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Biomedical subjects

B Wüthrich

Publications and source records attributed to B Wüthrich.

At least 19 recordsLinked to original sources
PubMed1995

[Delayed allergic reaction to Chlorambucil (Leukeran). Case report and literature review].

A 63-year-old man developed a mild hemorrhagic diathesis which led to the diagnosis of chronic lymphatic leukemia. Treatment with prednisone and chlorambucil was initiated. During the first 10 day-cycle (10 mg chlorambucil and 100 mg prednisone) no side effects were noted. On the 8th day of second cycle (10 mg chlorambucil and 25 mg prednisone) the patient noticed fever, tiredness, myalgia, pruritus and erythema on the skin. The third cycle (10 mg chlorambucil alone) hat to be stopped on the second day due to the development of myalgia, generalized erythroderma with exfoliation and edema of the face and arms. In the patch-test with chlorambucil, a strongly positive (histologically verified) allergic reaction was noted. A lymphocyte stimulation test (detecting in vitro lymphocytes sensitized to chlorambucil) was also positive. These findings, together with the marked clinical reaction to chlorambucil alone, led to the diagnosis of a delayed hypersensitivity reaction to chlorambucil. Such well documented allergic reactions to chlorambucil are very rarely described in the literature. Up to now only 1 case of immune hemolytic anemia, 1 case of Lyell-syndrome, 2 cases of delayed hypersensitivity reactions and a few cases of less well documented type I reactions have been described. In all these cases no crossreactivity with other alkylating agents occurred, and hence all patients could be successfully treated with cyclophosphamide.

Chlorambucil↗
PubMed1995

[Poppyseed anaphylaxis].

We describe 3 patients with a severe allergic immediate-type reaction to poppy-seeds, diagnosed from clinical findings, skin tests and specific IgE antibodies (CAP). All show a serologic positivity to sesame seed, possibly due to a cross reactivity to similar allergens. From 1978 until 1987 402 food allergy patients seen at the Allergy Unit, Department of Dermatology, University Hospital Zurich, Switzerland, included no case of allergy to poppy-seeds. Because of today's trend to vegetarian food such immediate type reactions can be expected to occur more frequently.

Adult↗
PubMed1995

Relapsing eosinophilic perimyositis.

Relapsing eosinophilic perimyositis is a rare entity. Only 11 cases have been reported in the literature. We describe a patient with relapsing myopathy, peripheral blood eosinophilia and cutaneous manifestations, who had histopathological features of eosinophilic perimysial inflammation. His disease responded to moderate doses of glucocorticosteroids, and pursued an apparently benign course. Serum levels of eosinophilic cationic protein correlate with disease activity, and may be helpful in monitoring treatment. The features of this case are compared with those of other hypereosinophilic syndromes. It appears to be part of the spectrum of eosinophilic myositis.

Anti-Inflammatory Agents↗
PubMed1995

Scalp dermatitis, distinctive hair abnormalities and atopic disease in the ectrodactyly-ectodermal dysplasia-clefting syndrome.

We report a 2-year-old girl with a combination of the ectodermal dysplasia, ectrodactyly, cleft lip/palate (EEC) syndrome, distinctive hair abnormalities, scalp dermatitis and atopic disease. To our knowledge, this is the first report of scalp dermatitis in the EEC syndrome. Distinctive structural hair abnormalities shared by the syndromes of ectodermal dysplasia and clefting are helicotrichia, pili torti et canaliculi, and cuticle defects, all of which were observed in the present case. A high incidence of atopic disease in certain subsets of ectodermal dysplasia has been reported. In our patient this manifested as food-induced exacerbation of atopic dermatitis, associated with positive prick tests and significant levels of circulating specific IgE.

Abnormalities, Multiple↗
PubMed1995

Levels of soluble ICAM-1 in atopic dermatitis. A new marker for monitoring the clinical activity?

Levels of soluble intercellular adhesion molecule-1 (sICAM-1) were measured in sera from patients with an acute exacerbation of their atopic dermatitis (AD) (n = 16) on admission to and discharge from our department of dermatology. At admission, the sICAM-1 levels in sera from patients with AD were slightly higher than those of the blood donors (n = 100) and dropped at discharge significantly (P = 0.014) after improvement of the skin conditions. Therefore, sICAM-1 may be, together with soluble interleukin-2 receptor (sIL-2), eosinophilic cationic protein (ECP), and CD14, another marker for monitoring AD.

