalyoncu AF
- Subjects
- Humans, Female, Adult, Middle Aged, Male, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Drug Hypersensitivity diagnosis, Anaphylaxis diagnosis, Anaphylaxis chemically induced, Angioedema diagnosis, Rhinitis, Urticaria diagnosis
- Abstract
Background: The European Network for Drug Allergy (ENDA) proposed a consensus document for hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in 2011. A subgroup of patients with NSAIDs-exacerbated respiratory disease (NERD) develop urticaria/angioedema type reactions in response to NSAIDs. The Kalyoncu classification might be a novel option to classify patients with NSAID hypersensitivity (NH). In this study, we compare the ENDA and the Kalyoncu classifications., Methods: This study enrolled a total of 196 patients. NH reaction types were categorized as asthma, rhinitis, urticaria/angioedema and anaphylaxis. Based on the reaction history and oral provocation test findings, patients were grouped according to ENDA and Kalyoncu classifications., Results: The mean age of the 196 patients was 40.32±13.28 years, and 130 (66.3%) of them were female. Under the ENDA and Kalyoncu classifications, the most common NH subgroups were NERD (32%), and isolated NH (34.2%), the least prevalent NH subgroups were single NSAID-induced delayed reactions (SNIDR) (1.5%), and pseudo Samter's syndrome (11.7%)., Conclusions: Our research revealed that the Kalyoncu classification is more descriptive of patients with NERD exhibiting urticaria/angioedema-type reactions. It also provides future risk assessment for development of NERD. For controversial cases, the Kalyoncu classification can be utilized as a new complimentary option alone or in conjunction with ENDA classification., Competing Interests: The authors declare no potential conflicts of interests with respect to research, authorship and/or publication of this article.
- Published
- 2022
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23. Critical Documents on Cow's Milk Allergy and Anaphylaxis: Two Recent WAO Position Papers
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Lanny J. Rosenwasser
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Allergy ,Pediatrics ,business.industry ,Immunology ,Alternative medicine ,Milk allergy ,medicine.disease ,Editorial ,Food allergy ,Family medicine ,Immunology and Allergy ,Medicine ,Position (finance) ,Position paper ,Allergists ,business ,Anaphylaxis - Abstract
The purpose of this editorial is to highlight the recent ratification as WAO Position Papers of 2 important documents published in the World Allergy Organization Journal (WAO Journal). The "World Allergy Organization (WAO) Guidelines on the Diagnosis and Rationale against Cow's Milk Allergy (DRACMA) Guidelines," ratified as a WAO Position Paper by the WAO House of Delegates, March 21, 2011, involves a significant pediatric food allergy problem and provides invaluable guidelines for the clinician. This impressive collection of information on this worldwide problem will help in the management of cow's milk allergy, which has profound implications for growth and development and the health of children worldwide. Under the able leadership of Professor Alessandro Fiocchi (Italy), the Chair of the WAO Special Committee on Food Allergy, an international group has put together a scholarly and well-appointed review of all the issues related to cow's milk allergy (CMA), ranging from methodology and epidemiology through a variety of other aspects of the clinical syndrome. DRACMA provides the guidelines for diagnosing CMA, and the proper natural history treatment alternatives ranging from avoidance through identification of milk derived from a variety of other sources, including unusual sources, which can be used for dietary supplementation. DRACMA employed evidence-based methodology utilizing the criteria of Grading of Recommendations Assessment, Development and Evaluation (GRADE) in its analysis of the literature. "World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis," the WAO Position Paper ratified on February 18, 2011, is a thorough, extensive work completed by worldwide anaphylaxis and allergy experts of the WAO Special Committee on Anaphylaxis led by Chair, Professor F. Estelle Simons. In addition to clearly defining, in a concise manner, the syndrome, its severity, and the possibility for treatment, the document has also provided a very clear and detailed management plan for acute anaphylaxis in both high- and low-resource areas. This is an important stride forward and the WAO Journal as always looks to better care for allergy sufferers at risk for anaphylaxis and for significant morbidity and mortality. This position paper is an excellent resource to help those circumstances. The Position Paper series within the WAO Journal is intended to address the needs of the profession worldwide. Along with the 2 most recent documents, and another on the state of sublingual immunotherapy (SLIT), the series also includes a treatise on defining an allergist, basic qualities of an allergist, training required for allergists, and educational requirements--all to impart allergy education to students, residents, and practitioners. The WAO and the WAO Journal will continue to invest in the development and identification of guidelines for treating important, clinically relevant syndromes associated with allergic disease such as cow's milk allergy or anaphylaxis. The recently ratified position papers and other WAO documents published in WAO Journal can be accessed in the following linked list of titles: • World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines • World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis • Sub-Lingual Immunotherapy: World Allergy Organization Position Paper 2009 • Recommendations for Competency in Allergy Training for Undergraduates Qualifying as Medical Practitioners: A Position Paper of the World Allergy Organization • Requirements for Physician Competencies in Allergy: Key Clinical Competencies Appropriate for the Care of Patients With Allergic or Immunologic Diseases: A Position Statement of the World Allergy Organization • What Is an Allergist?: Reconciled Document Incorporating Member Society Comments, September 3, 2007
- Published
- 2013
24. Prostaglandin-generating factor of anaphylaxis. Identification and isolation.
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Steel L and Kaliner M
- Subjects
- Amino Acids analysis, Animals, Chromatography, Gel, Chromatography, Ion Exchange, Chromatography, Paper, Guinea Pigs, Histamine Release, Humans, Lung immunology, Anaphylaxis physiopathology, Prostaglandins biosynthesis
- Abstract
Anaphylaxis of human lung in vitro is accompanied by prostaglandin (PG) formation. To search for factors capable of generating PG, supernatants prepared by reversed anaphylaxis of human lung tissue were added to guinea pig lung and PG formation examined. The PG-generating activity fractionated between Mr = 500 and 5000 by ultramembrane filtration and was designated prostaglandin-generating factor of anaphylaxis or PGF-A. Partially purified PGF-A was soluble in 80% ethanol and insoluble in chloroform or ethyl acetate. Paper chromatography of anti-IgE-treated human lung preparations revealed a ninhydrin-positive spot at RF 0.27 to 0.41 with PG-generating activity. When subjected to gel filtration on Sephadex G-50 or G-25, PGF-A demonstrated peak PG-generating capacity at Mr = 1200 to 1800. Peak fractions were pooled and chromatographed on CM52 cellulose with PGF-A activity eluting at 0.16 to 0.3 M NH4COOH. The pooled peak of PGF-A activity from Sephadex G-25 filtration and CM52 chromatography eluted as a single peak at 0.024 M NH4HCO3 on DE52. Application of the peak off DE52 to a paper chromatogram revealed a single ninhydrin-positive spot with an RF 0.27 to 0.41 with the capacity to generate PGs. Amino acid analysis of three purifications revealed the following: Glu/Asp/Gly/Ser/Thr (6:3:2:1:1). Based on these analyses, a Mr = 1450 was calculated for the PGF-A. Therefore, PGF-A represents a novel mediator of lung anaphylaxis which may be partly responsible for PG generation accompanying allergic reactions.
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- 1981
25. Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper
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Lene Heise Garvey, Mj Torres, M. Pagani, M. B. Bilò, H. N. G. Oude Elberink, Roberta Zanotti, Patrizia Bonadonna, Antonino Romano, Werner Aberer, Knut Brockow, Holger Mosbech, and Groningen Research Institute for Asthma and COPD (GRIAC)
- Subjects
SERUM TRYPTASE LEVELS ,Immunology ,Drug allergy ,Anti-Inflammatory Agents ,tryptase ,Contrast Media ,Tryptase ,Clonal Evolution ,Humans ,MASTOCYTOSIS REMA ,Immunology and Allergy ,Medicine ,Anesthesia ,Systemic mastocytosis ,CONSENSUS PROPOSAL ,IODINATED CONTRAST-MEDIA ,mastocytosis ,ANAPHYLAXIS ,biology ,business.industry ,Cutaneous Mastocytosis ,Settore MED/09 - MEDICINA INTERNA ,clonal mast cell disorders ,SYSTEMIC MASTOCYTOSIS ,medicine.disease ,Mast cell ,Anti-Bacterial Agents ,Analgesics, Opioid ,medicine.anatomical_structure ,ACTIVATION SYNDROMES ,HUMAN SKIN ,biology.protein ,Tryptases ,SPANISH NETWORK ,HYMENOPTERA VENOM ALLERGY ,Bone marrow ,Differential diagnosis ,business ,drug allergy ,drug hypersensitivity ,Anaphylaxis - Abstract
Mastocytosis is a clonal disorder characterized by the proliferation and accumulation of mast cells (MC) in different tissues, with a preferential localization in skin and bone marrow (BM). The excess of MC in mastocytosis as well as the increased releasability of MC may lead to a higher frequency and severity of immediate hypersensitivity reactions. Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. Fatal anaphylaxis has been described particularly following hymenoptera stings, but also occasionally after the intake of drugs such as nonsteroidal anti-inflammatory drugs, opioids and drugs in the perioperative setting. However, data on the frequency of drug hypersensitivity in mastocytosis and vice versa are scarce and evidence for an association appears to be limited. Nevertheless, clonal MC disorders should be ruled out in cases of severe anaphylaxis: basal serum tryptase determination, physical examination for cutaneous mastocytosis lesions, and clinical characteristics of anaphylactic reaction might be useful for differential diagnosis. In this position paper, the ENDA group performed a literature search on immediate drug hypersensitivity reactions in clonal MC disorders using MEDLINE, EMBASE, and Cochrane Library, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation.
