PubMed Health⌕ Search

Biomedical subjects

A Capriles-Hulett

Publications and source records attributed to A Capriles-Hulett.

8 recordsLinked to original sources
PubMed2004

The multiple faces of nonsteroidal antiinflammatory drug hypersensitivity.

Based on the clinical picture and triggering drugs, allergic and pseudoallergic adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) can be classified in four patterns : respiratory, cutaneous, mixed and systemic. This categorization is useful for the purpose of describing patient populations included in studies about NSAID adverse reactions as well as for the routine management of the patient in the clinical setting.

Angioedema↗
PubMed2001

Tolerability to new COX-2 inhibitors in NSAID-sensitive patients with cutaneous reactions.

BACKGROUND: The safety of new anti-inflammatory drugs in patients intolerant to classic cyclooxygenase (COX) inhibitors with urticaria and angioedema has not been determined. OBJECTIVES: To investigate the clinical tolerance to COX-2 inhibitors in patients with cutaneous symptoms attributable to classic nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: Patients with urticaria or angioedema triggered by NSAIDs were challenged with COX-2 inhibitors by the single-blinded, placebo-controlled oral method. RESULTS: One hundred ten NSAID-sensitive patients were submitted to 184 oral challenges with COX-2 inhibitors. Eighty-two patients (74.5%) were cross-reactors and 28 patients (25.4%) were single reactors. Reaction rates for COX-2 inhibitors were 21.3% for nimesulide, 17.3% for meloxicam, 33.3% for celecoxib, and 3.0% for rofecoxib. CONCLUSIONS: Some COX-2 inhibitors, such as rofecoxib, are relatively safe in NSAID-sensitive patients with urticaria or angioedema. However, the tolerance profile varies with the drug, which might be related to a differential selectivity of the drug for COX-1 and COX-2. COX-1 inhibition would represent a major mechanism for cutaneous adverse reactions to NSAIDs. Controlled oral provocation with new NSAIDs is useful for the proper management of patients sensitive to classic NSAIDs requiring analgesic and anti-inflammatory treatment.

Administration, Oral↗
PubMed2000

Atopy is a risk factor for non-steroidal anti-inflammatory drug sensitivity.

BACKGROUND: There is scarce information in the literature about a possible association between atopy and certain clinical manifestations of NSAID sensitivity. OBJECTIVES: (1) To evaluate the prevalence of atopy in patients proved to be sensitive to cyclooxygenase inhibitors. (2) To assess cross-reactivity to two alternative NSAIDs, paracetamol (acetaminophen) and nimesulide. METHODS: NSAID-sensitive patients attending an allergy clinic and unselected controls were prick tested with inhalant allergens. Oral challenges with NSAIDs were carried out by the single-blinded (SBOC) method. Clinical data about personal and family history of allergic and atopic diseases were obtained by a careful review of the medical records and by direct questioning by experienced allergists. RESULTS: Fifty patients had positive SBOCs to the suspected NSAID and only these were studied. A personal history of atopic diseases was present in 41 patients (82%) and 7 controls (14.5%), and a family history in 24 patients (48%) and 6 controls (12.5%). Prick skin tests with aeroallergens were positive in 39 of 45 patients tested (86.6%) and in 14 of 48 controls (29.1%), (P = .0001). Skin test positivity rates were higher in patients with cutaneous challenge reactions who responded to only one NSAID (single reactors) in comparison to cross-reactors (P = .04). The most frequent clinical manifestations of NSAID sensitivity were (1) cutaneous (angioedema, urticaria) in 34 patients, (2) blended (cutaneous plus respiratory) in 12, (3) respiratory in 3, and (4) anaphylactoid in 1. Aspirin, pyrazolone, paracetamol, and ibuprofen were the drugs more frequently implicated in these reactions. Cross-sensitivity with paracetamol and nimesulide were 32% and 25%, respectively. CONCLUSIONS: The prevalence of atopy is increased in challenge-proven NSAID-intolerant patients. The atopic condition may represent an important risk factor for developing reactions to these drugs. Paracetamol and nimesulide are relatively safe alternative choices in those patients, although their use still carries some risk of unwanted reactions.

Adult↗
PubMed2000

Trichophyton-specific IgE in patients with dermatophytosis is not associated with aeroallergen sensitivity.

