Biomedical subjects
Publications and source records attributed to J Botey.
Two cases of anaphylactic reactions set off by the ingestion of a small amount of mustard sauce are described. Mediation by specific IgE to mustard was determined by skin prick tests and radioimmunoassay, which suggested a type I hypersensitivity mechanism. Despite the antigenic potency of mustard, a spice that is consumed frequently, very few cases of hypersensitivity from ingestion have been described.
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Due to its great simplicity, the determination of total and specific IgE with a reagent strip could be a screening method for in vitro allergy diagnosis if a correlation with classical techniques is verified. The TOTALE reagent strip for semiquantitative determination of total serum IgE is one of these methods and unites the now classical foundation (anti-IgE/IgE/anti-IgE labeled sandwich) and the ease of the reagent strip technique. In a preliminary evaluation of these methods we compared the PRIST isotopic method to the TOTALE one for serum total IgE. In summary, the most relevant consequences from this comparison are the following ones: a) The initial sample is the same for both: serum. b) No additional equipment or materials other than the serum sample are needed for TOTALE practising. c) The reagent strip has a lower cost and is faster than the PRIST method. d) Correlation coefficients were 0.89 (n = 35) in the range of measurement under study and 0.93 (n = 23) in the range from 5 to 200 U/L.
We selected 183 patients with asthma, rhinitis and/or conjunctivitis. They responded positively to Parietaria Judaica skin prick-tests. In the first test 91 were positive. Of those 11 were monosensitive and 80 polysensitive. In the follow-up tests 92 were positive, of which 5 were monosensitive and 87 polysensitive. There were 54 cases of rhinitis, of which 23 developed asthma. Of 129 asthma cases, 90 developed asthma with rhinitis. The main seasons are Spring and Autumn and activity declines during winter. 18.57% are perennial. IgE was greater in the re-examination of the polysensitive cases. The monosensative cases confirmed the clinical symptoms most characteristic of rhinitis syndrome, 16.893% and asthma with rhinitis, 49.18%.
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Results of practical tests with whole milk and the three most allergenic proteins were compared in 32 children who were suspected of showing allergy to milk. Diagnosis was composed of a suggestive clinical history, familial atopy, positive in vitro and in vivo tests and regression of symptoms under an exclusion diet. Tests of re-introduction were done with 11 children. Better agreement between the provocation tests and the other elements of the diagnosis was found when the tests were made with the fractions, rather than whole milk. Furthermore, the finding of reduced allergy to casein allows consideration of re-introduction of milk in the form of cheese.
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Determination of total and specific IgE using reactive test strips may afford a useful screening method in the in vitro diagnosis of allergens owing to easy use and possible correlation with established methods. T.D. LETI reactive strips for the semiquantitative determination of total IgE is a method combining classical fundamentals (sandwich anti-IgE-IgE-labeled anti-IgE) and the use of strip methods. It also permits determination of specific IgE levels in a wide range of Mediterranean and food (10) allergens. In a preliminary assessment, this method was correlated with isotopic PRIST for total IgE and with Phadebas RAST for specific IgE. The most important features are: a) no additional equipment besides serum or whole blood; b) cheaper and faster than PRIST for total IgE; c) correlation coefficient of 0.88 in the proposed range (n = 20) and 0.91 (n = 25) in the 10-500 U/ml range for PRIST/T.D. LETI for total IgE; d) specific IgE determination strips present sensitivity and specificity of 88 and 91%, respectively, in 180 allergens assayed in relation to Phadebas RAST. In conclusion, the in vitro diagnosis of allergens using reactive strips is currently a practical and simple method. By optimizing the top of the scale for total IgE and reducing the volume and/or time in specific IgE, it may prove to be an important screening method.
We present the case of a 7-year-old IgE-dependent asthmatic child who, moments after ingesting several pomegranate seeds, showed a clinical condition of bronchospasm which responded to treatment with inhaled salbutamol. Cutaneous tests using the prick-by-prick techniques with extract of the fresh fruit were positive and the RAST for pomegranate was 0.8 PRU/ml. In the literature studied, we have found few specific references to allergy to pomegranate.
Hypersensitivity to beta lactams, especially that mediated by IgE or IgG4, is the most frequent complaint of adverse drug reactions. There are multiple studies dedicated at establishing a method that can permit us to arrive at an accurate diagnosis, but from these studies one deduces that the difficulty lies in the lack of a test with a 100% reliability. In the present study we evaluate the correlation between the different methods. For this we selected 16 children, composed of 8 males and 8 females, whose ages ranged between 2 years 7 months and 9 years 8 months, and who had a reaction to penicillin G via parenteral. The following tests were done on them: Skin tests with a major determinant antigen (constant composition and molecular weight), with minor determinants. Human basophil degranulation test (modified Leynadier technique). Mathov's progressive controlled provocation test, which we considered the most reliable. Only in eight cases a diagnosis of penicillin allergy was arrived at. The correlation between the different tests were: Mathov - HBDT 93.75%; Mathov - PPL 93.75% and PPL - HBDT 87.5%.
