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Biomedical subjects

W Aberer

Publications and source records attributed to W Aberer.

At least 19 recordsLinked to original sources
PubMed1992

Drug eruptions from mesna. After cyclophosphamide treatment of patients with systemic lupus erythematosus and dermatomyositis.

BACKGROUND: Mesna is used to abolish urotoxicity of cyclophosphamide and related compounds in immunosuppressive and antineoplastic treatment schedules. Adverse reactions to this drug have been reported only rarely. OBSERVATIONS: Drug eruptions to mesna have developed in seven of 15 patients with autoimmune disorders treated with monthly pulses of intravenous cyclophosphamide. Two different types of drug eruptions were observed: five patients had development of a macular and partly papular or urticarial rash and angioedema and two patients had a generalized fixed drug eruption, primarily and predominantly at the sites of previous skin lesions of their underlying condition. The results of prick, patch, and intradermal tests were similar in both types of rash; however, the two patients with fixed drug eruption had developed a generalized eruption upon prick testing with mesna. CONCLUSIONS: Two distinct eruptions to mesna have been induced in these patients during cyclophosphamide/corticosteroid therapy; these eruptions are not thought to share a common pathogenic mechanism. The results of skin and challenge tests do not support the hypothesis that a type 1 or a type 4 immune reaction may be responsible for these eruptions. The unusually high incidence (about 50%) of these reactions and their clinical presentation make it important to distinguish them from an exacerbation of the preexistent autoimmune disorder.

Adult↗
PubMed1992

[Quality control in the allergy laboratory--4 years "Allergy Ring Trial" in Austria].

In 1988 the Austrian Society for Allergology and Immunology initiated an external quality control program for the in vitro allergy diagnosis. In 12 mailings, 62 sera from allergic patients were sent to selected laboratories in order to determine total and antigen specific IgE according to the laboratory-specific methods. The values for total IgE varied considerably (73.9% were within +/- 1 SD, 94.3% within +/- 2 SD and 99.1% within +/- 2 SD, but only 0.9% beyond that). Sources of error were mainly attributable to inappropriate equipment and low quality reagents, but also bad test performance, with respect to personnel and the routines. In contrast, antigen specific IgE against pollen, mites, moulds, insect venoms, animal danders, drugs, parasites, environmental and food antigens revealed quite homogeneous results. Out of 1492 data, only 46 (3.1%) had to be declared as "wrong", and the variability of the RAST-classes was low. Whereas the quality of the reagents from all the different suppliers was not absolutely reliable at the beginning of the study, it improved considerably with time, as consequence of our complaints. The comparability of the methods for detecting total-IgE were non-satisfactory, whereas those for antigen specific IgE were generally good. The variety of methods employed (radio- and enzyme immunologic, fluoro- and nephelometric methods, etc.) should entail appropriate consequences, especially critical comparisons within one and the same laboratory; in addition, international standardization of the "normal" values should replace company-standards, and quality control programs for each test system before it is marketed should be mandatory. Our results confirm, that external control should be obligatory for any laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1991

Clinical characteristics of patients with repeated systemic reactions during specific immunotherapy with hymenoptera venoms. A retrospective study.

In general, specific immunotherapy with hymenoptera venoms can be considered as safe, but occasionally there are patients who cannot reach the maintenance dose due to repeated systemic reactions (RSR) or who suffer from RSR during maintenance therapy. In a multicenter retrospective study comprising seven departments in Germany, Austria and Switzerland 23 patients with RSR were reported from approximately 3000 patients treated with hymenoptera venoms (bee and wasp venom to approximately equivalent frequency). From these, 22 were allergic to bee venom and only one to vespid venom. In general the clinical symptoms of RSR were milder than the initial reaction. But 4/23 (18%) exhibited cardiovascular reactions up to full shock. Neither anamnestic details, reactivity in skin tests or in vitro tests revealed a special pattern of patients with RSR. In some patients, however, an extremely high reactivity in the skin test was found and may indicate the possibility of further RSR.

Adolescent↗
PubMed1991

Vaccination despite thimerosal sensitivity.

Thimerosal sensitivity is extremely common in Austria, being surpassed as a contact allergen only by nickel. This high incidence is still rising and is probably due to the frequent vaccinations which are performed in Austria. Most of the patch-test-positive patients had recently been immunized with thimerosal-containing vaccines, and no other obvious sources of exposure to thimerosal could be found. On retrospective questioning, 48 out of 50 patients had had no problems with their recent immunization; the 2 who reported massive local reactions had received their injections, against the recommendation of the manufacturer, subcutaneously. In a prospective study, 12 thimerosal-sensitized persons received their follow-up immunization at our department, and no side effects occurred. This enables us to conclude that sensitization had occurred through vaccines, but that those amounts of thimerosal delivered i.m. are not sufficient to elicit clinical symptoms. Patch-test positivity to thimerosal thus represents no contra-indication to i.m. immunization with thimerosal-containing vaccines.

