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Background: Allergy diagnosis in patients exposed to multiple pollen species is complex and misdiagnosis is often a cause for unsuccessful specific immunotherapy. Objective: We studied the sensitization profile of individual allergens (major, minor and pan-allergens) in pollen-sensitized patients in a region with high exposure to olive pollen by investigating the influence of minor allergens on allergic disease and the association between pan- and minor allergen sensitizations. Methods: A panel of 13 purified allergens, which included the most relevant allergens in the area, as well as minor olive allergens and pan-allergens, were screened using a high-capacity technology (ADVIA-Centaur®) in 891 patients. Results: Olive allergy as measured by specific IgE to Ole e 1 was the leading pollinosis in the area. The minor olive allergens Ole e 7 and Ole e 9 were markers of more severe allergic illness. Profilin sensitization was associated mainly with grass allergy, the second most prevalent pollinosis. Salsola kali pollen allergy was the third most common cause of pollinosis in the area. The prevalence of sensitization to the peach allergen Pru p 3, a nonspecific lipid-transfer protein, was notable. Conclusion: Epidemiological analysis by component-resolved diagnosis is a new method, which elucidates the interaction between allergen exposure gradient and patient sensitization. High exposure leads to differential sensitization profiles some of which are associated with more severe allergic conditions. Profilin sensitization, related mainly to grass pollinosis, was a marker of more severe grass pollen sensitization. [ABSTRACT FROM AUTHOR]

The clinical characteristics in olive pollen allergy are dependent on the antigenic load, the allergens profile, and the genetic restrictions. Our objective was to determine specific response pattern in Ole e 2 and Ole e 10 sensitization at those levels.We studied 146 patients with seasonal rhinitis and/or asthma and positive prick test toOlea europaeapollen. IgE against Ole e 2 and Ole e 10 were detected by skin prick test and ELISA. HLA-DRB1 and HLA-DQB1 loci were typed by polymerase chain reaction sequence-specific primers method.A total of 102 (69.9%) and 79 (54.0%) patients showed significant IgE antibody response against Ole e 2 and Ole e 10, respectively. There was a significant association between Ole e 2 (OR 2.2,P = 0.04) and Ole e 10 reactivities (OR 2.8,P = 0.007) with asthma. In addition, total and specific IgE antibody levels significantly correlated with asthma (P < 0.05). Patients who reacted to both allergens reached the highest asthma risk factor (OR 4.3,P = 0.002). Phenotypic frequency of DR7 (OR 5.4,Pc = 0.003) and DQ2 (OR 3.6,Pc = 0.02) were increased in positive Ole e 2 patients compared with control subjects. DR2(15) phenotypic frequency was significantly increased (OR 5.6,Pc = 0.02) in positive Ole e 10 patients compared with control subjects.Our data suggest an association of Ole e 2 and Ole e 10 with bronchial asthma. Also, we found a genetic control of Ole e 2 and Ole e 10 IgE-specific responses that could be relevant to clinical disease in olive pollen allergy. [ABSTRACT FROM AUTHOR]

Background: Olea europaea pollen is an important cause of seasonal allergic rhinitis and bronchial asthma in southern Spain. For patients allergic to grass pol– len the critical concentration of airborn pollen is 50 grains/m[sup 3] , but in the case of Olea pollinosis no data is available. Methods: Fifty–six seasonal allergic rhinitis patients (29 in 1994 and 27 in 1995) were included in this study, all of whom lived in Jaen. Daily symptom card were filled in and pollen counts during May and June were performed in both years. A linear regression model was used for analysis of the airborne pollen concentration and the symptom score. Results: Significant correlations among daily counts of Olea pollen and rhinitis symptoms were obtained. Most of our monosensitized patients needed a high Olea pollen concentration in the atmosphere (around 400 grains/m[sup 3] ) to suffer at least from mild allergic rhinitis symptoms. Conclusion: Local conditions with a wide area dedicated to olive tree cultivars result in a high concentration of this pollen in the atmosphere. Monosensitized Olea patients in our area seem to need exceptionally high levels to suffer from allergic symptoms. [ABSTRACT FROM AUTHOR]