BACKGROUND: It has been proposed that Trichophyton infection is associated with atopy and allergy. OBJECTIVES: Our purpose was (1) to confirm whether atopy predisposes to chronic dermatophytosis and (2) to investigate whether Trichophyton infection induces atopic disease. METHODS: Patients attending dermatology clinics and suspected of having dermatomycosis underwent in a prospective manner fungal culture and Trichophyton and inhalant skin tests, and blood serum was collected for total IgE and Trichophyton radioallergosorbent testing. Personal and family history of atopic diseases was also investigated. RESULTS: According to mycologic culture, atopic history, and inhalant skin test results, patients were classified into 4 groups: (1) atopy plus mycosis (n = 28), (2) atopy (n = 26), (3) mycosis (n = 35), and (4) no atopy, no mycosis (n = 33). Patients with active mycosis (groups 1 and 3) demonstrated significantly increased positivity of Trichophyton skin tests compared with patients without fungal infection (groups 2 and 4), regardless of their atopic status, whereas atopic patients (those in groups 1 and 2) had significantly increased levels of total serum IgE compared with nonatopic subjects. Trichophytosis was not more prevalent in atopic than in nonatopic subjects, and atopic diseases were not more frequent in culture-positive than in culture-negative patients. CONCLUSIONS: Our results indicate that Trichophyton -specific IgE is observed in patients with trichophytosis regardless of atopy.

Adolescent↗
PubMed1997

Mite-contaminated foods as a cause of anaphylaxis.

BACKGROUND: Although insect and arthropod contamination of certain foods has been recognized for many years, allergic manifestations caused by ingestion of mite allergens have only rarely been reported. OBJECTIVE: The purpose of this study is to present clinical observations in patients who experienced acute anaphylaxis after eating mite-contaminated foods. METHODS: Thirty atopic subjects who were first seen with systemic anaphylaxis precipitated by the ingestion of wheat-containing foods underwent skin prick tests with inhalant and food extracts, as well as with uncontaminated and mite-contaminated wheat flour. Flour samples were examined microscopically for identification and counting of mites. Der p 1 and Der f 1 levels were quantitated by using immunochemical methods. RESULTS: The most common symptoms were breathlessness, angioedema, wheezing, and rhinorrhea, which started between 10 and 240 minutes after eating. Abundant mites were present in the flour obtained from 28 patients; Suidasia spp. mites were found in grated bread from the other two patients. Positive prick test responses to Dermatophagoides farinae-and mite-contaminated flour and negative skin test responses to wheat extract, other food extracts, and uncontaminated wheat flour were found in all patients. Skin test responses were positive in volunteers with mite allergy even after heating the mite-contaminated flour at 100 degrees C. Screening of 35 unselected flour samples demonstrated the presence of mites in 13 of them (37.1%). CONCLUSIONS: Systemic anaphylaxis can occur after the ingestion of heated or unheated mite-contaminated foods. This problem may be more prevalent in tropical and subtropical countries than previously recognized.

Adolescent↗
PubMed1997

A new triad: sensitivity to aspirin, allergic rhinitis, and severe allergic reaction to ingested aeroallergens.

Increasing attention has recently been paid to a group of patients who experience anaphylaxis after ingestion of foods prepared with mite-contaminated wheat flour. We present three cases of this syndrome, which occurs more often in young adults with allergic rhinitis and/or asthma. We have observed an increased frequency of sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), manifested as urticaria or angioedema, in patients with this condition.

Adolescent↗
PubMed1995

Very low frequency of latex and fruit allergy in patients with spina bifida from Venezuela: influence of socioeconomic factors.

BACKGROUND: The prevalence of latex allergy appears to be substantially higher in certain high risk groups, particularly in children with spina bifida. The source of this increase is presently unknown and may be due either to increased infantile exposure or to an intrinsic predilection for atopy in this condition. OBJECTIVE: We attempted to ascertain the prevalence of latex and tropical fruit allergy in children of lower socioeconomic strata with spina bifida from Caracas, Venezuela, who have limited operative and other medical exposure to latex. METHODS: Ninety-three unselected patients with spina bifida from clinic and hospital populations were prick tested with commercial (Stallergenes-Pasteur) latex extract and crude glove (Baxter-Triflex, 1/5 wt/vol) latex extract as well as with standardized mite and cockroach, 1/10 wt/vol, extracts (Hollister-Stier). An array of tropical fruits were also included in the battery of skin test materials, using the prick by prick method. Careful family and personal history for allergy as well as any reactions to rubber products were noted, placing emphasis on intraoperative anaphylaxis, number of operations and use of bladder catheters. RESULTS: Only four patients of the 93 skin tested (4.3%) were positive to latex. Atopy was not a predisposing factor for latex allergy and neither was the number of surgical interventions. No fruit allergy was found in this population and three of the four skin test-positive patients had facial angioedema when exposed to balloons. CONCLUSIONS: The very low incidence of latex allergy found in our patients with spina bifida could very well be due to a low level of rubber exposure as best exemplified in the use of nonlatex bladder catheters, frequently washed and resterilized surgeon's gloves, and low number of operations per patient. The fact that atopy was no more prevalent in children with spina bifida than in the general population in Venezuela strongly supports exposure level as the major factor determining latex sensitization.

Adolescent↗