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Biomedical subjects

G L Sussman

Publications and source records attributed to G L Sussman.

10 recordsLinked to original sources
PubMed1992

Melkersson-Rosenthal syndrome: clinical, pathologic, and therapeutic considerations.

Melkersson-Rosenthal syndrome (MRS) has been described as a rare disease. Localized swelling (usually of the lips) with noncaseating epithelioid granuloma is necessary for diagnosis. We report 11 patients with biopsy-proven MRS. Mean age was 28 years (range 12-47 years). Mean duration of lesions was 4.4 years. Lip biopsy confirmed typical sarcoid-like granuloma. Five additional patients with typical symptoms are awaiting or refused lip biopsy. Clinically all patients presented with localized swelling of the lips. Treatment with clofazimine (100 mg 4 times weekly for 3-11 months) was associated with complete remission in 5/10 patients and clinical improvement in 3/10 patients with moderate constant swelling. Two patients (one severe and one moderate swelling) failed to respond to treatment. Rebiopsy in four patients confirmed improvement with disappearance or decreased granulomatous inflammation in 3/4. Complete spontaneous remission was also seen in three untreated patients. We conclude MRS is not uncommon, clofazimine may be effective treatment in moderate lesions and spontaneous remissions can occur.

Adolescent↗
PubMed1991

The spectrum of IgE-mediated responses to latex.

A spectrum of IgE-mediated allergic responses to latex is presented in this report of 14 patients, including health care workers, sensitized by exposure to latex gloves. Symptoms often occurred immediately after exposure to latex, and manifestations varied according to the route of latex antigen presentation. Skin exposure usually caused contact urticaria. Exposure to latex in the air elicited allergic rhinitis, conjunctivitis, and asthma. Systemic effects from latex occurred intraoperatively due to the surgeon's latex gloves. Anaphylactic shock included the above symptoms with the addition of tachycardia and hypotension. All patients had positive latex skin tests. Serum IgE antibody to latex was found with a latex radioallergosorbent test in all but one tested patient. Physicians should be aware that latex allergy can present as anaphylaxis during surgery, barium enema, or dental work. Latex skin tests are a satisfactory method of diagnosis. Nonlatex gloves are available and are tolerated by affected people.

Adolescent↗
PubMed1990

Characteristics of patients with food-related complaints.

Forty-five patients with classic food-allergic symptoms and/or subjective food-related complaints not traditionally associated with food allergy underwent evaluation. On the basis of a comprehensive clinical history, skin testing, and placebo-controlled, double-blind food challenges, patients were assigned to one of two groups: patients with reactions highly suggestive of IgE-mediated food hypersensitivity (group A, N = 22) and patients with atypical adverse food reactions that could not be confirmed by double-blind food challenge (group B, N = 23). Most patients in both groups were female, 77.3% and 91.3% of patients in group A and B, respectively. In group B, onset of symptoms occurred at an older age than in group A, 28.9 years +/- 17.2 versus 17.1 +/- 12.1 (p = 0.0015), respectively, and involved more foods, 25.6 +/- 22.1 versus 5.2 +/- 5.5 (p = 0.0002). Foods causing most prominent symptoms among patients in group A included legumes, tree nuts, crustaceans, and fish. In group B, milk, white sugar, wheat, egg, smoked/cured meat, and yeast were among the most troublesome foods. All but one patient in group A gave a positive skin test response to food; only four patients in group B had a positive response. We conclude that a subset of patients with food-related complaints can be accurately predicted to have a negative double-blind challenge with suspected foods on the basis of information obtained by history and skin testing.

Adolescent↗
PubMed1989

Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients.