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- 2015
26. Safety of an inactivated COVID-19 vaccine in patients with - wheat-dependent exercise-induced anaphylaxis.
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Du Z and Yin J
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- Gliadin, Humans, Retrospective Studies, Anaphylaxis epidemiology, Anaphylaxis etiology, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Exercise adverse effects, Wheat Hypersensitivity
- Abstract
Background: Inactivated vaccines against coronavirus disease-2019 (COVID-19) offer an effective public health intervention to mitigate this devastating pandemic. However, little is known about their safety in patients with wheat-dependent exercise-induced anaphylaxis (WDEIA)., Methods: We recruited 72 WDEIA patients and 730 healthy matched controls who received an inactivated COVID-19 vaccine. Participants were monitored for 4 weeks after each immunization for adverse reactions and completed questionnaires regarding local and systemic reactions at 7 and 28 days after each vaccination. For those who had received the COVID-19 vaccine prior to enrollment, adverse event data were obtained retrospectively., Results: Local and systemic adverse events occurred at similar rates in the WDEIA group and the control group. In both groups, injection-site pain and fatigue were the most common local and systemic reactions, respectively. Compared with healthy controls, more allergic events were reported in the WDEIA group (after dose 1, 0.5% vs. 4.2%, p=0.019; after dose 2, 0% vs. 1.4%, p=0.089). Allergic reactions mainly manifested as rash, urticaria, and edema, which were mild and controllable. No serious allergic events were reported., Conclusions: The adverse event profile of inactivated COVID-19 vaccine did not differ between WDEIA patients and healthy controls. The risk of allergic reactions in patients with WDEIA seems higher, but no anaphylaxis was reported, and the allergic reactions were controllable. Inactivated COVID-19 vaccines appear to be well-tolerated in WDEIA patients, but patients with potential allergy risks should be cautious.
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- 2022
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27. Epinephrine Auto-Injectors for Anaphylaxis Treatment in the School Setting: A Discussion Paper
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Abigail Tarr Cooke and Robin Meize-Grochowski
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medicine.medical_specialty ,Allergy ,school setting ,Allergic reaction ,education ,Anaphylaxis treatment ,Current Issues and Practices in School Nursing ,food allergies ,School nursing ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,school nursing ,anaphylaxis ,medicine ,Intensive care medicine ,General Nursing ,lcsh:RT1-120 ,lcsh:Nursing ,business.industry ,School setting ,medicine.disease ,Epinephrine ,030228 respiratory system ,epinephrine auto-injectors ,business ,Practice Update ,Anaphylaxis ,policy ,medicine.drug - Abstract
Introduction: Anaphylaxis is a serious, life-threatening systemic allergic reaction that may occur in individuals not previously diagnosed with an allergy. Emergency first-line treatment of choice for acute anaphylaxis is intramuscular administration of epinephrine via an auto-injector. In the school setting, students with known allergies typically keep or carry an epinephrine auto-injector (EAI). For students who do not have a known allergy or for those whose personal EAIs are unavailable, an anaphylactic event could have serious adverse outcomes if an EAI is not available via an undesignated stock supply in the school. Methods: We searched the published literature from 2000 through 2018 in CINAHL, MEDLINE, and PubMed using the following search terms: anaphylaxis, school setting, epinephrine auto-injector, and food allergies. Throughout this article, undesignated stock EAIs, stock EAIs, EAI stock, and open-order EAIs are used interchangeably. Conclusion: Anaphylaxis is increasing worldwide as the incidence of food allergies increases. Although stock EAIs for students in schools can have important benefits, the availability of EAIs in the school setting is limited. Barriers to undesignated stock EAIs include the lengthy administrative process for developing school policies and protocols; gaps in nurses’ self-perceived knowledge versus objective knowledge on the topic of anaphylaxis; limited resources in many school districts; and complex role demands, lack of confidence in trained staff, or insufficient school nurse staffing. It is important that epinephrine be readily available in schools. Barriers to facilitating stock EAIs include those that can be addressed directly by nurses and those that may require policy changes. Nurses, particularly those working in school settings or pediatrics, could take the lead in discussions about the benefits of stock EAIs in schools, advocating for policy changes as warranted. Fully informed nurses can be better prepared to serve as advocates in ensuring that EAIs are available in school settings.
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- 2019
28. Sublingual immunotherapy (SLIT) - indications, mechanism, and efficacy Position paper prepared by the Section of Immunotherapy, Polish Society of Allergy
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Marek Jutel, Małgorzata Bartkowiak-Emeryk, Anna Bręborowicz, Ewa Cichocka-Jarosz, Andrzej Emeryk, Radosław Gawlik, Paweł Gonerko, Barbara Rogala, Anna Nowak-Węgrzyn, Bolesław Samoliński, and and other members of IT Section PTA
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Allergy ,Parietaria ,desensitization ,medicine.disease_cause ,Sublingual administration ,lcsh:Agriculture ,Allergen ,Humans ,Medicine ,Adverse effect ,Waste Management and Disposal ,Ecology, Evolution, Behavior and Systematics ,lcsh:Environmental sciences ,Asthma ,lcsh:GE1-350 ,Sublingual Immunotherapy ,child ,biology ,business.industry ,adult ,Public Health, Environmental and Occupational Health ,lcsh:S ,immunologic/methods ,medicine.disease ,biology.organism_classification ,Slit ,Immunology ,allergen/therapeutic use ,Poland ,business ,Anaphylaxis - Abstract
SLIT ( sublingual immunotherapy ) induces allergen-specific immune tolerance by sublingual administration of a gradually increasing dose of an allergen. The mechanism of SLIT is comparable to those during SCIT (subcutaneous immunotherapy), with the exception of local oral dendritic cells, pre-programmed to elicit tolerance. In the SLIT dose, to achieve the same efficacy as in SCIT, it should be 50–100 times higher with better safety profile. The highest quality evidence supporting the efficacy of SLIT lasting 1 – 3 years has been provided by the large scale double-blind, placebo-controlled (DBPC) trials for grass pollen extracts, both in children and adults with allergic rhinitis. Current indications for SLIT are allergic rhinitis (and conjunctivitis) in both children and adults sensitized to pollen allergens (trees, grass, Parietaria ), house dust mites ( Dermatophagoides pteronyssinus, Dermatophagoides farinae ), cat fur, as well as mild to moderate controlled atopic asthma in children sensitized to house dust mites. There are positive findings for both asthma and new sensitization prevention. Severe adverse events, including anaphylaxis, are very rare, and no fatalities have been reported. Local adverse reactions develop in up to 70 – 80% of patients. Risk factors for SLIT adverse events have not been clearly identified. Risk factors of non-adherence to treatment might be dependent on the patient, disease treatment, physician-patient relationship, and variables in the health care system organization.
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- 2016
29. Allergic reactions to midazolam: A case series from an Italian allergy unit.
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Nucera E, Parrinello G, Buonomo A, Aruanno A, and Rizzi A
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- Humans, Anaphylaxis, Drug Hypersensitivity diagnosis, Midazolam adverse effects
- Abstract
Midazolam is a short-acting benzodiazepine with central nervous system depressing action, commonly used for conscious sedation for various procedures and for its pharmacologic properties.In literature, severe adverse reactions to this drug are described, but only in few cases positive allergological tests were demonstrated.The authors collected herein five clinical cases of different allergic reactions to midazolam demonstrated by positive skin tests., Competing Interests: The authors declare that they have no conflicts of interest.
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- 2021
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30. Allergic rhinitis, anaphylaxis, allergic reactions: Key papers
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Maria G. Tanzi
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Allergy ,medicine.medical_specialty ,business.industry ,medicine.disease ,Dermatology ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Tolerability ,Egg allergy ,medicine ,Live attenuated influenza vaccine ,In patient ,030223 otorhinolaryngology ,business ,Anaphylaxis - Abstract
G on treatment of allergic rhinitis and strategies to manage anaphylaxis were among several key practice parameters released in 2015. In addition, a few key papers commented on the cross-reactivity and tolerability of cephalosporins in patients who have experienced hypersensitivity reactions to these agents in the past, and on the use of live attenuated in uenza vaccine (LAIV) in those with an egg allergy. These key papers are reviewed here; for additional information, clinicians are encouraged to access the full citations.
