3.Hypersensitivity vasculitis secondary to rabies vaccine in a 53-year-old Filipino male: A case report
Charlene Lorraine A. Elio ; Ma. Deanna S. Ramiscal
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):12-12
Vasculitis refers to the inflammation and damage of blood vessel walls. This presents as erythematous macules or palpable purpura with a predilection for dependent parts, particularly the legs. Vesicles and bullae are less common manifestations. Vasculitis can be idiopathic or associated with infections, systemic diseases, drugs, or vaccines. Vaccine-associated vasculitis has been reported in BCG, influenza, hepatitis, and more recently, COVID-19 vaccines. However, there is limited data on the adverse events associated with rabies vaccine administration.
A 53-year-old Filipino male presented with petechiae evolving into purpura and urticarial targetoid plaques with bullae on the extremities and trunk, after administration of inactivated purified Vero cell rabies vaccine (Verorab, Sanofi Pasteur) due to a Category 3 bite. There were no mucosal lesions. Nikolsky and Asboe-Hansen signs were negative. The patient had no previous reactions to drugs or vaccines.
Histopathology results confirmed the diagnosis of vasculitis. Resolution of skin lesions was achieved with administration of intravenous steroids and oral antihistamines.
Community surveys conducted in three Philippine provinces report the incidence of animal bites at 50 injuries per 1,000 population (5 percent) per year with 45 percent of patients seeking medical treatment at animal bite treatment centers.
There is limited data on adverse events associated with rabies vaccine administration. In general, allergic reactions to vaccines are rare, occurring in approximately 1 in 50,000 to 1 in 1,000,000 doses. These reactions may be due to antigens, residual media, stabilizers, preservatives, or other excipients in the vaccine.
Rash, urticaria, and pruritus have been reported, along with injection site reactions such as erythema, edema, and pain. Fever, malaise, headaches, low mood, purpura, urticaria, Stevens-Johnson Syndrome and erythema multiforme may also occur.
Adequate documentation and reporting of adverse reactions due to vaccines contributes to long-term safety studies and establishing treatment guidelines.
Human ; Male ; Middle Aged: 45-64 Yrs Old ; Hypersensitivity ; Rabies Vaccines ; Vasculitis
4.Expert consensus on the prevention and treatment of adverse reactions in subcutaneous immunotherapy(2023, Chongqing).
Yu Cheng YANG ; Yang SHEN ; Xiang Dong WANG ; Yan JIANG ; Qian Hui QIU ; Jian LI ; Shao Qing YU ; Xia KE ; Feng LIU ; Yuan Teng XU ; Hong Fei LOU ; Hong Tian WANG ; Guo Dong YU ; Rui XU ; Juan MENG ; Cui Da MENG ; Na SUN ; Jian Jun CHEN ; Ming ZENG ; Zhi Hai XIE ; Yue Qi SUN ; Jun TANG ; Ke Qing ZHAO ; Wei Tian ZHANG ; Zhao Hui SHI ; Cheng Li XU ; Yan Li YANG ; Mei Ping LU ; Hui Ping YE ; Xin WEI ; Bin SUN ; Yun Fang AN ; Ya Nan SUN ; Yu Rong GU ; Tian Hong ZHANG ; Luo BA ; Qin Tai YANG ; Jing YE ; Yu XU ; Hua Bin LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(7):643-656
5.Effects of acupuncture on neurologic function and serum inflammatory factors after thrombolysis in acute ischemic stroke.
Dao-Wei ZHAN ; Hua QIAN ; Xi-Bing YANG ; Yun-Jian BAI ; Li-Yu MAO ; Kai-Tao LUO
Chinese Acupuncture & Moxibustion 2023;43(5):489-492
OBJECTIVE:
To observe the effects of acupuncture on neurologic function and serum inflammatory factors in patients after thrombolysis in acute ischemic stroke (AIS).
METHODS:
A total of 102 AIS patients with onset to treatment time (OTT) ≤3 h were randomly divided into an observation group and a control group, 51 cases each group. In the control group, thrombolysis and conventional medical treatment were applied. On the basis of the treatment as the control group, acupuncture at Shuigou (GV 26), Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6), etc. was applied in the observation group, 30 min each time, once a day. Both groups were treated for 2 weeks. Before and after treatment, the scores of National Institutes of Health stroke scale (NIHSS), modified Rankin scale (mRS), modified Barthel index (MBI) and serum level of homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP) were compared, and the clinical efficacy was evaluated in the two groups.
RESULTS:
After treatment, the scores of NIHSS, mRS and serum level of Hcy, hs-CRP were decreased compared with those before treatment (P<0.05), while the MBI scores were increased (P<0.05) in the two groups. The scores of NIHSS, mRS and serum level of Hcy, hs-CRP in the observation group were lower than those in the control group (P<0.05, P<0.01), the MBI score in the observation group was higher than that in the control group (P<0.01). The total effective rate was 88.2% (45/51) in the observation group, which was superior to 70.6% (36/51) in the control group (P<0.05).
