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Biomedical subjects

A J Bircher

Publications and source records attributed to A J Bircher.

At least 19 recordsLinked to original sources
PubMed1996

Adult onset of cow's milk protein allergy with small-intestinal mucosal IgE mast cells.

We report a female patient with adult onset of cow's milk protein allergy. For 1 year, she experienced repeated gastrointestinal symptoms and had a single exercise-induced anaphylactic reaction. In addition to positive skin tests and specific IgE to milk proteins and a positive challenge test, immunohistochemistry of the small intestine showed a marked increase of IgE-positive mast cells. This finding is highly specific and could provide an additional tool for diagnosing cow's milk protein allergy and possibly also other food allergies.

Adult↗
PubMed1996

Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests.

A 43-year-old woman suffered from recurrent localized swellings and an eczematous dermatitis starting 1 day after an injection of lidocaine. Intradermal patch and lymphocyte transformation tests revealed sensitization to lidocaine and cross-reactivity to the other aminoacylamide local anesthetics bupivacaine, mepivacaine and prilocaine, but not to articane. Contact allergy to the ester local anesthetics benzocaine, procaine and tetracaine, the quinoline or aminoacylamide cinchocaine, and the preservatives methylparaben and metabisulfite, was excluded. A subcutaneous challenge with articaine was well tolerated.

Adult↗
PubMed1996

Delayed-type hypersensitivity to cow's milk protein in Melkersson-Rosenthal syndrome: coincidence or pathogenetic role?

BACKGROUND: Intolerance to cow's milk protein is frequently seen in children and rarely in adults. Non-IgE-mediated hypersensitivity to cow's milk protein has been suspected in children based on in vitro evidence. Food intolerance may play a pathogenetic role in some cases of Melkersson-Rosenthal syndrome, which is often of unknown origin. OBJECTIVE: We describe an adult female patient who developed a Melkersson-Rosenthal syndrome and at the same time was found to have in vivo and in vitro evidence of a delayed-type hypersensitivity to cow's milk protein. METHODS: Allergic and immunologic examinations, including skin prick tests, patch tests, serology, lymphocyte transformation tests and biopsies were performed. RESULTS: A positive patch test to alpha-lactalbumin, a positive lymphocyte transformation test to whole cow's milk and an immunohistology with infiltration of CD4+ and CD8+ T cells were found. CONCLUSIONS: There is a possible pathogenetic relation between delayed-type hypersensitivity to cow's milk protein and Melkersson-Rosenthal syndrome in the patient presented.

Animals↗
PubMed1996

Delayed hypersensitivity reactions to corticosteroids applied to mucous membranes.

Despite the widespread use of corticosteroids on the mucous membranes of the nose, eye and bronchial tree, mucosal contact sensitivity has apparently been uncommon. However, since the introduction of new corticosteroids such as tixocortol pivalate and budesonide, mucosal contact sensitivity, particularly that affecting the nasal mucosa, has increasingly been reported. Contact allergy on other mucosal surfaces and in the bronchial tree is very rare. We report three women who had contact allergy to tixocortol pivalate or budesonide in nasal sprays, and one woman who had an allergic contact stomatitis from tixocortol pivalate in oral lozenges.

Administration, Intranasal↗
PubMed1995

Delayed hypersensitivity to one low-molecular-weight heparin with tolerance of other low-molecular-weight heparins.

We report a patient who developed infiltrated plaques at the sites of subcutaneous injection of a low-molecular-weight heparin. Skin tests and a lymphocyte transformation test revealed hypersensitivity to sandoparin and heparin sodium. The low-molecular-weight heparins nadroparin and dalteparin were subsequently tolerated without adverse effects. Possible risk factors for sensitization are discussed.

Drug Hypersensitivity↗
PubMed1995

The allergen of Ficus benjamina in house dust.

Ficus benjamina, a member of the Moraceae family, is a tropical, non-flowering green plant which is widely used for ornamental purposes. It is an occupational allergen in plant keepers but sensitization is also increasingly found in non-occupationally exposed atopic and non-atopic patients. The allergen of Ficus benjamina is located in the plant sap, a so-called latex. By radioallergosorbent test-(RAST)-inhibition studies allergen could also be demonstrated in the dust collected from the leaf surface and in dust samples from the floor of rooms where the plant was placed. These findings could result in more extensive preventive measures in patients sensitized to Ficus benjamina. In addition there is some evidence that possibly a crossreactivity between latex of Ficus benjamina and latex from the rubber tree Hevea brasiliensis, a member of the Euphorbiaceae family, may exist.