From a pool of 624 patients with idiopathic chronic urticaria and angioedema, 90 patients had evidence of associated thyroid autoimmunity (TA). Since the number expected by chance alone is 37, given that less than 6% of normal subjects have TA, the association is significant (p less than 0.01; chi-square test). Age and sex distribution was typical of patients with TA. Clinically, most patients suffered relentless and severe urticaria and/or angioedema. With the exception of thyroid function and thyroid antibody tests, other laboratory tests were not rewarding. In most cases, treatment with 1 thyroxine did not improve urticaria or angioedema, but a few patients demonstrated a dramatic response. Awareness of the association resulted in the identification of previously undiagnosed thyroid disease. The authors hypothesize that a subset of idiopathic chronic urticaria and angioedema may be an autoimmune disease.

Adolescent↗
PubMed1988

Dietary aspects of adverse reactions to foods in adults.

Dietary considerations play an important role in the diagnosis, treatment and management of immunologic and nonimmunologic reactions to foods. Food diaries and trial elimination diets may prove helpful in identifying the responsible foods. Elimination diets must be monitored carefully for nutritional adequacy and should be used no longer than absolutely necessary; in some instances appropriate vitamin and mineral supplementation may be necessary. Ideally the identification of foods that provoke symptoms should be confirmed by means of double-blind challenge testing. Avoidance of some problem foods is unlikely to cause nutritional problems, but the practical and nutritional implications of allergies to staple foods such as cow's milk, eggs and wheat are far greater. Nonimmunologic adverse reactions that may mimic food allergic reactions include gastrointestinal disorders, sensitivity to food additives and psychologically based adverse reactions. There may be some degree of tolerance in metabolic disorders, which makes dietary management easier. Sensitivity to food additives necessitates careful scrutiny of food labels. In psychologic adverse reactions to foods, several foods are often involved, which increases the risk of nutritional problems.

Adult↗
PubMed1987

Anaphylactic reaction to synthetic luteinizing hormone-releasing hormone.

Synthetic LH-RH is a polypeptide that is structurally identical to natural LH-RH. It has been used as a safe ovulation induction agent. A case is presented in which a patient had an anaphylactic reaction when treated with LH-RH by IV infusion. Positive skin testing confirmed this as an IgE-mediated reaction. This is the first reported case of such a reaction and stresses that careful precautions be taken when administering all medications.

Adult↗
PubMedDate not supplied

Psyllium anaphylaxis.

Allergic reactions from handling psyllium have been reported since 1970. Health professionals and workers in laxative-manufacturing plants are at greatest risk. Sensitized people are at risk of life-threatening anaphylactic reactions. Two illustrative cases are presented. The first is A 39-year-old female dialysis nurse with a 3-year history of nasal and eye symptoms from exposure to psyllium. She obtained an over-the-counter psyllium bulk laxative, took it for constipation and developed flushing, tachycardia, urticaria, angioedema, laryngeal edema, and lightheadedness. An epicutaneous skin test and radioallergosorbent test for psyllium were both strongly positive. The second is a 42-year-old female nurse with a history of asthma who had allergic nasal and eye symptoms while dispensing psyllium. She received a prescription for crystallized psyllium, took it by mouth, and developed immediate flushing, tachycardia, urticaria, and angioedema. With subsequent ingestion of psyllium she had, in addition, severe wheezing, lightheadedness, and loss of consciousness. A psyllium epicutaneous skin test was strongly positive. These patient reports illustrate the risk of severe allergic reactions in sensitized people. Ingestion by sensitized people, such as from a routine postoperative and postpartum order, is potentially dangerous.

Adult↗
PubMedDate not supplied

Latex allergy: its importance in clinical practice.

Latex has been identified as a potent and significant allergen. Atopic medical and dental personnel who regularly use latex gloves and patients with chronic latex exposure are at increased risk of latex allergy. If this allergy is unrecognized, anaphylactic shock can occur as a result of mucosal latex absorption at the time of surgery or procedure. Use of a nonlatex glove can prevent this potentially fatal event. Latex anaphylaxis also can occur from absorption through disrupted skin in occupationally exposed patients. Further prospective studies are needed to look at the significance of a positive latex skin test, particularly in the history-negative population. Only then can we define appropriate screening procedures.

Dermatitis, Contact↗