Adult↗
PubMed1995

Severe anaphylactic reaction to bovine serum albumin at the first attempt of artificial insemination.

A 33-year-old woman without history of previous atopic diseases or drug allergies developed a severe anaphylactic reaction with asthma, vomiting, itching, generalized urticaria, and angioedema during artificial insemination with her husband's sperm. The sperm-processing medium contained bovine serum albumin (BSA). Skin prick test and RAST demonstrated an IgE-mediated hypersensitivity to BSA as well as a polyvalent atopic sensitization to pollens, animal danders, cow's milk, beef, pork, and mutton. SDS-PAGE studies indicated serum albumin to be the appropriate allergen with a high degree of cross-reactivity between serum albumin from different animal species. Artificial insemination with fluid containing potential allergens can, therefore, represent an unnecessary risk for atopic females, even in the absence of prior clinical symptoms of allergic diseases. Preoperative testing with the medium is recommended.

Adult↗
PubMed1995

Prevalence of atopy and pollinosis in the adult population of Switzerland (SAPALDIA study). Swiss Study on Air Pollution and Lung Diseases in Adults.

The Swiss SAPALDIA study is a large multicenter cross-sectional study initiated in 1991 to evaluate the relationship between environment and respiratory symptoms and diseases in adults, and included subjects from eight areas in Switzerland with distinctive environmental characteristics. We present here prevalence data for atopy, pollinosis and atopic asthma obtained from a random sample of 8,357 adults (18-60 years) assessed by standardized computer-based interview as well as by allergy skin prick tests (SPTs) (performed with Phazet) to grass, birch and Parietaria pollen, house dust mite, cat and dog epithelia and the moulds Alternaria and Cladosporium and by an in vitro allergy screen test (Phadiatop CAP FEIA system). On the basis of a positive Phadiatop (total 28.9%; males 32.9%, females 25.0%; p < 0.001) and/or a positive SPT (total 23%; males 25.0%, females 20.8%; p < 0.001), 32.3% of the study population were considered atopic (males 35.7%, females 28.8%; p < 0.001). Concerning the prevalence of skin sensitization (SPT wheal > or = 3 mm), the highest rate was observed for grass (12.7%), followed by house dust mite (8.9%), silver birch (7.9%), cat (3.8%) and dog (2.8%), whereas moulds and Parietaria elicited less than 1% positive SPTs. The prevalence of atopic rhinitis (rhinitis symptoms associated with atopy) was 13.5% (males 14.3%, females 12.6%; p < 0.05) and the prevalence of current hay fever varied between 9.1% (questionnaire answer and a positive SPT to at least one pollen), 11.2% (questionnaire answer and presence of atopy) to 14.2% (questionnaire answer only) with no significant difference by sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Allergen exposure in acute asthma causes the release of platelet-activating factor (PAF) as demonstrated by the desensitization of platelets to PAF.

Platelet-activating factor (PAF) is released in IgE-mediated allergic diseases. The normal level, the method of its determination and its clinical importance are subject of controversy. We hypothesized that a functional assay could help to better analyze the actual concentrations in vivo because PAF may be released locally and is short-lived. An assay to detect PAF by the desensitized state of human platelets exposed to PAF in vitro or ex vivo was developed: We analyzed the synergistic platelet response to dual agonist stimulation at extraordinarily low doses (collagen 0.10 microgram/ml and PAF 2.5 x 10(-8) M) in aggregation and release reaction and its absence after previous exposure to PAF at concentrations between 5 x 10(-9) and 5 x 10(-11) M in vitro. The same test was then applied to examine the platelets from patients with IgE-mediated allergic asthma before and after inhalation of the specific allergen (inhalative provocation test; a reduction of the FEV1 by > 15% was considered positive). The lack of a synergistic response to collagen with PAF was found after preincubation of the platelets with 5 x 10(-9) M PAF and a reduction of +/- 50% with 5 x 10(-10) M in vitro. A significant reduction of the aggregation response (-56 +/- 18%) and of the release of beta-thromboglobulin (-75 +/- 24%) was found in 6 patients with a positive inhalative provocation test but not in 3 patients with a negative response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Immunoblot study of IgE binding allergens in celery roots.