Since Cooke first described bronchospasm induced by acetyl salicylic acid in asthmatic patients in 1919, numerous studies have been done with the objective of understanding the pathology, treatment and incidence of aspirin-induced asthma. The incidence is difficult to establish but according to two recent studies, the percentage in the infantile asthmatic population was estimated at 13% and 28%. This prevalence is greater than that suspected at first and reveals the necessity of reviewing this problem. In this study we present 4 pediatric patients, 2 atopics and 2 non-atopics affected with aspirin-induced asthma. A detailed clinical history, oral provocation test to acetyl salicylic acid, other non-steroid anti-inflammatory analgesics and additives was performed. The oral provocation test with acetyl salicylic acid was positive in all 4 cases. The oral provocation with non-steroid anti-inflammatory analgesics and other additives was negative in 2 patients. In the remaining 2 patients, one demonstrated sensitivity only to tartrazine and the other to tartrazine, red coccine, mefenamic acid and benorylate. In conclusion, aspirin-induced asthma is not infrequent in infancy. Therefore, it is important to bear it always in mind and to diagnose it through oral provocation besides looking for possible cross reactions.
This study presents the cases of five children who consulted us because of skin pathology, in which a hypersensitivity to monosodium glutamate (MSG) was detected. In four children, the motive for consultation was urticaria; in two children, urticaria was accompanied by angioedema, while the fifth child presented with atopic dermatitis and urticaria. In the four cases of urticaria, the etiological diagnosis was probable drug allergy. The oral provocation test (OPT), carried out with monosodium glutamate (MSG) in opaque capsules containing 50 and 100 mgr., was positive in two hours in four of the five children. MSG's mechanism of action is unknown, and though its use is world-wide, no evidence of hypersensitivity with cutaneous symptomatology has been found in any of the studies carried out to date.
From the report of Hirschberg, only 3 years after aspirin synthesis, there have been numerous works dedicated to showing the different types of adverse reactions found following aspirin administration. However, there are few publications on the process of urticaria and/or acute angioedema induced by ASA and few reported cases were found in children. Thus, we present 6 atopic children with urticaria and/or angioedema related with ASA. A carefully detailed history, oral provocation with ASA, oral provocation with other NSAI and HBDT with ASA were done to all of them. The oral provocation with ASA was positive in 5 of the 6 cases. The provocations with the rest of the NSAI and tartrazine and sodium benzoate were negative in all of the patients. The HBDT was positive in 5 of the cases. In conclusion, we insist that aspirin intolerance is not infrequent in infancy and it is not rare to see urticaria and or angioedema, in spite of the fact that asthmatics, atopics or non atopics, usually present as bronchospasm. We also believe that the HBDT can be a method of diagnosis used in these cases.
We report the case of 8 children (whose ages ranged between 2 and 7) who consulted us because of urticaria, accompanied by angioedema in 5 of the cases. An additives study was performed based on a habitual program. Sodium bisulfite hypersensitivity was detected with oral provocation test with doses of 5 and 25 mgs. The tests were positive within the first hour of observation in 2 cases, in the rest the reaction appeared later after the administration of the second dose; the reaction in 2 of the cases were semi-delayed. No respiratory symptomatology was detected in these patients.
We present 25 patients, aged between 18 and 153 months, with clinical symptoms suggestive of allergy to food antigens. After undergoing exhaustive studies (including case histories, cutaneous tests for reactions to food antigen, peripheral eosinophils, secretory and humoral immunity, determination of total IgE and of specific RAST, exclusion-provocation diets) and without being able to identify an offender, patients were submitted to oral provocation with different food additives (tartrazine, sunset yellow FCF, new coccine, erythrosine, sodium benzoate, 4-methyl hydroxybenzoate and acetylsalicylic acid) after 48 hours of exclusion from their diets of dyes, preservatives and salicylates. The results obtained reflect, at a global level, 57.89% of positivities for dyes, 34.21% for the benzoates and 7.81% for acetyl-salicylic acid. The low incidence of crossed intolerance phenomena should be emphasized (32% of the patients). The disparity of our results with those of other authors could be due to the age of our patients, the clinical patterns they present and the dietary habits of different countries and regions.