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A Ferrannini

Publications and source records attributed to A Ferrannini.

At least 19 recordsLinked to original sources
PubMed2006

Allergic reactions to inhalant glucocorticosteroids: a hot topic for pneumologists and allergologists.

Allergic contact dermatitis to topical glucocorticosteroids (GCS) is a delayed type cell-mediated hypersensitivity reaction; it is frequently observed in dermatological and allergological practice, although its incidence is likely underestimated. By contrast, allergic contact sensitization to inhalant GCS is virtually unknown to most pneumologists. Here, we review some cases of adverse reactions to inhalant GCS in terms of pathogenetic mechanisms, risk factors, epidemiology, and allergic cross-sensitivity. In fact, this particular form of sensitization to drugs that have a wide spectrum of use in pneumological practice deserves more attention than in the past.

Administration, Inhalation↗
PubMed2006

Levocetirizine in the treatment of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Chronic urticaria is a common skin condition. It is frequently a disabling disease because of the persistence of clinical symptoms, the unpredictable course and its negative influence on the quality of life. OBJECTIVES: To determine whether levocetirizine is efficacious in the treatment of chronic idiopathic urticaria. METHODS: A randomized, double-blind, placebo-controlled study was conducted in 106 patients with a diagnosis of chronic idiopathic urticaria. A 1-week single blind placebo run-in period (baseline) was followed by a 6-week double blind active treatment period. The patients were randomized to receive one of the following treatments once daily: (a) oral levocetirizine 5 mg, or (b) oral placebo. The study ended after another 1-week single blind placebo washout period. RESULTS: The evaluable population consisted of 100 patients. Levocetirizine administered once daily is effective and well tolerated in the treatment of the symptoms of chronic idiopathic urticaria and in improving the patient's quality of life. Levocetirizine was superior to placebo in reducing the mean total symptoms score as well as individual symptoms, the number of daily episodes and the number of weals, the overall severity of symptoms and the quality of life. The significant beneficial effects of levocetirizine lasted only during the active trial, while at follow-up there was a significant worsening of all the variables evaluated in this study, after the end of the active trial (week 7). CONCLUSIONS: A global assessment indicates that levocetirizine 5 mg once daily is an effective agent in patients with chronic idiopathic urticaria, as its action provides a rapid and satisfactory control of the symptoms and measures of subjective disease, although this is limited to the duration of treatment.

Adult↗
PubMed2006

Desloratadine in combination with montelukast suppresses the dermographometer challenge test papule, and is effective in the treatment of delayed pressure urticaria: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Delayed pressure urticaria (DPU) comes under the heading of physical urticaria. Characteristically itchy, tender or painful weals occur at sites of local pressure including the waistband, soles of the feet and palms of the hands. Lesion onset is typically 3-12 h after the application of pressure, and lesions may persist for more than 24 h. The treatment of DPU is often unsatisfactory. OBJECTIVES: To determine the efficacy of desloratadine and montelukast in the treatment of DPU. METHODS: The study was conducted in 36 subjects affected by DPU. A challenge test with a dermographometer was administered to confirm the diagnosis. After diagnosis, patients were randomized to receive the following treatment once daily for 2 weeks: (i) oral desloratadine 5 mg plus oral placebo; (ii) oral desloratadine 5 mg plus montelukast 10 mg; and (iii) oral placebo alone. RESULTS: At rechallenge, patients from the treatment groups (desloratadine plus montelukast group and desloratadine alone group) demonstrated a significant reduction in mean diameter of papules after 70 s of pressure compared with the placebo group (P < 0.05). Moreover, patients treated with desloratadine plus montelukast showed a significant reduction in mean diameter of papules at 70 s of pressure compared with those treated with desloratadine alone (P < 0.05). In addition, the combination was effective in improving clinical parameters (erythema, oedema and pruritus, and number of separate urticarial episodes). CONCLUSIONS: This study has demonstrated that both desloratadine alone and desloratadine plus montelukast administered once daily yield improvements with respect to the baseline assessment, regarding the suppression of the dermographometer challenge test papule and clinical improvement of urticaria. However, the combination of desloratadine and montelukast was shown to be more efficacious and may therefore be proposed in patients with DPU, in order to avoid corticosteroid therapy.

Acetates↗
PubMed2006

Cross-reactivity in cell-mediated and IgE-mediated hypersensitivity to glucocorticoids.