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- 2016
31. Food-induced anaphylaxis in children up to 3-years-old preliminary study.
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Gawryjołek J and Krogulska A
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- Age Factors, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Child, Preschool, Female, Heart Diseases etiology, Hospitalization statistics & numerical data, Humans, Immunoglobulin E blood, Incidence, Infant, Male, Milk Hypersensitivity complications, Preliminary Data, Respiration Disorders diagnosis, Respiration Disorders etiology, Retrospective Studies, Symptom Assessment, Urticaria etiology, Anaphylaxis etiology, Food adverse effects, Food Hypersensitivity complications
- Abstract
Introduction and Objectives: The aim of this study was to determine the frequency of food-induced anaphylaxis, analyze the symptoms, and triggering factors in a group of youngest children. Also, the study aims to estimate the frequency of anaphylaxis episodes in children in the Kuyavian-Pomeranian Voivodeship region., Methods: Retrospective analysis of medical records of 29 children aged 0-3 years that presented symptoms of food-induced anaphylaxis. Medical charts were reviewed using a collection of documents with the clinical data., Results: The frequency of anaphylaxis was determined to be 0.3% of all hospitalized children aged 0-3 years and 1.9% of children suspected of food allergy. The mean age of an anaphylactic reaction was 12±9 months. The most common symptom was mild-moderate urticaria. The respiratory symptoms were significantly more prevalent in toddlers than in infants (p = 0.148). Cardiac symptoms occurred only in the infant group, i.e., in two (11%) infants. As a possible cause of the symptoms, in 18 (62%) cases, parents most often indicated the consumption of milk or milk-rice porridge. Anaphylaxis as the first manifestation of food-allergy was significantly more prevalent in infants than in older children (p = 0.0002)., Conclusions: The incidence of anaphylactic reactions rated at 0.3% of all children hospitalized at this age. The most common symptoms of anaphylactic reaction were skin lesions. The primary cause of allergic reactions was cow's milk after the first exposure at home. Anaphylaxis has different patterns of symptoms depending on the age of the child.
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- 2021
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32. Anaphylactic anaesthetic reactions. The value of paper radioallergosorbent tests for IgE antibodies to muscle relaxants and thiopentone
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E. S. K. Assem
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Adult ,Male ,Allergy ,Adolescent ,Succinylcholine ,Anesthesia, General ,Immunoglobulin E ,Histamine Release ,Antibodies ,Drug Hypersensitivity ,Radioallergosorbent Test ,Leucocyte histamine release test ,medicine ,Humans ,General anaesthesia ,Thiopental ,Alcuronium ,Child ,Anaphylaxis ,Skin Tests ,medicine.diagnostic_test ,biology ,business.industry ,Radioallergosorbent test ,Anaphylactic reaction ,Middle Aged ,medicine.disease ,Anesthesiology and Pain Medicine ,Anesthesia ,biology.protein ,Female ,business - Abstract
The three currently available paper radioallergosorbent tests ('suxamethonium', alcuronium and thiopentone) were evaluated. 'Suxamethonium' radioallergosorbent test (which employs choline conjugated to paper discs) proved to be reliable in the detection of allergy to neuromuscular blockers, which were confirmed as the most common cause of anaphylactic reaction during general anaesthesia. Thiopentone radioallergosorbent test may also be useful, and is recommended in conjunction with 'suxamethonium' radioallergosorbent test in the preliminary investigation of reactions. Patients with positive 'suxamethonium' radioallergosorbent test usually require further testing, including alcuronium radioallergosorbent test, skin testing with a wide range of drug concentrations or leucocyte histamine release test.
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- 1990
33. COVID-19 pandemic
- Author
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W. J. Fokkens, Jürgen Schwarze, Cezmi A. Akdis, J Mullol, W. Czarlewski, Claudia Traidl-Hoffmann, Claus Bachert, D. Larenas-Linnemann, Tomas Chivato, M. Gotua, Mateo Bonini, Ludger Klimek, Vincenzo Patella, A. A. Cruz, Stephanie Dramburg, Kari C. Nadeau, H W Fritsch, K. Ohta, Thomas Eiwegger, Robert M. Naclerio, Antti Lauerma, A. Yorgancioglu, Aslı Gelincik, Piotr Kuna, Oliver Pfaar, Carmen Riggioni, Violeta Kvedariene, Markus Ollert, Sinthia Bosnic-Anticevich, V. Cardona, S. Del Giacco, Sanna Toppila-Salmi, Helen A. Brough, Heimo Breiteneder, Valérie Hox, B. Samolinski, Zuzana Diamant, G.W. Canonica, Lihong Zhang, María José Torres, Y. Okamoto, Liam O'Mahony, Radosław Gawlik, Jolanta Walusiak-Skorupa, Sharon Chinthrajah, Winfried Rief, T. Haatela, M. Morais-Almeida, Ioana Agache, Manfred Schedlowski, I Skypala, R. Brehler, D. Y. Wang, João Fonseca, I. J. Ansotegui, Robyn E O'Hehir, Oscar Palomares, Charlotte G. Mortz, J. C. Ivancevich, C. Suppli Ulrik, M. T. Ventura, P M Matricardi, S Untersmayr, Gabrielle L. Onorato, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Vanitha Sampath, Arũnas Valiulis, Marek Jutel, Luisa Brussino, Pedro Carreiro-Martins, Jean Bousquet, Nikolaos G. Papadopoulos, A. Bedbrook, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Edward F. Knol, Ear, Nose and Throat, AII - Inflammatory diseases, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Philipps Universität Marburg = Philipps University of Marburg, Allergologie, Stimm und Sprachstörungen [Wiesbaden, Germany], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], University of Wrocław [Poland] (UWr), ALL-MED, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Medizinische Universität Wien = Medical University of Vienna, Stanford University, Skane University Hospital [Malmo], Lund University [Lund], Charles University [Prague] (CU), University Medical Center Groningen [Groningen] (UMCG), Univ Toronto, Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Mol Med, Toronto, ON M5G 0A4, Canada, The Hospital for sick children [Toronto] (SickKids), University of Toronto, Amsterdam UMC - Amsterdam University Medical Center, Alfred Health, Victoria University [Melbourne], University College Cork (UCC), Sean N. Parker Center for Allergy and Asthma Research [Stanford], Stanford Medicine, Stanford University-Stanford University, University Clinics of Essen, University of Essen, Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Helmholtz Zentrum München = German Research Center for Environmental Health, University Hospital Augsburg, National University of Singapore (NUS), Beijing Tongren Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Evelina London Children's Hospital, King‘s College London, CEU-San Pablo University and HM-Hospitals School of Medicine, University of Cagliari, Medical University of Silesia (SUM), Istanbul University, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Helsinki University Central Hospital, University of Helsinki, Odense University Hospital (OUH), Luxembourg Institute of Health (LIH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Hospital Sant Joan de Déu [Barcelona], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], University of Edinburgh, NHS Foundation Trust [London], The Royal Marsden, Nofer Institute of Occupational Medicine (NIOM), Hospital Quirónsalud Bizkaia [Bilbao], Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of Turin, Mauriziano Umberto I Hospital, Humanitas University [Milan] (Hunimed), Vall d'Hebron University Hospital [Barcelona], Hospital de Dona Estefania, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Federal University of Bahia School of Medicine, Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Medical Consulting Czarlewski, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, MEDIDA, Lda, David Tvildiani Medical University (DTMU), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Barlicki University Hospital, Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], Pantai Hospital [Kuala Lumpur], Hospital CUF Descobertas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), CIBER de Epidemiología y Salud Pública (CIBERESP), Johns Hopkins University School of Medicine [Baltimore], Fukujuji Hospital, Tokyo National Hospital, Chiba Rosai Hospital, Chiba University Hospital, Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, 'Santa Maria della Speranza' Hospital, Centro Hospitalar e Universitário [Coimbra], Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), University of Coimbra [Portugal] (UC), Medical University of Warsaw - Poland, Hvidovre Hospital, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Transilvania University of Brasov, Salvy-Córdoba, Nathalie, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center
- Subjects
0301 basic medicine ,viruses ,Eaaci Position Paper ,Medizin ,Cochrane Library ,GUIDELINES ,FOOD ALLERGY ,allergen immunotherapy ,allergy clinic ,anaphylaxis ,asthma ,clinical trials ,COVID-19 ,Position Paper ,psychological impact ,SARS-CoV-2 ,Allergists ,Health Personnel ,Humans ,Hypersensitivity ,Information Technology ,Patient Care Team ,Triage ,SARS‐CoV‐2 ,DESENSITIZATION ,0302 clinical medicine ,MESH: Patient Care Team ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,HDE ALER ,Pandemic ,Health care ,Immunology and Allergy ,ATOPIC-DERMATITIS ,MESH: COVID-19 ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,allergen immunotherapy (AIT) ,virus diseases ,DRUG HYPERSENSITIVITY REACTIONS ,3. Good health ,INFECTIONS ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,MESH: Triage ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Allergen immunotherapy ,medicine.medical_specialty ,MESH: Information Technology ,MESH: Hypersensitivity ,Immunology ,education ,MEDLINE ,DIAGNOSIS ,psychological COVID ,03 medical and health sciences ,MESH: Allergists ,COVID‐19 ,medicine ,MESH: SARS-CoV-2 ,ddc:610 ,RHINOSINUSITIS ,MESH: Humans ,business.industry ,Clinical trial ,Coronavirus ,EXACERBATIONS ,030104 developmental biology ,030228 respiratory system ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Family medicine ,3121 General medicine, internal medicine and other clinical medicine ,Position paper ,MESH: Health Personnel ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.
