Skin testing in chymopapain anaphylaxis.
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Adult↗
Biomedical subjects
F C Cogen
Publications and source records attributed to F C Cogen.
Histamine release and complement changes following injection of contrast media in humans.
Mechanisms responsible for allergic-like reactions following administration of radiographic contrast media (RCM) are unclear. Aortic root blood specimens were obtained sequentially in 6 subjects following injection of RCM into the pulmonary artery during cardiac catheterization. In 5 subjects, elevated plasma histamine levels (up to 80 ng/ml) occurred within minutes. Levels of C3, C4, factor B, and total hemolytic complement activity were decreased in the same specimens. No hemodynamic or clinical abnormalities were noted. These findings support the concept that RCM can liberate histamine in vivo in humans. Complement alterations may be related to localized RCM-protein interaction. It is unclear whether complement changes are related to the RCM-induced allergic mediator release.
Adult↗
Phencyclidine-associated acute rhabdomyolysis.
Phencyclidine (PCP) is a dissociative veterinary anesthetic and tranquilizer that at present is being abused as a psychedelic and hallucinogenic agent with increasing frequency. The cases of two young patients suffering from phencyclidine toxicity are reported. In each, central nervous system depression was accompanied by an acute dystonic motor reaction resulting in acute rhabdomyolysis and myoglobinuria. Skeletal muscle injury was felt to be the result of excessive involuntary isometrimc motor activity rather than a direct effect of phencyclidine on skeletal muscle. Patients suffering from phencyclidine intoxication should be screened for acute rhabdomyolysis. Phencyclidine intoxication should be included in the differential of nontraumatic rhabdomyolysis and should be considered among the potential causes of acute myoglobinuric renal failure.
Acute Disease↗
Adverse radiographic contrast media reactions.
There are many unanswered questions about the mechanisms and prevention of adverse reactions to RCM. Serious reactions will likely occur less often in your experience if you observe these precautions: 1. Consider that every patient is a candiate for an adverse reaction when you request the contrast study. 2. Be particularly cautious in performing the study in those with previous reactions to RMC, those who are strongly atopic, and those in whom intravenous cholangiography is planned. Look for alternative diagnostic approaches in treating these individuals. 3. If there is any likelihood of increased reactivity, inform the patient, carry out a study with intravenous infusion in place and appropriate physician observation during and after the study, consider prestudy treatment with antihistamines and/or steroids, and be prepared to institute emergency measures should the need arise.
Anaphylaxis↗
Chronic eosinophilic pneumonia followed by polyarteritis nodosa complicating the course of bronchial asthma. Report of a case.
The syndrome of pulmonary infiltrates with eosinophilia (PIE) occurs rarely in the asthmatic patient. An unusual case is presented in which progressive bronchoconstriction and exaggerated blood eosinophilia preceded the recognition of two seemingly unrelated diseases, each of which can independently result in hypereosinophilia and the PIE syndrome. In the male patient studied, the first illness, biopsy-proved chronic eosinophilic pneumonia, was responsive to corticosteroid therapy. Four uneventful years later, polyarteritis nodosa with eventual pulmonary involvement developed. A careful search for specific underlying pulmonary and systemic disease is in order when hypereosinophilia occurs in the clinically unstable asthmatic patient.
Aminophylline↗