In the last few decades, glucocorticoids have received increasing attention for their capability of provoking systemic hypersensitivity reactions, when administered orally, parenterally, or intralesionally, as well as allergic skin and mucosal symptoms, when applied locally to the skin in patients with contact dermatitis or to the mucosa in patients with asthma and/or rhinitis. However, because of their anti-inflammatory and immunosuppressive properties, glucocorticoids are often not suspected of such hypersensitivity reactions. In addition, because glucocorticoids retain their anti-inflammatory potential, even if they act as sensitizers, the signs and symptoms of allergic reactions are not always obvious, particularly when they overlap with those caused by the very diseases glucocorticoids are used to treat. Moreover, interpretation of diagnostic tests, specifically that of patch-test reactions, can be difficult. In this review, particular attention is addressed to the problem of allergenic cross-reactivity among topical and systemic glucocorticoids. We also look at the clinical and practical aspects of both cell-mediated and IgE-mediated hypersensitivity reactions to glucocorticoids and their consequences on anti-inflammatory therapeutic choices.

Cross Reactions↗
PubMed2004

Immune tolerance to drugs. (II).: Long-term tolerability of nimesulide in patients with NSAID hypersensitivity.

Nimesulide is well-tolerated as an alternative to nonsteroidal antiinflammatory drugs (NSAIDs) in patients with a previous adverse reaction to other classes of NSAIDs. However, there is little information in the literature about its long-term tolerability. The study was carried out on 625 patients who had experienced adverse reactions to one or more NSAIDs. All patients received and tolerated peroral challenges with nimesulide. On the first day, patients were given an equivalent number of placebo doses to the planned number of nimesulide doses. In a successive session, the test was administered by means of increasing doses of nimesulide at 30 min intervals until the common daily therapeutic dose of 100 mg was reached (10 mg-20 mg-30 mg-40 mg). A questionnaire was distributed to all subjects. In particular, they were asked to clarify any reactive symptoms they had developed after ingestion of the drug. It was found that only 2.1% (4/192) of subjects who were given this drug experienced urticaria during treatment. We have identified three significant risk factors: a history of chronic urticaria, a history of antibiotic hypersensitivity and a history of hypersensitivity to more than one class of NSAIDs. In patients with the above risk factors, a prior tolerance test with a selective COX2 antagonist should be administered.

Adult↗
PubMed2004

Sodium benzoate-induced repeated episodes of acute urticaria/angio-oedema: randomized controlled trial.

BACKGROUND: Sodium benzoate (E 211) is widely used to delay yeast spoilage of acidic foods and beverages. Numerous cases of adverse reactions to benzoate have been recorded, but most of the studies that have been conducted lacked proper placebo controls or blinding. OBJECTIVE: The aim of this study is to determine the incidence of intolerance to sodium benzoate among subjects who experienced repeated episodes of acute urticaria/angio-oedema following the ingestion of a meal or a product containing this substance. METHODS: This was a retrospective study based on the analysis of data from patients reported to have experienced episodes of urticaria, with or without angio-oedema, after ingesting meals or products containing sodium benzoate. At the first visit to the outpatients clinic, a careful history was taken. Patients were then given the following diagnostic tests: tests for IgE for common inhalant allergens and food allergens, and a double-blind, placebo-controlled challenge with sodium benzoate. RESULTS: A total of 47 subjects were enrolled in the study; five (11%) showed at least one relevant positive reaction to an IgE test for food allergy. Only one subject (2%) had a reaction after the ingestion of 75 mg of sodium benzoate without an adverse reaction to placebo. CONCLUSION: This study shows that the percentage of repeated episodes of acute urticaria/angio-oedema reactions induced by sodium benzoate is very low (2%). In view of our results, we suggest that when faced with patients who have suffered adverse reactions that could be attributed to sodium benzoate, physicians should also carefully evaluate other possible causes.

Acute Disease↗
PubMed2004

Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Chronic urticaria (CU) is a common skin condition. It is frequently a disabling disease due to the persistency of clinical symptoms, the unpredictable course and negative influence on the quality of life. OBJECTIVE: The aim of this study is to determine whether montelukast, a LTD4 receptor antagonist, plus desloratadine, is more efficacious than desloratadine alone in the treatment of chronic urticaria. MATERIALS: A randomized, double-blind, placebo-controlled study was conducted on 81 patients with a diagnosis of CU. A 1-week single-blind placebo run-in period (baseline) was followed by a 6-weeks double blind active treatment period. The patients were randomized to receive the following treatment once daily: (a) oral desloratadine (5 mg) plus placebo; (b) desloratadine (5 mg) plus montelukast (10 mg); (c) oral placebo alone. The study ended after another 1-week single-blind placebo washout period. RESULTS: The evaluable population thus consisted of 76 patients. Both desloratadine alone and desloratadine plus montelukast administered once daily yielded improvements with respect to the baseline assessment as regards pruritus, number of separate episodes, size and number of weals, visual analogue score and patients' quality of life and with respect to the placebo group both in the active treatment period and in the run-out period. However, desloratadine plus montelukast was shown to improve the symptoms and patients' quality of life significantly more than desloratadine alone, although it did not have a significant effect on the number of urticarial episodes. CONCLUSION: The combination of desloratadine plus montelukast is effective in the treatment of CU. It may therefore be a valid alternative in patients with relatively mild CU, in view of its efficacy and the lack of adverse events.