Adolescent↗
PubMed1995

Contact hypersensitivity to corticosteroids in routine patch test patients. A multi-centre study of the Swiss Contact Dermatitis Research Group.

BACKGROUND: Contact hypersensitivity to corticosteroids is increasingly reported and has been identified as a problem of considerable clinical relevance. The prevalence of positive patch tests to corticosteroids ranges from 0.2 up to 5%. OBJECTIVE: The prevalence of positive patch tests to corticosteroids in Switzerland was determined in a multi-centre study of patients undergoing routine patch tests. METHODS: As representatives of corticosteroid groups, the following substances were used for screening: tixocortol pivalate and hydrocortisone for group A (hydrocortisone type), hydrocortisone butyrate for group D (hydrocortisone butyrate type) and budesonide for both groups B (triamcinolone type) and D. Patients positive for at least one corticosteroid were retested with the screening series and 12 corticosteroids commonly used in Switzerland. RESULTS: Among 3,016 consecutive patients, 65 individuals (2.2%) with a total of 106 positive reactions were found. Retesting showed a concordance of 70-98%, depending on the corticosteroid and the score of the positive reaction. In the subsequently tested corticosteroid series including 12 substances, 19 out of 56 screening-positive patients had a positive result to one or several corticosteroids. There were only few evident cross-reactive patterns in between the corticosteroids tested. CONCLUSIONS: Corticosteroids should be included in routine patch testing, because contact sensitization to a corticosteroid is of considerable practical importance. We confirm that as markers of corticosteroid sensitization tixocortol pivalate, budesonide and hydrocortisone butyrate may be suited, because there is no single corticosteroid which is a marker for all four corticosteroid groups. Patch test reactions of 2+ or higher have a better reproducibility than 1+ reactions.

Administration, Topical↗
PubMed1995

Contact allergy to topical corticosteroids and systemic contact dermatitis from prednisolone with tolerance of triamcinolone.

We report the case of a 27-year-old female who had an allergic contact dermatitis to topical corticosteroids belonging to the corticosteroid groups A and D. Upon oral treatment with prednisolone a disseminated exanthema began within 24 h. Patch tests revealed sensitization to corticosteroids of group A, C and D, including prednisolone-21-acetate and betamethasone valerate, but not of group B corticosteroids such as triamcinolone. After intradermal testing of corticosteroids the exanthema flared again and the patient was treated with oral triamcinolone, with rapid improvement of her symptoms. A literature review revealed that exanthematous reactions after systemic treatment with corticosteroids have been rarely reported. Since corticosteroids are essential emergency drugs, a safe corticosteroid should be identified for such patients. Patch and intradermal tests may be used for that purpose.

Administration, Topical↗
PubMed1994

A new clinical disorder of twisted and rolled body hairs with multiple, large knots.

BACKGROUND: We present a new hair disorder characterized by an unusual twisting and matting of body hairs. This disorder may occur as an acquired or, possibly, an inherited trait. OBJECTIVE: Our purpose was to analyze the clinical features of three patients and report the changes revealed by light microscopy and scanning electron microscopy. METHODS: We examined two unrelated adults with acquired multiple large knots of body hairs and a newborn infant with a familial history of the same entity. RESULTS: In the two adults the hairs were rolled and knotted together, and twisting of body hairs occurred in areas where rubbing was frequent. In the familial type, which was suggestive of an autosomal dominant inheritance pattern, no mechanical explanation could be found. Light microscopy confirmed the clinical impression of twisted and felted hairs, and scanning electron microscopy revealed sticking of at least 20 hairs. No underlying skin disease or deeper process was found. CONCLUSION: Multiple twisted and rolled body hairs that may develop into multiple, large knots may appear as a minor variant of hair matting or felting. Scanning electron microscopy shows multiple hairs that originate from different hair follicles and roll and stick together centrally.

Aged↗