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- 2021
34. Pediatric idiopathic anaphylaxis: practical management from infants to adolescents.
- Author
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Mori F, Saretta F, Giovannini M, Gelsomino M, Liotti L, Barni S, Mastrorilli C, Pecoraro L, Castagnoli R, Arasi S, Caminiti L, Klain A, Miraglia Del Giudice M, and Novembre E
- Subjects
- Humans, Child, Adolescent, Infant, Diagnosis, Differential, Child, Preschool, Algorithms, Anaphylaxis diagnosis, Anaphylaxis therapy, Anaphylaxis etiology, Anaphylaxis drug therapy
- Abstract
Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis., (© 2024. The Author(s).)
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- 2024
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35. Management of anaphylaxis due to COVID-19 vaccines in the elderly
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Paulo Augusto Moreira Camargos, Radolslaw Gawlik, Mirko Petrovic, Gunter J. Sturm, Kristof Nekam, Sergio Bonini, Zhanat Ispayeva, Marilyn Urrutia Pereira, Jean Bousquet, Antti Lauerma, Menachem Rottem, Arzu Yorgancioglu, Hubert Blain, Antonio Cherubini, Mário Morais-Almeida, Nathalie Salles, Charlotte G. Mortz, Sylwia Smolinska, Davor Plavec, A. Bedbrook, Torsten Zuberbier, Helga Kraxner, M. Beatrice Bilò, Sinthia Bosnic-Anticevich, Gaëtan Gavazzi, Finbarr C. Martin, Alvaro A. Cruz, K. S. Bennoor, Isabella Annesi-Maesano, Mohamed H. Shamji, Karin Hoffmann-Sommergruber, Marina Atanaskovic-Markovic, Carsten Bindslev-Jensen, Lan Tt Le, Isabel Skypala, Ana Todo-Bom, Vincenzo Patella, Lorenzo Cecchi, Charlotte Suppli Ulrik, Oscar Palomares, Joaquin Sastre, Hans Jürgen Hoffmann, Knut Brockow, Eva Untersmayr, Martin Hrubisko, Bernadette Eberlein, Aziz Sheikh, Milan Sova, Osman M. Yusuf, Violeta Kvedariene, G. Walter Canonica, Dana Wallace, Ioana Agache, Milena Sokolowska, Jos M. G. A. Schols, Susan Waserman, Stéphanie Miot, Carla Irani, Regina E Roller-Winsberger, Michael Levin, Yves Rolland, Emma Montella, Bilun Gemicioglu, Bolesław Samoliński, Stefano Del Giacco, Madda lenaIllario, Yehia El-Gamal, Olga Lourenço, Jean-Christoph Roger J-P Caubet, Luisa Brussino, Marysia Recto, De Yun Wang, Igor Kaidashev, Renaud Louis, Antonino Romano, Mario E. Zernotti, Jacques Reynes, Pedro Carreiro-Martins, Alexandra F. Santos, Marek Niedoszytko, M. Gotua, Musa Khaitov, Thomas B. Casale, Andrea Matucci, Bernardo Sousa-Pinto, Rafael Stelmach, Dejan Dokic, Joana Vitte, Motohiro Ebisawa, Maria Teresa Ventura, Joaquim Mullol, Tomas Chivato, Petr Panzner, Oliver Pfaar, Sanna Toppila-Salmi, Ioanna Tsiligianni, Wytske Fokkens, Alessandra Vultaggio, H. Neffen, Juan Carlos Ivancevich, Ya-dong Gao, Anna Sediva, Maja Hofmann, Ana Maria Carriazo, João Fonseca, Marek Jutel, A. Benetos, Nhân Pham-Thi, Mona Al-Ahmad, Arunas Valiulis, Mihaela Zidarn, Elizabeth Angier, Yoshitaka Okamoto, Montserrat Fernandez-Rivas, Cezmi A. Akdis, Philip W. Rouadi, Olivier Guérin, John Farrell, Mikaela Odemyr, George Christoff, Vera Mahler, Claus Bachert, Edward F. Knol, Wienczyslawa Czarlewski, Robyn E O'Hehir, Victoria Cardona, Ludger Klimek, Tari Haahtela, Vincent Le Moing, Branislava Milenkovic, Carmen Rondon, Kaja Julge, Jolanta Walusiak-Skorupa, Nikolaos G. Papadopoulos, Aslı Gelincik, Markus Ollert, Piotr Kuna, Leyla Namazova-Baranova, Margitta Worm, Annick Barbaud, Elena Camelia Berghea, Todor A. Popov, Derek K. Chu, María José Torres, Faradiba Sarquis Serpa, Nicola Scichilone, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Gianni Passalacqua, Humboldt-Universität zu Berlin, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Humboldt University Of Berlin, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transylvania University, Wrocław Medical University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Cagliari, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Università Politecnica delle Marche [Ancona] (UNIVPM), Medical Consulting Czarlewski, Universiti Putra Malaysia, University of Southampton, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Belgrade [Belgrade], Ghent University Hospital, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Dhaka Shishu Hospital [Bangladesh], University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Odense University Hospital (OUH), Italian National Research Council, National Research Council [Italy] (CNR), The University of Sydney, Technische Universität München = Technical University of Munich (TUM), Università degli studi di Torino = University of Turin (UNITO), Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), IRCCS Research Hospital, Milan, Vall d'Hebron University Hospital [Barcelona], Centro Hospitalar de Lisboa Central E.P.E, University of South Florida [Tampa] (USF), Geneva University Hospital (HUG), Azienda Usl Toscana centro [Firenze], Софийски университет = Sofia University, McMaster University [Hamilton, Ontario], State University of Bahia, Institute of Public Health of Republic of North Macedonia [Skopje], Ain Shams University (ASU), Sagamihara National Hospital [Kanagawa, Japan], Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Amsterdam UMC - Amsterdam University Medical Center, Universidade do Porto = University of Porto, Wuhan University [China], CHU Grenoble, Silesian University of Medicine, Istanbul Faculty of Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Centre Hospitalier Universitaire de Nice (CHU Nice), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Medizinische Universität Wien = Medical University of Vienna, Aarhus University [Aarhus], Oncology Institute of St Elisabeth, University of Naples Federico II = Università degli studi di Napoli Federico II, St Joseph University, Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Kazakh National Medical University, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Tartu University Institute of Clinical Medicine, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Federal Medicobiological Agency [Moscow, Russian Federation], University Medical Center [Utrecht], Semmelweis University [Budapest], Medical University of Łódź (MUL), Vilnius University [Vilnius], University of Medicine and Pharmacy (VIETNAM), University of Cape Town, CHU Sart Tilman, Université de Liège, University of Beira Interior [Portugal] (UBI), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, CHU Montpellier, Wroclaw Medical University [Wrocław, Pologne], University of Bari Aldo Moro (UNIBA), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sagamihara National Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Toulouse [Toulouse], RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Bousquet J., Agache I., Blain H., Jutel M., Ventura M.T., Worm M., Del Giacco S., Benetos A., Bilo B.M., Czarlewski W., Abdul Latiff A.H., Al-Ahmad M., Angier E., Annesi-Maesano I., Atanaskovic-Markovic M., Bachert C., Barbaud A., Bedbrook A., Bennoor K.S., Berghea E.C., Bindslev-Jensen C., Bonini S., Bosnic-Anticevich S., Brockow K., Brussino L., Camargos P., Canonica G.W., Cardona V., Carreiro-Martins P., Carriazo A., Casale T., Caubet J.-C., Cecchi L., Cherubini A., Christoff G., Chu D.K., Cruz A.A., Dokic D., El-Gamal Y., Ebisawa M., Eberlein B., Farrell J., Fernandez-Rivas M., Fokkens W.J., Fonseca J.A., Gao Y., Gavazzi G., Gawlik R., Gelincik A., Gemicioglu B., Gotua M., Guerin O., Haahtela T., Hoffmann-Sommergruber K., Hoffmann H.J., Hofmann M., Hrubisko M., Illario M., Irani C., Ispayeva Z., Ivancevich J.C., Julge K., Kaidashev I., Khaitov M., Knol E., Kraxner H., Kuna P., Kvedariene V., Lauerma A., Le L.T.T., Le Moing V., Levin M., Louis R., Lourenco O., Mahler V., Martin F.C., Matucci A., Milenkovic B., Miot S., Montella E., Morais-Almeida M., Mortz C.G., Mullol J., Namazova-Baranova L., Neffen H., Nekam K., Niedoszytko M., Odemyr M., O'Hehir R.E., Okamoto Y., Ollert M., Palomares O., Papadopoulos N.G., Panzner P., Passalacqua G., Patella V., Petrovic M., Pfaar O., Pham-Thi N., Plavec D., Popov T.A., Recto M.T., Regateiro F.S., Reynes J., Roller-Winsberger R.E., Rolland Y., Romano A., Rondon C., Rottem M., Rouadi P.W., Salles N., Samolinski B., Santos A.F., S Sarquis F., Sastre J., M. G. A. Schols J., Scichilone N., Sediva A., Shamji M.H., Sheikh A., Skypala I., Smolinska S., Sokolowska M., Sousa-Pinto B., Sova M., Stelmach R., Sturm G., Suppli Ulrik C., Todo-Bom A.M., Toppila-Salmi S., Tsiligianni I., Torres M., Untersmayr E., Urrutia Pereira M., Valiulis A., Vitte J., Vultaggio A., Wallace D., Walusiak-Skorupa J., Wang D.-Y., Waserman S., Yorgancioglu A., Yusuf O.M., Zernotti M., Zidarn M., Chivato T., Akdis C.A., Zuberbier T., Klimek L., HUS Inflammation Center, University of Helsinki, and Department of Dermatology, Allergology and Venereology