Acetates↗
PubMed2004

Type I latex allergy in health care workers with latex-induced contact urticaria syndrome: a follow-up study.

BACKGROUND: Latex allergy is an important occupational health issue among health care workers (HCWs). Secondary prevention in sensitized/allergic individuals involves avoiding exposure to NRL products. AIMS OF THE STUDY: The aim of this follow-up study is to determine the long-term health consequences in HCWs with type I latex allergy with latex-related contact urticaria syndrome, of providing appropriate information and practical avoidance education. METHODS: Seventeen HCWs with latex-induced contact urticaria syndrome, as ascertained by the glove use test, were investigated. Initial and follow-up visits included: a detailed questionnaire, skin prick test (SPT) with glove eluates and with commercial latex extract, SPT with common inhalant and food extracts, serum specific immunoglobulin (Ig)E to latex and some foods and the glove use test. RESULTS: On re-examination, 11 (64.7%) subjects showed positive SPTs to extemporaneous extract and 10 (58.8%) patients showed a positive SPT to commercial extract. Of the nine patients with detectable levels of serum latex specific IgE at first evaluation, four (44.4%) became negative and four were assigned to at least one class lower. Only one (11.1%) employee had higher radioallergosorbent test values than those at the latex allergy diagnosis. At follow-up, the 17 individuals had positive latex challenge results, although the duration of exposure causing a reaction increased. CONCLUSION: Our study shows that preventive measures are sufficient to induce a reduction of sensitization. Continued avoidance is needed to prevent re-sensitization or adverse reactions on re-exposure.

Adult↗
PubMed2003

Latex hypersensitivity: relationship with positive prick test and patch test responses among hairdressers.

BACKGROUND: Natural rubber latex is a frequent cause of IgE-mediated allergy in hairdressers; but a non-IgE-mediated allergy to latex proteins can also occur. Sixty-one hairdressers, reporting latex glove-related symptoms, were enrolled in the study. METHODS: They were evaluated for latex allergy by assessment of serum specific IgE and skin prick tests. Patients were patch tested to a rubber additive series and to latex. Proportions were compared by one-tailed Fisher's exact test; mean values of continuous variables were compared by Student's t-test. RESULTS: A diagnosis of IgE-mediated latex allergy was made in 11 (18%) hairdressers; patch tests with rubber-related antigens were positive in 24 (39.3%) subjects. The most positive patch tests were those with para-phenylenediamine (33%). Two hairdressers (3.3%) showed delayed reactions to the latex sample. Hairdressers with IgE-mediated latex allergy were older and presented a personal history of atopy and local hives after exposure to latex; they were more likely to have a positive response to other allergens on prick or patch testing. CONCLUSIONS: Our study demonstrates a certain number of false-positive and false-negative results when reported symptoms of possible latex sensitivity were compared to prick and CAP tests to latex, indicating the problems of relying solely on self-report.

Adolescent↗
PubMed2003

Clinical and aetiological aspects in urticaria and angio-oedema.

BACKGROUND: Urticaria is a common disorder that affects as many as 20% of all people at some time during their lifetime. OBJECTIVES: To analyse the prevalence of various forms of urticaria according to an aetiological and clinical classification, we carried out a 4-year study in an outpatient clinic. METHODS: The study was carried out on 562 consecutive patients (178 males and 384 females; mean age 35.4 +/- 16), who had been referred to our unit for the study of urticaria and angio-oedema. Baseline investigations included: the patient's family and personal history of allergy; duration of symptoms, presence of associated symptoms and objective signs of the current episode; clinical, laboratory and instrumental investigations; assessment of response to antihistamine treatment. RESULTS: A family history of atopy was present in 35% of patients and a personal history of allergy in 24%. We subdivided urticaria and angio-oedema into several groups on the basis of their clinical and aetiological aspects. Of the 562 patients, 424 (76%) presented with ordinary urticaria (43 acute urticaria, 311 chronic urticaria, 70 episodic urticaria), 80 (14%) physical urticaria, 49 (9%) angio-oedema without weals, six (1%) IgE-mediated contact urticaria and three (0.5%) urticarial vasculitis. In 64 cases (11%) urticaria/angio-oedema was associated with one or more symptoms. We identified 394 cases (82%) of idiopathic urticaria, 42 (9%) of immunological urticaria, 29 (6%) of non-immunological urticaria and 17 (3%) of urticaria secondary to infections. Of the treated subjects, 54% showed a good response to treatment with antihistamines. CONCLUSIONS: Our data provide an overview of urticaria/angio-oedema in a large series of patients, based on clinical-aetiological aspects, and related to recent diagnostic guidelines.

