No abstract available.
Anaphylaxis* ; Diagnosis*

No abstract available.
Anaphylaxis* ; Diagnosis*

Anaphylaxis ; diagnosis ; therapy ; Humans

PURPOSE: This study investigates the utility of serum tryptase for the confirmation of shrimp-induced anaphylaxis. METHODS: Patients with a history of shrimp allergy and positive skin prick tests (SPT) to commercial shrimp extract were recruited for shrimp challenges. Serum total tryptase was obtained at baseline and 60 min (peak) after the onset of symptoms. RESULTS: Thirty-nine patients were challenged. There were 12 patients with anaphylaxis, 20 with mild reactions and 7 without symptoms (control group). Characteristic features and baseline tryptase were not different among the 3 groups. The peak tryptase levels were higher than the baseline in anaphylaxis and mild reaction groups (P<0.05). The delta-tryptase (peak minus baseline) and the tryptase ratio (peak divided by baseline) in the anaphylaxis group were higher than the mild reaction and control groups (P<0.01). The optimum cut-off for peak tryptase to confirm anaphylaxis was 2.99 microg/L with 50% sensitivity, 85% specificity, 3.33 positive likelihood ratio (LR) and 0.59 negative LR. The manufacturer's cut-off for peak tryptase was >11.4 microg/L with 17% sensitivity, 100% specificity, infinity positive LR and 0.83 negative LR. The best cut-off for delta-tryptase was > or =0.8 microg/L with 83% sensitivity, 93% specificity, 11.86 positive LR and 0.18 negative LR. The best cut-off for tryptase ratio was > or =1.5 with 92% sensitivity, 96% specificity, 23 positive LR and 0.08 negative LR. CONCLUSIONS: The peak tryptase level should be compared with the baseline value to confirm anaphylaxis. The tryptase ratio provide the best sensitivity, specificity, positive and negative LR than a single peak serum tryptase for the confirmation of shrimp-induced anaphylaxis.
Anaphylaxis* ; Diagnosis* ; Humans ; Hypersensitivity ; Skin ; Tryptases*

The high-pace rise in advanced computing and imaging systems has given rise to a new research dimension called computer-aided diagnosis (CAD) system for various biomedical purposes. CAD-based diabetic retinopathy (DR) can be of paramount significance to enable early disease detection and diagnosis decision. Considering the robustness of deep neural networks (DNNs) to solve highly intricate classification problems, in this paper, AlexNet DNN, which functions on the basis of convolutional neural network (CNN), has been applied to enable an optimal DR CAD solution. The DR model applies a multilevel optimization measure that incorporates pre-processing, adaptive-learning-based Gaussian mixture model (GMM)-based concept region segmentation, connected component-analysis-based region of interest (ROI) localization, AlexNet DNN-based highly dimensional feature extraction, principle component analysis (PCA)- and linear discriminant analysis (LDA)-based feature selection, and support-vector-machine-based classification to ensure optimal five-class DR classification. The simulation results with standard KAGGLE fundus datasets reveal that the proposed AlexNet DNN-based DR exhibits a better performance with LDA feature selection, where it exhibits a DR classification accuracy of 97.93% with FC7 features, whereas with PCA, it shows 95.26% accuracy. Comparative analysis with spatial invariant feature transform (SIFT) technique (accuracy—94.40%) based DR feature extraction also confirms that AlexNet DNN-based DR outperforms SIFT-based DR.
Classification ; Dataset ; Diabetic Retinopathy ; Diagnosis ; Passive Cutaneous Anaphylaxis

The authors reported here a 23 years-old female patient with acute renal failure and anaphylaxis induced by rifampicin, who was suffered from exudative pericarditis. The diagnosis was made by its reproducibility with rifampicin. The pathogenesis of acute renal failure and anaphylaxis in this case was thought to be immunologic mechanism, because of elevated IgE and depressed complements. Relevant literature was also reviewed.
Acute Kidney Injury* ; Anaphylaxis* ; Complement System Proteins ; Diagnosis ; Female ; Humans ; Immunoglobulin E ; Pericarditis ; Rifampin ; Young Adult

Food-dependent exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening clinical reaction in which anaphylaxis develops when physical activity occurs within a few hours after ingesting a specific food. An 18-year-old girl experienced generalized urticaria, periorbital swelling, and dyspnea repeatedly by exercise after intake of a red ginseng health supplement. A confirmed diagnosis was established in this case by using an exercise challenge test after ingesting mixed-plant extract containing red ginseng health supplement. To the best of our knowledge, this is the first case of FDEIA caused by components in a red ginseng health supplement.
Adolescent ; Anaphylaxis* ; Diagnosis ; Dyspnea ; Female ; Humans ; Motor Activity ; Panax ; Plants* ; Urticaria

Allergic diseases are common in sports athletes, as they are in the general population. Any physician who involved in the care of athletes will commonly face the management of allergic conditions. Exercise-aggravated or exercise-induced allergic disorders are significant health problems to competitive athletes, although the majority of these disorders are mild and symptomatically annoying, several allergic diseases carry the risk of anaphylaxis and even sudden death. Meticulous approach in the diagnosis and management of allergic conditions is essential for the sports medicine physicians to afford all athletes can compete safely with their highest physical and mental level.
Anaphylaxis ; Asthma ; Athletes ; Death, Sudden ; Diagnosis ; Humans ; Sports ; Sports Medicine ; Urticaria

Effective treatment of hypotension during induction of general anesthesia depends onhow well the many causes of the hypotension are understood. However, differential diagnosis of hypotension is by no means easy, especially when the prevalenceof hypotension is low or when the patient is asymptomatic. A 75 year-old female, upon induction of general anesthesia for open thoracic surgery, became hypotensive and showed generalized erythematous papules, therefore having to postpone the surgery. Upon further evaluation through skin prick tests, the hypotensive event was concluded to be caused by anaphylactic side effects of atracurium. Hence, atracurium was avoided and the surgery was successfully performed.
Anaphylaxis ; Anesthesia, General ; Atracurium ; Diagnosis, Differential ; Female ; Humans ; Hypotension ; Skin ; Thoracic Surgery

Frequent use of non-steroidal anti-inflammatory drugs (NSAIDs) has been paralleled by increasing occurrence of adverse reactions, which vary from mild local skin rashes or gastric irritation to severe, generalized symptoms and even life-threatening anaphylaxis. NSAID-induced hypersensitivity reactions may involve both immunological and non-immunological mechanisms and should be differentiated from type A adverse reactions. Clinical diagnosis and effective management of a hypersensitive patient cannot be achieved without identifying the underlying mechanism. In this review, we discuss the current classification of NSAID-induced adverse reactions and propose a practical diagnostic algorithm that involves 7 steps leading to the determination of the type of NSAID-induced hypersensitivity and allows for proper patient management.
Anaphylaxis ; Anti-Inflammatory Agents, Non-Steroidal* ; Aspirin ; Classification* ; Diagnosis* ; Drug Hypersensitivity ; Exanthema ; Humans ; Hypersensitivity*