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Male ,Allergy ,Pediatrics ,Eaaci Position Paper ,COVID-19 vaccines ,older (adults ,GUIDELINES ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Medicine and Health Sciences ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Geriatrics ,MESH: Aged ,RISK ,Vaccines ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,people) ,EPINEPHRINE ,Epinephrine ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,COVID -19 vaccines ,Anaphylaxis ,medicine.drug ,older (adults/people) ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,MESH: Covid-19 ,MESH: Epinephrine ,Immunology ,adrenaline ,anaphylaxis ,Aged ,COVID-19 Vaccines ,Humans ,SARS-CoV-2 ,COVID-19 ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Diabetes mellitus ,Anaphylaxis/etiology ,MESH: SARS-CoV-2 ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,COVID‐19 vaccines ,Older - Adults/people ,Asthma ,MESH: Humans ,business.industry ,adrenaline, anaphylaxis, COVID-19 vaccines, older (adults/people) ,medicine.disease ,Obesity ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,MESH: Male ,MESH: Anaphylaxis ,Older ,3121 General medicine, internal medicine and other clinical medicine ,business ,MESH: Covid-19 vaccines ,030215 immunology - Abstract
Submitted by (omml@ubi.pt) on 2021-07-05T10:47:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T10:49:11Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Rejected by Pessoa (pfep@ubi.pt), reason: Rever os nomes dos autores. Depois da correção é só voltar a submeter. on 2021-07-05T10:54:19Z (GMT) Submitted by (omml@ubi.pt) on 2021-07-05T11:52:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:34:51Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:35:49Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Made available in DSpace on 2021-07-05T13:35:49Z (GMT). No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Previous issue date: 2021-04-02 info:eu-repo/semantics/publishedVersion
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- 2021
36. EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID‐19 vaccines
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Thomas Eiwegger, Stefan Vieths, Kari C. Nadeau, Carmen Riggioni, Stefano Del Giacco, Mohamed H. Shamji, Milena Sokolowska, Marek Jutel, Oscar Palomares, Ioana Agache, María José Torres, Domingo Barber, Markus Ollert, Ronald L. Rabin, University of Zurich, Agache, Ioana, and Shamji, Mohamed H
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0301 basic medicine ,medicine.medical_specialty ,Allergy ,COVID-19 Vaccines ,Immunology ,Eaaci Position Paper ,610 Medicine & health ,Disease ,virus ,03 medical and health sciences ,0302 clinical medicine ,10183 Swiss Institute of Allergy and Asthma Research ,medicine ,media_common.cataloged_instance ,Immunology and Allergy ,Humans ,Dosing ,European union ,Intensive care medicine ,Contraindication ,BNT162 Vaccine ,media_common ,COVID ,2403 Immunology ,business.industry ,SARS-CoV-2 ,COVID-19 ,SARS-CoV ,medicine.disease ,United Kingdom ,Vaccination ,030104 developmental biology ,030228 respiratory system ,2723 Immunology and Allergy ,Position paper ,business ,Anaphylaxis - Abstract
The first approved COVID‐19 vaccines include Pfizer/BioNTech BNT162B2, Moderna mRNA‐1273 and AstraZeneca recombinant adenoviral ChAdOx1‐S. Soon after approval, severe allergic reactions to the mRNA‐based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitisation. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID‐19 vaccines and to facilitate their broader and safer use.
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- 2021
37. Interference of hemolysis on the postmortem biochemical analysis of IgE by ECLIA
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Zhipeng Cao, Tianqi Wang, Yuqing Jia, Zeyu Li, and Bao-Li Zhu
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Male ,Postmortem biochemistry ,Method Paper ,Pilot Projects ,Immunoglobulin E ,Hemolysis ,01 natural sciences ,Serum ige ,Pathology and Forensic Medicine ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Forensic medicine ,medicine ,Humans ,030216 legal & forensic medicine ,Anaphylaxis ,Postmortem serum ,biology ,medicine.diagnostic_test ,business.industry ,010401 analytical chemistry ,Total ige ,Middle Aged ,medicine.disease ,0104 chemical sciences ,Electrochemiluminescent immunoassay ,Immunoassay ,Luminescent Measurements ,Linear Models ,Anaphylactic shock ,biology.protein ,Female ,IgE ,Autopsy ,business - Abstract
Forensic diagnosis of anaphylactic shock is a challenging task in forensic practice due to the lack of characteristic morphological changes. Postmortem analysis of serum IgE can provide helpful information for determining anaphylaxis. However, postmortem serum always suffers from hemolysis. To investigate the interference of hemolysis on postmortem analysis of total IgE by electrochemiluminescent immunoassay (ECLIA) and verify the suitability of the commercially available ECLIA kit for postmortem hemolyzed blood with the dilution-correction method, different levels of hemolyzed serum were prepared to evaluate the interference of hemolysis. A linear regression analysis was then performed on the concentration of total IgE in the completely hemolyzed blood and the corresponding serum. Our results indicated that hemolysis negatively interfered with the total IgE analysis by ECLIA and the interference (|Bias%|) increased with increasing levels of hemolysis. After controlling for |Bias%| by dilution, the test concentration of total IgE in the completely hemolyzed blood was still significantly lower than that in the serum (P
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- 2021
38. Assessment of selected parameters of the circulatory system in patients undergoing oral aspirin challenge
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Jolanta Perkowska, Elżbieta Kramarz, Krzysztof Kłos, and Jerzy Kruszewski
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Tachycardia ,medicine.medical_specialty ,aspirin ,Kounis syndrome ,Dermatology ,arrhythmia ,Ventricular tachycardia ,Internal medicine ,medicine ,Immunology and Allergy ,cardiovascular diseases ,Adverse effect ,Original Paper ,Aspirin ,business.industry ,medicine.disease ,RC31-1245 ,Blood pressure ,RL1-803 ,Ventricular fibrillation ,cardiovascular system ,Cardiology ,hypersensitivity ,medicine.symptom ,business ,oral aspirin challenge ,Anaphylaxis ,medicine.drug - Abstract
Introduction It is known that the administration of the drug during the oral aspirin challenge (OAC) can cause hypersensitivity symptoms not only from the respiratory system or skin, but also from the cardiovascular system. Aim To assess the occurrence and nature of cardiovascular adverse events during the OAC in patients suspected of hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). Material and methods The study included 52 patients with symptoms of hypersensitivity to aspirin (ASA) or other NSAIDs in the form of skin reactions or respiratory response in anamnesis. Patients were treated with OAC and simultaneously were subject to monitoring of clinical manifestations of hypersensitivity to ASA/NSAIDs, ventilation disorders and cardiovascular functions. Results The most common reaction of the cardiovascular system during OAC was tachycardia or supraventricular and ventricular extrasystoles, regardless of the day of the study and the result of OAC. Supraventricular and ventricular tachycardia was recorded incidentally. Atrial or ventricular fibrillation or flutter was not observed. There was no evidence of any ischemic heart disease. In 2 patients, hypotension was registered, but only 1 of them required typical treatment of anaphylaxis. Conclusions No clinically significant cardiac arrhythmias were recorded during OAC. The changes observed in the records of blood pressure and ECG monitoring show that OAC performed in accordance with the current guidelines does not pose a high risk to the patient’s health and life as a result of cardiovascular reactions.