OBJECTIVES: The purpose of this study was to characterize the IgE binding components of celery root by immunoblot analysis and to investigate the cross-reactive nature of the allergens. BACKGROUND: Sensitization to celery is very common in patients hypersensitive to mugwort pollen and birch pollen, and is due to cross-reactions of allergen-specific IgE antibodies. Recently, the pan-allergen profilin has been identified as an important cross-reactive allergen in celery, birch pollen and mugwort pollen. Very few data, however, on additional celery allergens are available. METHODS: Sera of 38 patients with an isolated or combined sensitization to birch pollen, mugwort pollen, and celery were investigated by immunoblot and immunoblot inhibition techniques using celery extract and purified Bet v I, the major allergen from birch pollen. The selection of sera was based on serologic sensitization, independent of clinical manifestations. Celery profilin was affinity isolated and analyzed by immunoblotting with patients' sera as well as with rabbit polyclonal antiserum raised against celery profilin. RESULTS: Only weak IgE binding occurred on celery immunoblots in the patient groups with a negative RAST to celery. Sera of 6/8 patients with a birch pollen/celery sensitization recognized a 16-kDa celery allergen that cross-reacted with Bet v I in immunoblot inhibition experiments. In the mugwort pollen/celery and birch pollen/mugwort pollen/celery patient groups, the sera of 6/16 patients contained IgE that bound to a 15 to 16-kDa double band identified as celery profilin. Furthermore, three sera of the birch pollen/mugwort pollen/celery group appeared to contain IgE antibodies against carbohydrate determinants. CONCLUSIONS: The 16-kDa Bet v I-related celery protein appears to be an important allergen for patients sensitized to birch pollen and celery. In contrast IgE binding to celery profilin appears to be more important in patients with an additional sensitization to mugwort pollen.

Allergens↗
PubMed1995

[Paraneoplastic dermatoses].

Paraneoplastic dermatoses or cutaneous paraneoplastic syndromes are a non neoplastic skin condition closely related to and in their manifestation directly influenced by an underlying malignancy. They are subdivided into two groups: one whose clinical picture reveals the presence of a malignant tumor and an association with a malign internal tumor in nearly 100%, and a second in which the possibility of a malignancy exists. Not included under the heading paraneoplastic dermatoses are changes with neoplastic cells appearing in the skin, tumors involving secondary illnesses, and genetically caused dermatologic syndromes accompanied by internal malignancies. Although the pathogenesis of the paraneoplastic dermatoses is very unclear, knowledge of these conditions is necessary, since it may in rare instances lead to an early diagnosis of a malignant tumor. On the other hand, only treatment of the underlying disease can improve the dermatoses.

Diagnosis, Differential↗
PubMed1994

[Pollinosis in Canton Ticino. A prospective study in Locarno].

A study was carried out in the southern part of Switzerland (Canton Ticino) in 1990-1993 to determine the spectrum of cutaneous sensitivity to a large amount of pollens and several perennial allergens (50), using skin prick tests in a sample of 503 consecutive patients suffering from hay fever. The Canton Ticino is a very specific geographical and botanical area which includes several plants of the alpine and Mediterranean flora as well as representatives of the tropical flora, forming a unique pattern from a botanical and allergological point of view. The results of the study indicate that in this region the patients have symptoms of hay fever almost 10 months a year (from December until October) with a peak in May and June (88% and 73% of the patients respectively have symptoms in these months). The symptoms are mainly localized in the upper respiratory tract and eyes. Asthmatic symptoms were found in about 23% of the patients. At the top of the allergen list were grass-pollens (72% of the patients had sensitivity); rye (69%); olive tree (54%); birch (46%); chestnut (37%); ash tree (36%); alder tree (33%); ragweed (17%); parietaria (18%). Of real interest in this study area are, besides the classical allergy-inducing pollens, those of chestnut, parietaria, olive tree, ash tree and cupressaceae (for example cypress). Chestnut pollens represent about 30% of the airborne pollens in this region. 30% of the patients had sensitivity against dust mites (Dermatophagoides pteronissimus und D. farinae), and 20% against cats. Sensitivity against 8 mould spores was 2-9%.

Adolescent↗