CONCLUSION
Acupuncture could promote the recovery of neurologic function in patients after thrombolysis in AIS, improve the ability of daily living, which may be related to reducing the level of inflammatory factors, thus inhibiting inflammatory response and improving cerebral ischemia reperfusion injury.
United States
;
Humans
;
Ischemic Stroke
;
C-Reactive Protein
;
Acupuncture Therapy
;
Inflammation
;
Homocysteine
;
Hypersensitivity
;
Thrombolytic Therapy
6.Dapsone hypersensitivity syndrome.
Qing ZHAO ; Lele SUN ; Yonghu SUN ; Dean NAISBITT ; Hong LIU ; Furen ZHANG
Chinese Medical Journal 2023;136(13):1560-1562
7.Dupilumab for Treatment of Food-Dependent, Exercise-Induced Anaphylaxis: Report of One Case.
Li-Ping ZHU ; Rui TANG ; Qing WANG ; Hong LI
Chinese Medical Sciences Journal 2023;38(2):159-162
Food-dependent, exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening disorder that often occurs with exercise, and patients typically have eaten a specific food within hours before disease onset. This disease is exceedingly rare, with a prevalence of 0.02%. No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly. Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years. As the anaphylactic symptoms had not been controlled after traditional treatments, the patient was given subcutaneous injection of dupilumab seven times within 33 weeks. During dupilumab treatments, the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis. Thus, Dupilumab may improve the allergic reactions in FDEIA patients.
Male
;
Humans
;
Child
;
Anaphylaxis/etiology*
;
Food Hypersensitivity/diagnosis*
;
Exercise-Induced Allergies
;
Antibodies, Monoclonal, Humanized/therapeutic use*
8.Risk factors for the development of airway hyperresponsiveness in patients with allergic rhinitis.
Jinjin ZHANG ; Yanwen CUI ; Yadong GAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(6):457-462
Allergic rhinitis(AR) is an independent risk factor for allergic asthma. Some AR patients may have developed airway hyperresponsiveness(AHR) in the absence of asthma symptoms. In this stage, AHR is often neglected due to the absence of typical asthma symptoms. Exploring the clinically relevant risk factors for AHR in patients with AR, as well as the clinical indicators and biomarkers to predict AHR in patients with AR, is of great significance to the prevention of the occurrence of AHR and asthma. This review summarized the risk factors for the development of AHR in AR patients, and gave hints to the prevention of AHR in AR patients.
Humans
;
Rhinitis, Allergic
;
Respiratory Hypersensitivity
;
Asthma
;
Risk Factors
9.The advances of allergen component detection in IgE-mediated food allergy.
Hao CHEN ; Rong Fei ZHU ; Xiao Tang LIAO ; Bao Qing SUN
Chinese Journal of Preventive Medicine 2023;57(3):333-340
There are many types in food allergy, and the most common is mediated by IgE. Currently, the diagnosis of food allergy mainly relied on skin prick test and serum specific IgE of allergen extract, which can not identify cross-sensitization. Component-resolved diagnosis (CRD) can identify the major allergen components and cross-components of food allergens, which plays an important role in dietary guidance, prognosis monitoring and diagnosis of special types of IgE-mediated food allergy. This article enumerates clinical characteristics of the IgE-mediated common food allergies, such as milk, egg and seafood allergy, and special type of food allergy, such as cat pork syndrome, oral allergy syndrome, α-gal syndrome and food-dependent exercise-induced anaphylaxis, summarizes the advances of CRD in these types of IgE-mediated food allergy, in order to provide an evidence for the diagnosis, treatment and prevention of IgE-mediated food allergy.
Humans
;
Allergens
;
Immunoglobulin E
;
Food Hypersensitivity/diagnosis*
;
Skin Tests
10.Research progress of oral allergy syndrome.
Zhuang Zhuang FAN ; Zhi Yue LU ; Jian Qiu JIN
Chinese Journal of Preventive Medicine 2023;57(3):341-347
Oral allergy syndrome (OAS) is an IgE-mediated hypersensitivity. Patients with pollen allergy will experience oropharyngeal allergy after eating fresh fruits or vegetables containing homologous pathogenesis-related allergen, occasionally accompanied by systemic symptoms, it is a special type of food hypersensitivity in which respiratory allergens and food allergens are similar structurally and lead to the cross-reactivity. At present, there is little research and attention to it in China. To master the definition, epidemiological characteristics, pathological mechanism, diagnosis, prevention and treatment of OAS is very important to the prevention and control of OAS. This article reviews the research progress of OAS, providing reference and prevention basis for clinicians to improve the diagnosis and differential diagnosis of OAS.
Humans
;
Pollen
;
Food Hypersensitivity/diagnosis*
;
Rhinitis, Allergic, Seasonal/therapy*
;
Allergens
;
Fruit
;
Cross Reactions


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