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- 2020
39. COVID-19 vaccine-associated anaphylaxis: A statement of the World Allergy Organization Anaphylaxis Committee
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TURNER, Paul J., ANSOTEGUI, Ignacio J., CAMPBELL, Dianne E., CARDONA, Victoria, EBISAWA, Motohiro, EL-GAMAL, Yehia, FINEMAN, Stanley, GELLER, Mario, GONZALEZ-ESTRADA, Alexei, GREENBERGER, Paul A., LEUNG, Agnes S.Y., LEVIN, Michael E., MURARO, Antonella, BORGES, Mario SÁNCHEZ, SENNA, Gianenrico, TANNO, Luciana K., THONG, Bernard Yu-Hor, Margitta, WORM, Committee, WAO Anaphylaxis, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, The University of Sydney, Hospital Quirónsalud Bizkaia [Bilbao], DataLab Group [Montrouge], Vall d'Hebron University Hospital [Barcelona], Sagamihara National Hospital [Kanagawa, Japan], Ain Shams University (ASU), Emory University School of Medicine, Emory University [Atlanta, GA], Academia Nacional de Medicina, Mayo Clinic [Jacksonville], Northwestern University Feinberg School of Medicine, Prince of Wales Hospital, University of Cape Town, Food Allergy Referral Centre Veneto Region [Padua, Italy], Università degli Studi di Padova = University of Padua (Unipd), Centro Médico Docente La Trinidad, Università degli studi di Verona = University of Verona (UNIVR), Hospital Sírio-Libanês [São Paulo, Brazil], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Tan Tock Seng Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Salvy-Córdoba, Nathalie, Institut Català de la Salut, [Turner PJ] National Heart Lung Institute, Imperial College London, London, UK. Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, Australia. [Ansotegui IJ] Dept. Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain. [Campbell DE] Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, Australia. DBV Technologies, Montrouge, France. [Cardona V] Secció d’Al·lèrgia, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Ebisawa M] Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan. [El-Gamal Y] Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt, and Vall d'Hebron Barcelona Hospital Campus
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Allergy ,Immune System Diseases::Hypersensitivity::Hypersensitivity, Immediate::Anaphylaxis [DISEASES] ,Complex Mixtures::Biological Products::Vaccines::Viral Vaccines [CHEMICALS AND DRUGS] ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,0302 clinical medicine ,Pandemic ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Immunology and Allergy ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,030223 otorhinolaryngology ,Adverse event following immunization ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Anaphylaxis ,COVID-19 (Malaltia) - Vacunació ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Pulmonary and Respiratory Medicine ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Polyethylene glycol ,Immunology ,Article ,03 medical and health sciences ,enfermedades del sistema inmune::hipersensibilidad::hipersensibilidad inmediata::anafilaxia [ENFERMEDADES] ,medicine ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Intensive care medicine ,Adverse effect ,business.industry ,Public health ,Medicaments - Efectes secundaris ,COVID-19 ,1103 Clinical Sciences ,medicine.disease ,Anafilaxi ,Coronavirus ,mezclas complejas::productos biológicos::vacunas::vacunas víricas [COMPUESTOS QUÍMICOS Y DROGAS] ,WAO Anaphylaxis Committee ,030228 respiratory system ,Immunization ,Vaccine ,Position paper ,Allergists ,business ,lcsh:RC581-607 - Abstract
Anafilaxi; COVID-19; Polietilenglicol Anafilaxia; COVID-19; Polietilenglicol Anaphylaxis; COVID-19; Polyethylene glycol Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Vaccines often cause adverse events; however, the vast majority of adverse events following immunization (AEFI) are a consequence of the vaccine stimulating a protective immune response, and not allergic in etiology. Anaphylaxis as an AEFI is uncommon, occurring at a rate of less than 1 per million doses for most vaccines. However, within the first days of initiating mass vaccination with the Pfizer-BioNTech COVID-19 vaccine BNT162b2, there were reports of anaphylaxis from the United Kingdom and United States. More recent data imply an incidence of anaphylaxis closer to 1:200,000 doses with respect to the Pfizer-BioNTech vaccine. In this position paper, we discuss the background to reactions to the current COVID-19 vaccines and relevant steps to mitigate against the risk of anaphylaxis as an AEFI. We propose a global surveillance strategy led by allergists in order to understand the potential risk and generate data to inform evidence-based guidance, and thus provide reassurance to public health bodies and members of the public.
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- 2021
40. First pediatric electronic algorithm to stratify risk of penicillin allergy.
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Roberts, Hannah, Soller, Lianne, Ng, Karen, Chan, Edmond S., Roberts, Ashley, Kang, Kristopher, Hildebrand, Kyla J., and Wong, Tiffany
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MEDICAL personnel ,CHILD patients ,ALGORITHMS ,PENICILLIN ,ALLERGIES - Abstract
Beta-lactam allergy is reported in 5–10% of children in North America, but up to 94–97% of patients are deemed not allergic after allergist assessment. The utility of standardized skin testing for penicillin allergy in the pediatric population has been recently questioned. Oral drug challenges when appropriate, are preferred over skin testing, and can definitively rule out immediate, IgE-mediated drug allergy. To our knowledge, this is the only pediatric study to assess the reliability of a penicillin allergy stratification tool using a paper and electronic clinical algorithm. By using an electronic algorithm, we identified 61 patients (of 95 deemed not allergic by gold standard allergist decision) as low risk for penicillin allergy, with no false negatives and without the need for allergist assessment or skin testing. In this study, we demonstrate that an electronic algorithm can be used by various pediatric clinicians when evaluating possible penicillin allergy to reliably identify low risk patients. We identified the electronic algorithm was superior to the paper version, capturing an even higher percentage of low risk patients than the paper version. By developing an electronic algorithm to accurately assess penicillin allergy risk based on appropriate history, without the need for diagnostic testing or allergist assessment, we can empower non-allergist health care professionals to safely de-label low risk pediatric patients and assist in alleviating subspecialty wait times for penicillin allergy assessment. [ABSTRACT FROM AUTHOR]
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- 2020
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41. Is the concept of 'peanut-free schools' useful in the routine management of peanut-allergic children at risk of anaphylaxis?
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Margitta Worm, Imke Reese, Barbara Ballmer-Weber, Anja Wassmann-Otto, Susanne Lau, Christiane Schäfer, Jörg Kleine-Tebbe, Sabine Doelle-Birke, Kirsten Beyer, Lars Lange, Birgit Ahrens, Katharina Blumchen, Annice Heratizadeh, Ute Lepp, Thomas Werfel, Zsolt Szépfalusi, Vera Mahler, and Sabine Schnadt
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medicine.medical_specialty ,Allergy ,Peanut allergy ,education ,Emergency treatment ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Coping strategies ,business.industry ,food and beverages ,Anaphylactic reactions ,Allergen avoidance ,medicine.disease ,030228 respiratory system ,Family medicine ,Position paper ,business ,Anaphylaxis ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit - Abstract
Summary Background Parents of school-age children with food allergies and potential anaphylactic reactions want their children to have an unburdened and risk-free everyday school life. Thus, particularly in the case of peanut allergy, demands for peanut-free schools are put forward. Results and discussion The position paper of the food allergy working group of the German Society for Allergology and Clinical Immunology (Deutsche Gesellschaft für Allergologie und klinische Immunologie) highlights why the concept of peanut-free schools does not protect peanut allergic children, but rather bears potential disadvantages and risks for all those involved. The focus on peanut as a potential trigger of anaphylactic reactions ignores other relevant triggers. Conclusion In order to address the fears and concerns of patients, parents, and school staff, it is mandatory to develop various coping strategies. These should enable and ensure the safety and participation of food-allergic pupils in classes and other school activities. Therefore, it is important to implement adequate measures for allergen avoidance and emergency treatment for students with confirmed food allergies.
