Biomedical subjects

R S Stoloff

Publications and source records attributed to R S Stoloff.

4 recordsLinked to original sources

PubMed1993

Algorithms for the diagnosis and management of idiopathic anaphylaxis.

A major approach to the prevention of anaphylaxis due to exposure to an allergen is avoidance of the allergens. In cases of idiopathic anaphylaxis (IA), the method of management must first be pharmacologic control of the acute episode of IA and then the prevention of recurrent episodes. The appropriate management requires diagnosis, classification, and immediate initiation of a treatment regimen that will control and then induce a remission in patients with IA of the frequent (F) type. The classification and management of IA are reviewed and algorithms are presented for initial and long-term management of patients with IA.

Algorithms↗

PubMed1992

Malignant idiopathic anaphylaxis: three additional cases and extended evaluation.

Northwestern University's Division of Allergy and Immunology (NUAI) has evaluated and treated 225 patients with idiopathic anaphylaxis (IA) over a period of 16 years. Four patients have been identified with malignant IA. The term "malignant" is used to identify those patients with the most severe form of IA that is resistant to standard therapy. The diagnosis of malignant IA is made in patients with IA whose controlling oral corticosteroid dose was not able to be reduced below 60 mg of prednisone (or its equivalent) every other day or 20 mg of prednisone (or its equivalent) every day without an exacerbation of IA. Presented here is the long-term evaluation of one patient as well as three additional patients with malignant IA managed by our service. At the time of this report we have had no deaths due to IA in patients treated with pharmacologic regimen.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Idiopathic anaphylaxis: diagnostic variants and the problem of nonorganic disease.

We report on an expanding series of cases of idiopathic anaphylaxis (IA) with development of a classification, therapeutic regimens, and control of disease and induction of remission. Simultaneously, a growing series of cases referred for diagnosis and management of IA do not have IA. These cases, which approximate 10% of our series of IA cases, present serious time-consuming diagnostic problems for physicians. We present a series of nine cases of this type of nonorganic disease and describe the presenting symptoms, failure to document clinical abnormalities, and the lack of a response to a regimen shown to be effective in altering the course of true IA. The classification of IA has been expanded to include IA variants for patients in whom the symptoms complex varies significantly from other types of IA. Diagnostic suggestions and the problems of management are reviewed.

Adult↗

PubMedDate not supplied

Idiopathic anaphylaxis: total experience with 225 patients.

Idiopathic anaphylaxis (IA) is defined as anaphylaxis with no identifiable precipitating agent or event. Episodes of IA can be life threatening, and onset of episodes is unpredictable and usually recurrent. The epidemiologic features and clinical course of 225 patients diagnosed with IA and managed according to the described protocol with prednisone, H1 antagonists, and beta adrenergic agents were evaluated. There were no fatalities from IA in our series. There was a sevenfold reduction in the average rate of episodes requiring emergency care after initiation of pharmacologic management. Ninety five of 147 patients being observed are in remission, defined as absence of episodes for 1 year without corticosteroid therapy. During 636 patient years of observation, no inciting cause of anaphylaxis or alternative organic disease was defined. The diagnosis of IA was highly reliable in this series. Long-term prognosis is good, with the majority of patients experiencing remission.

Adolescent↗