Adolescent↗
PubMed1991

[Contact eczema and "standard test"--do "International Standard Test Series" coincide with Austrian local characteristics?].

Testing with a "standard" group of substances has proved of great value when allergic contact dermatitis is suspected and the offending agent cannot be pinpointed by careful history-taking. But internationally standardized series do not take into account locally important and individual factors, changing consumer habits or economic aspects. We have, thus, compared the suitability of two standard series, the ICDRG-European and the DKG-German standard, for Austrian purposes. 1,478 patients with a clinical diagnosis of contact dermatitis were patch tested between 11/88 and 4/90 with the ICDRG allergens; the second collective of 505 patients was tested between 5/90 and 1/91 with the DKG series. Only 12 out of the 27 substances of the ICDRG series exceeded the critical incidence of 1%; 6 were below this limit but positive in more than 0.5% and 9 hardly ever aroused positive reactions. In the DKG series, 17 out of 23 substances surpassed the limit, 2 were positive in more than 0.5%, and 4 caused virtually no reactions. However, 4 allergens with frequent sensitization rates were included neither in the ICDRG nor in the DKG series and 2 others were missing in the over-dimensioned ICDRG standard. Our results demonstrate that internationally established standard series have to adapted for the local situation in Austria, and that a constant review is essential with replacement of allergens as necessary according to changing production techniques and consumer habits. Suggestions for an "Austrian standard patch test series" are proposed on the basis of our results but in spite of being helpful in general terms interpretation of such a test in the individual patient with eczema remains problematic.

Allergens↗
PubMed1991

[Contact eczema and epicutaneous tests--distribution of allergens and changes in the spectrum in Vienna].

Thousands of contact antigens have been defined. It is, however, remarkable that only a small group of substances (15 to 20) have proved to be frequent or otherwise important causes of allergic contact dermatitis. In agreement with reports from comparable centres, metals are high up on the "hitlist" of frequent allergens (nickel 24%, cobalt 9%, chromates 6%), followed by ingredients of cosmetics and toiletries (fragrances 16%, balsam of Peru 10%, Kathon 5%), whilst already way back are topical medicines (neomycin 4%, parabens 3%, lanolin 2%, benzocaine 1%) and rubber additives (thiuram-mix 2% and carba-mix 1%). Almost all other substances lie below the 1% limit. There was only one remarkable exception in comparison with the results of most other European studies, namely thiomersal, which is widely distributed as a preservative in vaccines in Austria and climbed to second place, with a sensitization rate of 18%. Although the phenylborate mercurials (historic sensitizations due to topical antiseptics) still reached a surprisingly high incidence of 6%, there were hardly any cases of cross-sensitization with thiomersal. A comparison with the international literature illustrates Austria-specific trends and a change in the spectrum over the past years. Interpretation of patch testing requires great specialist knowledge and experience.

Adolescent↗
PubMed1990

[The nephrotoxic effect of therapy with fumaric acid esters in psoriasis].

Two sisters, aged 25 and 29 years, with generalized psoriasis guttata since childhood, developed nausea, upper-abdominal pain, loss of appetite, palpitations and flushes in the course of local and oral administration of fumaric acid esters. Because of these side effects the treatment was discontinued after about two weeks, and the symptoms disappeared. But proteinuria and haematuria were subsequently noted, creatinine concentration rose to 2.2 and 2.5 mg/dl, respectively, while creatinine clearance fell to 44 and 27 ml/min, respectively. Examination of urinary sediments and analysis of urinary proteins gave results compatible with tubular-interstitial renal damage. The abnormal renal functions and urinary findings proved reversible within three weeks.

Administration, Oral↗
PubMed1990

Ammoniated mercury ointment: outdated but still in use.

Although severe mercury-associated side effects, such as poisoning and high irritant and allergic potential, as well as the weak potency of mercury as an antiseptic or antipsoriatic agent, are well-known, topical mercury preparations are still listed in several pharmacopoeias, including that of the United States, UK and several other European countries. Thus, topical mercurials are still in use, even though more effective and less toxic drugs are now available. We report 2 cases of severe allergic reaction to ammoniated mercury and hope, in agreement with the pertinent literature, to contribute to its removal, and that of most other mercurials, from the therapeutic armamentarium.

Administration, Cutaneous↗
PubMed1990

[Post-zoster-specific skin infiltrates in chronic lymphatic leukemia].

Eight weeks after suffering from herpes zoster of the right 5th cranial nerve, an 80-year-old woman with chronic lymphocytic leukaemia developed zoster-like pseudovesicular lesions in the same nerve segment. Histological and immunohistological investigations revealed specific infiltrates of chronic lymphocytic leukaemia. Chemotherapy for the underlying disease was intensified, and the cutaneous infiltrates disappeared quickly. The patient died shortly afterwards due to exacerbation of the lymphoma.

Aged↗