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- 2020
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42. Selected allergic diseases of the gastrointestinal tract
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Zbigniew Bartuzi, Michał Przybyszewski, Andrzej Kuźmiński, Natalia Sokołowska-Ukleja, Alina Tomaszewska, Małgorzata Graczyk, and Magdalena Żbikowska-Gotz
- Subjects
medicine.medical_specialty ,Gastroenterology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Internal medicine ,Eosinophilic ,Medicine ,Enteropathy ,Stomatitis ,Irritable bowel syndrome ,Enterocolitis ,Gastrointestinal tract ,Review Paper ,food allergy ,business.industry ,medicine.disease ,030211 gastroenterology & hepatology ,gastrointestinal tract ,medicine.symptom ,business ,Anaphylaxis - Abstract
Clinical symptoms of food allergy may affect not only the digestive tract, but also the respiratory system, skin, or cardiovascular system. They may manifest themselves as gastrointestinal problems, asthma attacks, hives, or anaphylactic shock. Allergic reactions of the gastrointestinal tract may be IgE-independent (oral anaphylaxis syndrome, acute gastrointestinal reactions), mixed (eosinophilic gastrointestinal disorders), or IgE-independent (food-induced enterocolitis, proctitis, or enteropathy). The most serious conditions in which allergic background plays or can play an important role are: oral anaphylaxis syndrome, aphthous stomatitis, reflux disease, acute and chronic allergic reactions of gastric mucosa, irritable bowel syndrome, and eosinophilic gastrointestinal disorders.
- Published
- 2019
43. Immunological characterization of onion (Allium cepa) allergy
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Marcello Albanesi, Danilo Di Bona, Luigi Macchia, Lucia Anna Giliberti, Maria Filomena Caiaffa, Carlo Pasculli, and Maria Pia Rossi
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Allergy ,lcsh:Internal medicine ,Dermatology ,Lymphocyte proliferation ,lymphocyte proliferation ,Immunoglobulin E ,lipid transfer proteins ,Peripheral blood mononuclear cell ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,medicine ,lcsh:Dermatology ,Immunology and Allergy ,lcsh:RC31-1245 ,Original Paper ,food allergy ,biology ,business.industry ,IgE-ELISA inhibition ,fungi ,food and beverages ,lcsh:RL1-803 ,medicine.disease ,biology.organism_classification ,Immunology ,biology.protein ,Allium ,business ,Contact dermatitis ,Anaphylaxis ,onion allergy - Abstract
Introduction Onion (Allium cepa) handling can induce contact dermatitis, rhinoconjunctivitis and asthma. However, only sporadic reports exist on allergic reactions to onion consumption. Aim We describe herein a case of a 35-year-old man who had an episode of anaphylaxis following cooked onion ingestion. We evaluated onion-specific IgE, the possible cross-reactivity between onion and peach and lymphocyte proliferation in response to onion. Material and methods Specific IgE was evaluated using two techniques: skin test and ImmunoCAP technology. Cross-reactivity between onion and peach was evaluated by IgE-ELISA inhibition test. As for lymphocyte proliferation, blood mononuclear cells were stained with CFSE dye and cultured with an in-house onion extract. Proliferation and phenotype was assessed by flow-cytometry. Results The skin test and ImmunoCAP confirmed the IgE-dependent response towards onion. The incubation of the patient serum with increasing concentrations of the peach extract reduced only scarcely (~30%) onion-specific IgE. Interestingly, B cells but not T cells showed proliferation in response to onion extract. Conclusions In conclusion, our report shows that cooked onion can induce severe allergic reactions, suggesting the presence of thermostable components. Moreover, we applied for the first time a B-cell-based approach to the diagnosis of food allergy. This latter approach might also be applied to other allergic conditions.
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- 2019
44. Analysis of Hymenoptera venom allergy in own material. Clinical evaluation of reactions following stings, in patients qualified for venom immunotherapy
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Jerzy Kruszewski, Andrzej Chciałowski, and Michał Abramowicz
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lcsh:Internal medicine ,medicine.medical_specialty ,Dermatology ,hymenoptera venom allergy ,anaphylaxis ,lcsh:Dermatology ,Immunology and Allergy ,Medicine ,In patient ,Medical prescription ,lcsh:RC31-1245 ,Original Paper ,business.industry ,fungi ,Hymenoptera venom allergy ,lcsh:RL1-803 ,medicine.disease ,Venom immunotherapy ,Bee stings ,eye diseases ,Sting ,immunotherapy ,business ,Clinical evaluation ,Anaphylaxis - Abstract
Introduction Hymenoptera venom allergy (HVA) in some patients occurs with general symptoms involving respiratory and cardiovascular system with anaphylactic shock with constitutes a significant threat to life. Aim Assessment of the prevalence of HVA in our own material. Material and methods There were 498 patients after a general reaction to wasp and/or bee venom. The survey included questions: the type of stinging insect, body parts stung by insects, profession, frequency of stings by wasps and bees depending on professional activity, places of stings, clinical symptoms using the scale according to Muller, and the treatment following the sting. Among 498 patients, there were 281 women and 217 men. Results Wasp stings were more frequent and affected 382 (77%) persons, while bee stings affected 116 (23%) persons. Limbs constituted the most common area of the body stung by both wasps and bees. The sting was more frequent in rural areas and during summer rest. A severe systemic reaction (class III and IV according to Muller) occurred more often in people stung by bees. The most common medications included intravenous glucocorticosteroids, calcium preparations and antihistamines. Intramuscular Adrenaline injection was used in 48% of patients, while only 15% received its prescription as an emergency medication. Bee stings were the most common cause of severe systemic symptoms. Conclusions The treatment after the sting in a significant percentage of episodes still deviates from the recommendations of the guidelines, especially in the field of adrenaline recommendations for patients in case of a resting by an insect.
- Published
- 2019
45. Analysis on the risks of severe adverse events in rabies post-exposure prophylaxis and appropriate decision-making procedure
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Zerong Zhu, Zhenggang Zhu, Man Zhang, Shichun Huang, Li Cai, Yuan Fang, and Quan Hu
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Pharmacology ,medicine.medical_specialty ,Medical treatment ,business.industry ,medicine.medical_treatment ,030231 tropical medicine ,Immunology ,medicine.disease ,Rabies vaccination ,03 medical and health sciences ,0302 clinical medicine ,Emergency medicine ,medicine ,Immunology and Allergy ,Rabies ,030212 general & internal medicine ,Post-exposure prophylaxis ,Adverse effect ,business ,Anaphylaxis ,Research Paper - Abstract
Severe adverse events (AEs) following post-exposure rabies vaccination had been occasionally described in previous studies. Once AEs occurred, immediate medical treatment and appropriate change of vaccine and vaccination schedule were of significance. It was also important and challengeable to determine the relationship among adverse reactions, vaccines residues and laboratory tests for patients, to choose a proper vaccine in resumed vaccination, to avoid the reoccurrence of AEs and to ensure adequate immune response. Here, we present steps about how to cope with AEs by giving an example with a two-year-old girl who was identified as category II exposure to rabies, suffered from anaphylaxis after first dose administration with human diploid rabies vaccine (HDCV) so vaccination was temporarily suspended. Dexamethasone was prescribed to her in anti-allergy therapy. Allergy tests indicated that the patient was not sensitive to allergens and heterologous proteins. Vaccine test report showed that residual kanamycin existed in that batch of vaccines. This reminded us to provide her antibiotic skin sensitivity test which found she was allergic to kanamycin. Thus, we could conclude it was the cause of AEs. Then, 0.5 mL lyophilized Purified Vero Cell Rabies Vaccine (PVRV) without any residues was enrolled in the resumed vaccination. To ensure successful immunization, immunogenicity test was also provided which showed adequate immune response (RVNA ≥ 0.5 IU/mL) starting from day14. Besides, no further AEs occurred afterward. This study emphasized the importance of in-depth survey, analysis and implied the necessity to scientifically and properly choose the optimal vaccine for patients and appropriately provide treatments if AEs occurred.
