BACKGROUND: Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance. MATERIAL AND METHODS: We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber. RESULTS: The PEF improved on weekends and sick leave. The challenge test provoked a late asthmatic response and the non-specific bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount.

Acrylates↗

PubMedDate not supplied

Venom immunotherapy: tolerance to a 3-day protocol of rush-immunotherapy.

In the last 10 years in the Ramón y Cajal Hospital, in Madrid, we have treated 78 patients who had presented anaphylactic reactions after hymenoptera stings, by means of a rush immunotherapy protocol. Fifty patients received wasp venom and 30 received honeybee venom (2 patients were treated with both venom types). Venom immunotherapy is given to out-patients, at the hospital, in the morning. The interval between injections administered on the same day is 30 minutes and the patient stays for 2 hours under observation after the last daily dose. The schedule we use is as follows: Day 1 (0.05-1-5-10 micrograms of venom), Day 2 (20-40 micrograms), Day 3 (40-60 micrograms), Day 5 (100 micrograms). Afterwards, they receive 100 micrograms after 2 weeks and, finally, monthly. In order to achieve a better tolerance, patients are protected with antihistamines on the days they are administered the immunotherapy (mequitazine 5 mg every 12 hours) and also, doses equal or over 40 micrograms are given fractionally, injecting half dose in each arm. The percentage of systemic reactions (mild or moderate) is 13.3% for patients treated with honeybee venom and 2% for patients treated with wasp venom. These percentages are lower than those obtained with conventional protocols in which it takes several weeks to reach the maintenance dose. The speed and convenience of this protocol and also its appropriate safety have led us to use it as a routine treatment for patients who require venom immunotherapy after suffering anaphylactic reactions due to hymenoptera stings.

Anaphylaxis↗