Adult ; Anaphylaxis ; etiology ; Female ; Humans ; Male ; Semen ; immunology

A 56-year-old man who had suffered from seasonal rhinitis in spring and autumn experienced recurrent generalized urticaria and an oral burning sensation after eating several cooked herbs for 3 months. A skin-prick test showed positive responses to various pollens, celery, Chinese bellflower, and arrowroot. The Chinese bellflower-specific IgE ELISA OD value was 1.547. Oral challenge with unprocessed raw Chinese bellflower root provoked oral burning sensation, eyelid swelling, generalized urticaria, and hypotension. In an ELISA inhibition test, IgE binding to Chinese bellflower was significantly inhibited by Chinese bellflower, mugwort, and birch pollen extract. SDS-PAGE and immunoblot assay revealed nine IgE-binding components, and common protein bands were detected in the range of 40~55 kDa (Chinese bellflower-mugwort-birch) and 14 kDa (Chinese bellflower-birch). Chinese bellflower root can cause anaphylaxis and may have cross-reactivity with mugwort and birch.
Anaphylaxis/*etiology ; Artemisia/*immunology ; Betula/*immunology ; Cross Reactions ; Humans ; Immunoglobulin E/*immunology ; Male ; Middle Aged ; Platycodon/*immunology

Anaphylaxis following laminaria insertion rarely occurs but may be a life-threatening condition. Laminaria tents, prepared from natural sea kelp, are commonly used prior to elective termination of pregnancy to achieve cervical dilatation. We report herein two cases of anaphylaxis caused by IgE-mediated hypersensitivity to laminaria. Two women, each of whom had undergone at least one previous abortion where a laminaria had been utilized, developed anaphylactic reaction following laminaria insertion. The reaction included urticaria, nausea, breathing difficulty, and hypotension. The patients subsequently underwent skin testing and measurement of serum specific IgE level to laminaria extract, and were shown to elicit positive responses to laminaria. The implication and impact of laminaria allergy on gynecologic procedures are significant and this allergy should be included in the list of differential diagnoses for hypersensitive reaction in gynecologic procedures.
Adult ; Anaphylaxis/*etiology/*immunology ; Diagnosis, Differential ; Female ; Human ; Hypersensitivity, Immediate/*immunology ; Laminaria/*immunology ; Pregnancy ; Skin Tests ; Support, Non-U.S. Gov't

OBJECTIVETo determine the relation between the change of immunology indexes of serum and the occurrence of anaphylaxis in patients induced by Qingkailing injection, and to establish the method of detection of the type of anaphylaxis in patients induced by traditional Chinese medicine (TCM) injection.

METHODIn a prospective nested case-control study, we compared the concentration of IgE, IgG, IL-2, IL-4 of 20 cases in anaphylaxis induced by Qingkailing injection with those from 60 matched controls who remained normal after the using Qingkailing injection. The correlation between the change of IgE, IgG, IL-2, IL-4 of serum and the occurrence of anaphylaxis in patients induced by Qingkailing injection was determined, and we also evaluate the clinical values of IgE, IgG, IL-2, IL-4 of serum in diagnosis of anaphylaxis in patients induced by Qingkailing injection by Binary-Logistic regression analysis.

RESULTThe concentrations of IgE, IgG, IL-2, IL-4 of serum of 20 cases were significantly higher than those in controls (P < or = 0. 05). The concentrations of IgE, IgG, IL-2, IL4 of serum of 20 cases after the treatment with Qingkailing injection were significantly higher than those before the treatment with Qingkailing injection (P < or = 0.05). The Exp(B) of IgE, IgG, IL-2, IL-4 were 22. 018 (95.0% CI for EXP was 3.268-310.831), 11.271 (95.0% CI for EXP was 1.91-3.024), 23.612 (95.0% CI for EXP was 3.012-421.187), 16.486 (95.0% CI for EXP was 1.233-205.413), respectively.

CONCLUSIONThe allergic reaction caused by Qingkailing injection may be due to type I allergic reactions; The presence of IgE, IgG, IL-2, IL-4 can serve as clinical evaluation indicators in evaluation the damage degree of immune system caused by anaphylaxis in patients induced by Qingkailing injection. Cytokines are more likely to become the effective evaluation index in diagnosis of anaphylaxis in patients induced by TCM injection.

Adolescent ; Adult ; Aged ; Anaphylaxis ; blood ; etiology ; immunology ; Case-Control Studies ; Cytokines ; blood ; immunology ; Drug Hypersensitivity ; immunology ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Immunoglobulins ; blood ; immunology ; Male ; Middle Aged ; Prospective Studies ; Young Adult

Hypersensitivity to the stings of the Hymenoptera has been described since antiquity. The hypersensitive reactions to insect stings vary from minor skin reactions to severe and sometimes fatal anaphylaxis. Concerns about sting hypersensitivity have been increasing because of many incidents of allergic reactions of patients to the fire ant in the southern area of the United States as well as the harvester ant in some areas. We experienced one unique case with severe allergic reactions by ant of the Ectomomyrmex spp. of the subfamily Ponerinae, which is not a harvester ant. For three years the patient had been suffering from generalized allergic reactions such as anaphylaxis after the ant stings four-five attacks in a year. We determined that her reactions were due to specific IgE mediated type I hypersensitivity by the detection of a high level of specific IgE to the ant venom in her serum. The high level of specific IgG4 to the ant venom was also noted in her serum, however, the role of ant venom IgG4 was not clearly determined.
Adult ; Anaphylaxis/*etiology ; Ant Venoms/*immunology ; Case Report ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin E/*analysis ; Immunoglobulin G/*classification ; Support, Non-U.S. Gov't

OBJECTIVETo investigate the preclinical evaluation method of pseudoanaphylactoid reactions for Chinese herbal injections.