We report an insulin-treated diabetic patient who suffered, in a 2-month period, three severe anaphylactic reactions immediately after self-administered subcutaneous injections of neutral protamine Hagedorn (NPH) human recombinant-DNA insulin. These reactions consisted of local and systemic symptoms, including dyspnea and hypotension. A simultaneous sensitization to human insulin and to protamine was demonstrated, both by skin tests and by the determination of serum specific IgE. Suspecting protamine allergy, we performed a test dose to human lente insulin with perfect tolerance. After a 1-year follow-up with lente-insulin treatment, no reactions have occurred, despite treatment interruptions. Therefore, protamine IgE-mediated allergy probably caused our patient's reactions. In conclusion, protamine sensitization should be ruled out in any patient with a history of reactions to subcutaneous protamine-containing insulins, even if insulin sensitization is present. [ABSTRACT FROM AUTHOR]

We report a case of occupational bronchial asthma and rhinoconjunctivitis caused by Phoenix canariensis (PC) pollen. The canary palm is a type of palm tree, belonging to the Arecaceae family, which is widely distributed in frost-free regions as an ornamental tree. Our patient was referred because he suffered symptoms of bronchial asthma, rhinoconjunctivitis, and contact urticaria when pruning dried leaves from PC during the pollination months. The skin prick test (SPT) with a PC pollen extract was positive, as was the specific IgE to PC pollen determined by Phadezym RAST, indicating an IgE-mediated sensitization. The nonspecific bronchial provocation test (BPT) performed with methacholine disclosed a mild bronchial hyperreactivity, and specific BPT with PC pollen elicited an immediate fall of 25% in FEV1 with respect to baseline. On RAST inhibition studies, a significant cross-reactivity was found between PC pollen and date palm (P. dactylifera) pollen. These results suggest that PC pollen could be a potential allergen in PC-growing areas. [ABSTRACT FROM AUTHOR]

The avocado (Av) is a fruit that belongs to the Lauraceae family. We report 17 patients with immediate hypersensitivity to avocado. Clinical manifestations in relation to avocado ingestion were as follows: systemic anaphylaxis in seven patients, angioedema/urticaria in six, vomiting in two, bronchial asthma in one, and rhinoconjunctivitis in one Skin prick test (SFT) with fresh avocado was positive in all patients with the Strong avocado variety (SAy) and in 14 patients with the Hass avocado variety (HAy). Our patient-associated sensitizations were as follows: 10 to latex, eight to chestnut, eight to banana four to kiwi, and four to walnut. Avocado sensitizations patients with latex allergy' were typically middle-aged women, professionally exposed to latex, who also exhibited frequent associated sensitizations to chestnut. banana; and other fruits. Specific IgE against avocado was demonstrated in 11 of our patients by both commercial CAP and RAST with avocado extract coupled to nitrocellulose disks. Despite its lower protein content. SAv seems to be more allergenic than HAv both in vivo and in vitro. On incubating a pool of sera from our patients with avocado, latex , chestnut and banana extracts, a progressive RAST inhibition was obtained with SAv- and chestnut-marked disks. This suggests the existence of common antigenic determinants among these allergens. [ABSTRACT FROM AUTHOR]

Presents a patient with proven immunoglobulin E-mediated hypersensitivity due to erythromycin. Development of pruritic blisters on the penis with local hyperpigmentation; Fixed drug eruption and urticaria due to cross-reactivity; Epicutaneous patch tests on unaffected skin using different macrolides; Oral challenges with increasing doses of azithromycin; Basic structure of macrolides.

Parabens are preservatives widely used in drugs and cosmetics and rarely induce systemic contact dermatitis. In the patient, patch testing confirmed parabens as the cause of previously suspected allergic contact dermatitis from cosmetics. However, a detailed history ruled out this sensitization as the cause of her postoperative reaction. Instead, a positive patch test to suxamethonium and parenteral administration of the drug explain these clinical features. Muscle relaxants are the most common causes of immediate IgE-mediated reactions during general anesthesia. The quaternary ammonium group is the main epitope eliciting such reactions. All muscle relaxants exhibited a high degree of in vivo and in vitro cross-reactivity, based on this specific structure.

This article presents information on a case study related to contact urticaria in a child from raw potato. A 4-year-old boy, with a history of perennial rhinitis and a positive prick test to dermatophagoides pteronyssinus, exhibited symptoms of immediate urticaria related to contact with raw potato pulp. He suffered from erythema and severe itching with progressive onset of wheals, restricted to the contact area with raw potato pulp. Potato contact hypersensitivity is usually occupational but in this case, only sporadic exposure can be documented.

Reports on a fixed drug eruption associated with dimenhydrinate, in a nonprescription motion sickness medicine and on allergenic cross-reactivity in the Liliaceae family. Clinical presentation of the allergic reactions; Diagnosis; Tests and treatments conducted on patients.