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

Wheat is a common cause of food allergy. Wheat-induced anaphylaxis (WIA) and wheat-dependent exercise induced anaphylaxis (WDEIA) are severe forms of immunoglobulin E (IgE) mediated allergic reaction to wheat protein. As the diagnosis of WIA or WDEIA is not easy because of the risk of oral challenge, identification of specific IgE of various wheat proteins is helpful for diagnosis. In Korea, there are only a few reports on WIA in adults. We report six cases of WIA diagnosed on the basis of clinical history and specific IgE of wheat proteins or provocation test. For immunologic evaluation of severe wheat allergy including WIA and WDEIA, it is important to measure specific IgE to each component of wheat including gluten and omega-5 gliadin not just measuring wheat-specific IgE.
Adult* ; Anaphylaxis* ; Diagnosis ; Food Hypersensitivity ; Gliadin ; Glutens ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Korea ; Triticum ; Wheat Hypersensitivity

PURPOSE: Buckwheat is one of the most common allergen in food allergy, the pathomechanism is IgE-mediated, type I immune reaction. Antigenicity of Buckwheat is extremely strong, and hypersensitivity symptoms included asthmatic attacks, urticaria eruption, gastrointestinal disorders even anaphylactic shock. The purpose of this study is to evaluate diagnostic significance of allergy skin test and allergy history and analyze clinical features of buckwheat allergy confirmed by oral provocation test. METHODS: We carried out the retrospective study on 55 patients who had been performed oral buckwheat provocation test at Yonsei university children's allergic clinic. RESULTS: 1) 40 out of 55 cases(72.7%) showed positive buckwheat oral provocation test. 2) The most common clinical finding after oral provocation test was urticaria. 60% showed severe allergic reactions such as asthma attack or anaphylactic shock. 3) The rate which past history and positive skin test corresponded to oral provocation test was very high(86.1%). CONCLUSIONS: The most valuable diagnosis of food allergy is oral provocation test. However, predictive value of allergy skin test and past history was very high in buckwheat allergy. Our study suggest that the troblesome oral provocation test may be not needed in all cases of suspicious buckwheat allergy patients.
Anaphylaxis ; Asthma ; Diagnosis ; Fagopyrum* ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Retrospective Studies ; Skin Tests ; Urticaria

Because of the rapid action and high bioavailability, traditional Chinese medicine injections (TCMIs) had been widely used in clinical critical field. In recent years, with the increasing reports of clinical adverse reaction, more and more attention was paid to them, and acute allergic reaction was the main adverse reaction. Acute allergic reaction included type-I anaphylaxis reaction and anaphylactoid reaction, the latter had been found in a variety of TCMIs and accounted for 77% of adverse reaction. But the mechanism of anaphylactoid reaction was not completely understood, the standard animal model for TCMIs was not established, and the technical guidance for anaphylactoid reaction was not formulated. Thus the three aspects included mechanism, evaluation index and evaluation methods of TCMIs for anaphylactoid were reviewed. Five ways including direct stimulating pathway, complement pathway, coagulation pathway, kallikrein-kinin pathway and acute allergic pathway were the main mechanism of anaphylactoid reaction; whole animal model and cell model were the main evaluation methods; the occurrence index and effect index were reviewed for the evaluation index analysis.
Anaphylaxis ; chemically induced ; Animals ; Drug Hypersensitivity ; diagnosis ; etiology ; Humans ; Injections ; Medicine, Chinese Traditional ; adverse effects

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

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