Acute Disease↗
PubMed2003

Results of standard series patch testing in patients with occupational allergic contact dermatitis.

BACKGROUND: In the workplace, the skin is at high risk of exposure to chemicals and other contaminants, and occupational dermatitis is an important field of study. METHODS: We evaluated 230 patients referred to our clinic because they were affected by dermatitis suspected to be of occupational and allergic origin. They were tested with the allergens of the GIRDCA standard series, and with supplementary series when indicated. RESULTS: Among the 230 subjects, 49 were positive only to supplementary series (26.3% of all allergic contact dermatitis), while 130 (69.9% of all allergic contact dermatitis) were considered to have an occupational allergic contact dermatitis diagnosed by the standard series alone. The most frequent occupations of the patients were health care workers and hairdressers/beauticians. The most common agents responsible for occupational allergic contact dermatitis were metals and para-phenylenediamine. CONCLUSIONS: As the standard series detected a relatively low proportion of occupational allergic contact dermatitis, it is not adequate to recognize an occupational allergic contact dermatitis, certain supplementary series should also to be tested. However, even if such occupational series are used, we remain likely to continue to underestimate the frequency of occupational allergic contact dermatitis, because workers come into contact with a large number of substances that are often unknown.

Adolescent↗
PubMed2003

Suspected tartrazine-induced acute urticaria/angioedema is only rarely reproducible by oral rechallenge.

BACKGROUND: Tartrazine has been frequently linked to several diseases. However, a cause-and-effect role for tartrazine in these illnesses, especially in urticaria, has not always been established. OBJECTIVE: The aim of this study is to determine the incidence of intolerance to tartrazine among subjects who experienced an acute episode of urticaria/angioedema following the ingestion of a meal or a product containing this substance. METHODS: This was a retrospective study based on analysis of data of patients reported to have experienced episodes of urticaria and/or angioedema after ingesting meals or products containing tartrazine. At the first visit to the outpatients clinic, a careful anamnesis had been taken. Patients had then been submitted to the following diagnostic tests: IgE tests to common inhalant allergens and food allergens and a double-blind placebo-controlled challenge with tartrazine. RESULTS: A total of 102 subjects were enrolled in the study: 19 (18.6%) showed at least one relevant positive reaction to an IgE test for food allergy. Only one subject (1%) had reactions after ingestion of 5 mg of tartrazine, given on day 5. She did not have adverse reactions to placebo. CONCLUSION: This study shows that the percentage of acute urticaria and/or angioedema induced by tartrazine is very low (1%). In view of our results, we suggest that all physicians with patients who have suffered adverse reactions that could be attributed to tartrazine should also carefully evaluate other possible causes.

Adolescent↗
PubMed2002

Benzydamine: an alternative nonsteroidal anti-inflammatory drug in patients with nimesulide-induced urticaria.

BACKGROUND: Cutaneous adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs), in particular urticaria/angiedema syndrome, represent a frequent problem in clinical practice. To date laboratory tests for the diagnosis of these adverse reactions are not available. A patient with an adverse drug reaction to NSAIDs needs an alternative drug to assume if necessary. Nimesulide is a highly prescribed nonsteroidal anti-inflammatory drug (NSAID) world-wide. It is also described as one of the most tolerated NSAID. In this paper we present data on the tolerability of benzydamine in nimesulide-sensitive patients. PATIENTS AND METHODS: One hundred and thirty-seven patients with nimesulide-induced urticaria were submitted to a single-blind, placebo-controlled peroral challenge with increasing doses of benzydamine. RESULTS: One hundred and thirty-four out of 137 (98%) patients tolerated benzydamine without adverse effects, only three (2%) experienced immediate systemic urticaria (1 at the first dose and 2 at the second dose). CONCLUSION: Benzydamine is a well tolerated drug in patients with nimesulide-induced urticaria and it may represent a valid alternative NSAID in nimesulide-sensitive patients.

Acetaminophen↗
PubMed2002

Reactivity to autologous serum skin test and clinical features in chronic idiopathic urticaria.

The autologous-serum skin test (ASST) can cause a wheal-and-flare response in some cases of chronic idiopathic urticaria. We subjected 102 patients affected by chronic idiopathic urticaria to this test and studied some clinical parameters to detect any significant differences between ASST-positive and ASST-negative patients. The only significant difference we noted between the two groups was the incidence of angioedema (P = 0.01). We suggest that the ASST cannot be used alone either to predict the severity of urticaria or to define it as 'autoimmune'.

Angioedema↗