METHODBeagle dogs were divided into control group (C), 0.5% tween 80 group (T), Yuxincao injection containing 0.5% tween 80 (YT), distilled solution from Yuxincao (Y). Various groups of Beagle dogs were given 3 mL x kg(-1) of the test articles intravenously. The anaphylactoid reactions were observed immediately, while blood pressure, respiratory frequencies and heart rates were tested at 10 min and 30 min after administration.

RESULTA variety of symptoms that range from cutaneous and mucosa signs to bronchospasma and cardiovascular collapse, including angioedema at lip, conjunctiva, ear and circumoral skin, somnolence, lethargy, breathless or dyspnea, severe hypotension etc were observed in T and TY groups from immediately post-injection to at least 30 min after administration. These reactions occurred at both first injection or repeated injections at 24 weeks intervals, manifesting that it was pseudoanaphylactoid reaction mediated by non-immune mechanisms.

CONCLUSIONBeagle dogs could be used as an animal model for preclinical evaluation of pseudoanaphylactoid reactions of Chinese herbal injection with sensitivity, reproducibility, and high clinic consistency.

Anaphylaxis ; chemically induced ; etiology ; immunology ; Animals ; Dogs ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Injections, Intravenous ; Male ; Models, Animal ; Random Allocation

Anaphylactic transfusion reactions are rare complications of blood transfusions. Anhaptoglobinemia, a condition that has high incidence in Asia, can cause allergic transfusion reactions or anaphylaxis in severe cases. A 50-yr-old Korean woman was diagnosed with relapsed acute promyelocytic leukemia. She developed thrombocytopenia during chemotherapy and an anaphylactic transfusion reaction on the 4th and 5th platelet transfusions immediately after the transfusion of the platelet concentrates was initiated. Blood analysis showed no detectable serum haptoglobin. We examined her genetic phenotype and detected anhaptoglobinemia, which occurs because of an allelic deletion in the Hp gene cluster. The presence of an antibody against haptoglobin was detected by performing ELISA. To prevent anaphylactic reactions, apheresis platelets were transfused after washing. Consequently, anaphylactic transfusion reactions did not develop. Here, we report the first case of anhaptoglobinemia causing anaphylactic transfusion reaction in Korea.
Alleles ; Anaphylaxis/*etiology ; Antineoplastic Agents/therapeutic use ; Female ; Gene Deletion ; Haptoglobins/*genetics/immunology ; Humans ; Isoantibodies/immunology ; Leukemia, Promyelocytic, Acute/complications/*diagnosis/drug therapy ; Middle Aged ; Phenotype ; Platelet Transfusion/*adverse effects ; Recurrence ; Republic of Korea ; Thrombocytopenia/complications/diagnosis

OBJECTIVETo investigate the immunological mechanism of allergic dermatitis induced by trichloroethylene (TCE).

METHODSThe guinea pig model of TCE-induced allergic dermatitis was established by Guinea pig Maximization Test. The effects of TCE and its metabolites on splenic lymphocytes of TCE-sensitized and non-sensitized guinea pig were detected by MTT assay.

RESULTSFor TCE-sensitized guinea pig, the survival rate of lymphocytes cultured with TCE (+S9) was significantly higher than that cultured with TCE (-S9) (83.0% +/- 3.4% vs 75.9% +/- 7.9%, P < 0.01), while, for normal animals, the survival rate of lymphocytes cultured with TCE (+S9) was significantly lower than that cultured with TCE (-S9) (63.4% +/- 8.4% vs 77.0% +/- 7.2%, P < 0.01). The survival rate of lymphocytes cultured with TCE (+S9) in TCE-sensitized animals was higher than that in normal animals (83.0% +/- 3.4% vs 63.4% +/- 8.4%, P < 0.05), but no statistically significant difference was found for TCE (-S9) (75.9% +/- 7.9% vs 77.0% +/- 7.2%, P > 0.05).

CONCLUSIONCytotoxicity of TCE to normal lymphocytes and proliferation of sensitized lymphocytes were enhanced by metabolic activation. The metabolites of TCE may act as effective immune hapten to stimulate the proliferation of hapten-specific lymphocytes in TCE-sensitized animals.

Animals ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Dermatitis, Allergic Contact ; etiology ; immunology ; Female ; Guinea Pigs ; Lymphocytes ; drug effects ; Male ; Passive Cutaneous Anaphylaxis ; drug effects ; Spleen ; drug effects ; immunology ; Trichloroethylene ; toxicity