- Published
- 2018
46. Is the clinical manifestation of anaphylaxis in children influenced by the trigger of reaction?
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Ewa Cichocka-Jarosz, Tomasz Tomasik, Urszula Jedynak-Wąsowicz, Grzegorz Lis, Piotr Brzyski, and Izabela Tarczoń
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medicine.medical_specialty ,Original Paper ,business.industry ,clinical manifestation ,Mean age ,Dermatology ,Clinical manifestation ,medicine.disease ,Cardiovascular symptoms ,Blood pressure ,children ,Internal medicine ,medicine ,Vomiting ,anaphylaxis ,Immunology and Allergy ,trigger of anaphylaxis ,Insect venom ,Respiratory system ,medicine.symptom ,business ,Anaphylaxis - Abstract
Introduction The number of anaphylaxis diagnoses in children is rising, being still based on the clinical picture. Aim To determine whether triggers of anaphylaxis influence its clinical characteristics in children and adolescents. Material and methods The study group included 114 children (5 months-17 years, mean age: 8.0 ±4.8 years), (66%: boys) with the episode of anaphylaxis up to 1 year back. Medical data were entered to the NORA Registry by means of a validated structured on-line questionnaire. Results Three most frequent triggers of anaphylaxis were: insect venom (47.4%), food (35.1%), drugs (5.3%), with a predominance of food (egg white, cow's milk, nuts and peanuts) in the 0-6 years age group, while insect venom (bee predominance) in the 7-17 years age group (p = 0.016). Clinical manifestations differed between food vs. venom allergic reactions and presented as gastro-intestinal (GI) (61.4%) (p = 0.004), respiratory (RS) (93.9%) (p = 0.036), and cardiovascular (CVS) (74.6%) (p = 0.022) symptoms. Among objective symptoms, vomiting was the most common symptom in the 0-2 years age group (47.1%) (p = 0.006), while hypotension in those aged 7-12 years (40%) (p = 0.010). Severity of symptoms evaluated as Mueller's grade (IV - 74.5%) and as Ring and Messmer's grade (III - 65.8%), depended on the trigger (p = 0.028, p = 0.029, respectively). Life-threatening symptoms occurred in 26 children (fall of the blood pressure - 22%, loss of consciousness - 4.4%). Conclusions The clinical manifestation of anaphylaxis in children is both trigger and age dependent, irrespective of the gender. A typical patient with food anaphylaxis was younger, presenting predominantly GI symptoms, while a typical patient with venom anaphylaxis was older, with mostly cardiovascular symptoms.
- Published
- 2021
47. Non-invasive and minimally-invasive techniques for the diagnosis and management of allergic diseases
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Adam Chaker, Carsten B. Schmidt-Weber, Stefanie Eyerich, Markus Ollert, Ralf Baumann, Marek L. Kowalski, Oliver Pfaar, Ulrich M. Zissler, Alkis Togias, Constanze A. Jakwerth, Tilo Biedermann, Trevor T. Hansel, Knut Brockow, Ryan S Thwaites, Ian M. Adcock, Eva Untersmayr, Holger Garn, and EIT
- Subjects
Allergy ,medicine.medical_specialty ,Immunology ,Respiratory System ,Anaphylaxis ,Asthma ,Atopic Dermatitis ,Food Allergy ,Non-invasive Diagnosis ,Quality of life (healthcare) ,Health care ,anaphylaxis ,medicine ,Hypersensitivity ,Immunology and Allergy ,Humans ,Overdiagnosis ,Intensive care medicine ,Skin ,food allergy ,atopic dermatitis ,business.industry ,Atopic dermatitis ,asthma ,medicine.disease ,1107 Immunology ,Quality of Life ,Position paper ,noninvasive diagnosis ,business ,non-invasive diagnosis - Abstract
Allergy 76(4), 1010-1023 (2021). doi:10.1111/all.14645, Published by Wiley, Oxford
- Published
- 2021
48. Peanut Allergy and Component-Resolved Diagnostics Possibilities-What Are the Benefits?
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Połomska J, Dydak P, Sozańska B, and Sikorska-Szaflik H
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- Child, Adult, Humans, Immunoglobulin E, Antigens, Plant, Allergens, Arachis, Peanut Hypersensitivity diagnosis, Anaphylaxis
- Abstract
Peanut allergy is a widespread and potentially life-threatening condition that affects both children and adults, with a growing incidence worldwide. It is estimated to affect around 1-2% of the population in several developed countries. Component-resolved diagnostics is a modern approach to allergy diagnosis that focuses on identifying specific allergenic proteins to provide precise diagnoses and personalized treatment plans. It is a technique that enables the analysis of specific IgE antibodies against tightly defined molecules (components) that constitute the allergen. Component-resolved diagnostics is particularly valuable in peanut allergy diagnosis, helping to determine allergen components associated with severe reactions. It also aids in predicting the course of the allergy and enables the development of personalized immunotherapy plans; however, the full application of it for these purposes still requires more precise studies. In this paper, we present the current knowledge about peanut allergy and component-resolved diagnostics possibilities. We discuss the possibilities of using molecular diagnostics in the diagnosis of peanut allergy. We focus on examining and predicting the development of peanut allergy, including the risk of anaphylaxis, and describe the latest data related to desensitization to peanuts.
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- 2023
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49. World allergy organization anaphylaxis guidance 2020
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Luciana Kase Tanno, Montserrat Fernandez Rivas, Alexei Gonzalez-Estrada, Aziz Sheikh, Stanley M. Fineman, Yehia El-Gamal, Ignacio J. Ansotegui, Victoria Cardona, Paul Turner, Motohiro Ebisawa, Mario Geller, Bernard Yu-Hor Thong, Paul A. Greenberger, Gianenrico Senna, Margitta Worm, Mario Sanchez Borges, Vall d'Hebron University Hospital [Barcelona], Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Ain Shams University (ASU), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Emory University School of Medicine, Emory University [Atlanta, GA], Academia Nacional de Medicina, Mayo Clinic [Jacksonville], Northwestern University Feinberg School of Medicine, Centro Médico Docente La Trinidad, Clínica el Avila, Università degli studi di Verona = University of Verona (UNIVR), Usher Institute of Population Health Sciences and Informatics [Edinburgh, U.K.], University of Edinburgh, Hospital Sírio-Libanês [São Paulo, Brazil], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), INSERM-TRANSFERT [Paris] (IT), Institut National de la Santé et de la Recherche Médicale (INSERM), WHO-TDR Suisse, WHO-TDR Suisse-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Tan Tock Seng Hospital, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, School of Medicine [Western Sydney University], Western Sydney University, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], and Salvy-Córdoba, Nathalie
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Allergy ,0302 clinical medicine ,Immunology and Allergy ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,030223 otorhinolaryngology ,NSAIDs, nonsteroidal anti-inflammatory drugs ,IgE, immunoglobulin E ,CAST, cellular allergen stimulation test ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,BAT, basophil activation test ,EAI, epinephrine auto-injectors ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Acute systemic allergic reaction ,Epinephrine ,ACE - Angiotensin-converting enzyme ,MRGPRX2, Mas-related G-protein coupled receptor member X2 ,Guidance ,Position Paper ,Venom allergy ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Anaphylaxis ,medicine.drug ,lcsh:Immunologic diseases. Allergy ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Immunology ,Drug allergy ,IgG, immunoglobulin G ,FcεRI, IgE high-affinity receptor ,Guidelines ,Adrenaline ,03 medical and health sciences ,Food allergy ,medicine ,Intensive care medicine ,Glucocorticoids ,Health professionals ,business.industry ,Cofactors ,1103 Clinical Sciences ,medicine.disease ,ACE, Angiotensin converting enzyme ,IgE - Immunoglobulin E ,030228 respiratory system ,Antihistamines ,lcsh:RC581-607 ,business - Abstract
International audience; Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions. The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies. The rationale of this updated position document is the need to keep guidance aligned with the current state of the art of knowledge in anaphylaxis management. The World Allergy Organization (WAO) anaphylaxis guidelines were published in 2011, and the current guidance adopts their major indications, incorporating some novel changes. Intramuscular epinephrine (adrenaline) continues to be the first-line treatment for anaphylaxis. Nevertheless, its use remains suboptimal. After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management. The limited availability of epinephrine auto-injectors remains a major problem in many countries, as well as their affordability for some patients.
- Published
- 2020
50. Beliefs about food allergies in adolescents aged 11–19 years: A systematic review.
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Newman, Kristina L., Chater, Angel, and Knibb, Rebecca C.
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FOOD allergy ,TEENAGERS ,ALLERGIES ,THEMATIC analysis ,DATABASE searching ,RISK-taking behavior ,TEENAGE girls - Abstract
Aims: Research suggests of people with food allergy (FA), adolescents have the highest risk of fatal allergic reactions to food, yet understanding of this population and how they manage their condition is limited. Understanding beliefs and how they affect behaviour could inform ways to reduce risk taking behaviour and fatal reactions in adolescents. This systematic review aimed to explore beliefs adolescents hold about their FA, and how these may be associated with FA management. Demographics: Adolescents aged 11–19 years with FA. Methodology: A systematic search of seven databases was conducted. Papers of any design were included that reported on the beliefs about FA in adolescents aged 11–19 years. Data was systemised by narrative thematic analysis. Findings: 20 studies were included. Themes included navigating FA in different environments, carriage and use of adrenaline auto‐injectors, management of the risk of anaphylaxis, behaviour and understanding of others, and food‐allergic identity. Implications: Adolescents with FA hold a variety of condition beliefs; some beliefs were related to behaviour that could lead to an allergic reaction, while other beliefs were related to protective behaviours. Further research into understanding adolescent beliefs in order to inform clinical management and reduce the risk of potential fatal reactions is essential. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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