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Biomedical subjects

G K Boyd

Publications and source records attributed to G K Boyd.

15 recordsLinked to original sources
PubMed1989

Anaphylaxis from insect stings. Myths, controversy, and reality.

Some myths and controversies regarding allergy to insect stings have been resolved through research, and venom immunotherapy now has an important place in the prevention of life-threatening reactions to stings. Both children and adults who had cardiovascular and/or respiratory reactions to their most recent sting are candidates for this treatment, which should be discontinued at the end of 5 years (or sooner, if venom skin tests or radioallergosorbent tests are negative).

Adolescent↗
PubMed1980

Anaphylactic reactions to Hymenoptera stings in asthmatic patients.

We evaluated 587 cases with generalized reactions to stings of Hymenoptera. Eighty of these patients and twenty-eight normal controls had radioallergosorbent tests (RAST) to venoms of honey bee, yellow jacket, hornet, wasp and to phospholipase A. Those patients with systemic reactions had a significantly greater frequency of positive RAST than normal controls (51.3% vs. 7.1%, P < 0.001). The frequency of atopy (asthma/rhinitis) in case these 587 cases was only 22% and resembled the expected frequency in a general population. Asthmatic patients did not have an increased risk of developing systemic reactions to Hymenoptera stings. However, those asthmatic patients with systemic reactions to Hymenoptera stings had a significantly more severe anaphylactic reaction to a sting than non-asthmatics. These severe reactions were primarily manifested by acute dyspnoea, which appeared to represent a bronchospastic response to endogenous histamine release.

Anaphylaxis↗
PubMed1979

Adverse reactions to cromolyn.

The frequency of adverse reactions (dermatitis, myositis, and gastroenteritis) to cromolyn sodium in asthmatic patients was 2% (B/375). Reactions were non-life-threatening and completely reversible. Immunologic evaluations, including skin and serum tests for immediate and delayed reactivity, all were negative. Adverse reactions to cromolyn do not appear to be based on an immunologic mechanism. Cromolyn appears to be a safe drug for the treatment of asthma.

Adolescent↗
PubMed1979

Anaphylaxis to sunflower seed.

The clinical and immunological investigation of three patients with an acute anaphylaxis after ingesting commercial varieties of sunflower seeds is presented. Specific IgE-mediated hypersensitivity has been demonstrated in all three patients to sunflower seed extract by history, direct skin tests, and positive radioallergosorbent test (RAST) titers. RAST inhibition was positive in two patients tested. Similar tests on controls were negative.

Acute Disease↗
PubMedDate not supplied

Fatal nut anaphylaxis in a 16-year-old male: case report.

A case of fatal nut anaphylaxis in a 16-year-old atopic, steroid-dependent asthmatic male is reviewed. He had large positive skin tests (scratch) to walnuts and peanuts. Serum was positive for specific IgE antibody measured by solid-phase radioimmunoassay to pecans. The importance of the immediate use of epinephrine is emphasized. Accidental ingestion of foods to which patients are sensitive is a common error for which patients must be prepared with preloaded epinephrine syringes.

Anaphylaxis↗
PubMedDate not supplied

Natural history of insect sting allergy: the Rhode Island experience.

The frequency of insect sting allergy in a given population varies depending on the age group of the population and the type of criteria used (history, skin test or RAST). In a pediatric population with a mean age of 13 years (boy scouts), the frequency is 0.8% using history as the only criteria. With this same criteria in an adult population, other authors found the frequency to be higher, 3.3%. The difference is probably due to the prolonged exposure rate to insect stings in adults. Using skin test or RAST as the criteria, the frequency of sting allergy is much higher because of many false-positive reactions. With history alone, the frequency of sting reaction is similar in atopic and nonatopic populations. Sting-sensitive asthmatic patients usually have a severe reaction to a sting with the added symptom of acute bronchospasm. Our RAST studies to venoms revealed that false-positive reactions do occur; a higher frequency of positive reactions occurs within five years of the sting and cross-reactivity among Hymenoptera insects is common except for honey bee. Negative RAST may have more clinical validity than a positive RAST. Our past and present re-sting data reveal that a large percentage of initially sting-sensitive patients have no reaction on being re-stung. Our new study on untreated sting-sensitive patients revealed that 37% (7/19) had an improved response and 42% (8/19) had the same response on re-sting.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Follow-up of hymenoptera-sensitive patients without active immunotherapy.

Presently there is no definitive guideline for the treatment of adult patients suffering from generalized insect sting reactions limited to skin manifestations or purely respiratory compromise who have not been treated with immunotherapy. Previous studies in adults demonstrate that the majority of patients with insect sting anaphylaxis have a decreased reactivity to re-sting with time, suggesting the insect allergy itself may be self-limiting. In this study, we evaluated 63 patients with initial insect sting manifestations limited to the skin and the respiratory system and noted the incidence and degree of natural re-sting reactions to these patients who had not undergone venom immunotherapy. In those patients with mild systemic reactions limited to the skin, none experienced an increase in severity. A local reaction was found on repeat sting in three of five patients in this group, and two of five had an equivalent cutaneous response (i.e., urticaria/angioedema). In five patients who had an initial respiratory reaction, four of the patients had a local reaction while one patient repeated the same respiratory manifestations. None of the patients with cutaneous or respiratory symptoms demonstrated a more severe reaction upon re-sting. This demonstrates that there is a natural progression of tolerance to insect stings in the adult population.

Adolescent↗