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

Specific IgE to gliadin was proposed as a marker for wheat dependent exercise induced anaphylaxis, while Tri a 14 was found to induce IgE response in baker's asthma. We evaluated whether these components could be used for discriminating phenotypes of wheat allergy. Twenty-nine patients who were wheat-induced anaphylaxis and/or urticaria (n=21, group I) and baker's asthma (n=8, group II) were enrolled. The prevalence of serum specific IgE to Tri a 14 was higher in group II (25%) than in group I (4.8%), while the serum specific IgE to gliadin was significantly higher in group I (70%) than in group II (12.5%). The cutoff value for predicting the baker's asthma using the ratio of serum specific IgE to Tri a 14 to gliadin was 742.8 optical densityx1,000/(kU/L) with high sensitivity and specificity. These findings suggest that Tri a 14/gliadin may be a potential marker for predicting baker's asthma.
Adult ; Anaphylaxis/immunology ; Antigens, Plant/*immunology ; Asthma/blood/diagnosis/immunology ; Biological Markers/blood ; Carrier Proteins/*immunology ; Female ; Gliadin/*immunology ; Humans ; Immunoglobulin E/*blood/immunology ; Male ; Phenotype ; Triticum/immunology ; Urticaria/immunology ; Wheat Hypersensitivity/*diagnosis/*immunology

OBJECTIVE: To analyze the results of serum in allergic rhinitis and investigate the specific clinic allergen and serum immunoglobulin E (IgE) levels. METHOD: Allergy Screen method was used to detect the specific allergen and total serum IgE level of 134 cases of Allergic rhinitis. RESULT: The dust mite was the most common allergen in inhalation group in 134 cases of allergic rhinitis, the positive rates was 90%; then were donly, feline and scurfy fungus, the positive rates were 16%, 9%. The positive rates of total IgE was 54%. The serum IgE levels between 100 to 200 kU/L, there was 21 cases together, but there existed 7 negative cases. There were 51 cases' IgE levels more than 200 kU/L, the rates was 70.8%, but there still existed 4 negative cases. CONCLUSION Allergy screen method can find relevant allergen and provide basis for the prevention and treatment of allergic disease.
Adult ; Allergens ; blood ; immunology ; Animals ; Antigens, Dermatophagoides ; analysis ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Mites ; immunology ; Passive Cutaneous Anaphylaxis ; Pollen ; immunology ; Rhinitis, Allergic, Perennial ; diagnosis ; immunology

This is the first reported detection of serum IgE antibody to piperacillin-human serum albumin (HSA) conjugate in a patient presenting with anaphylaxis that developed after occupational exposure. A 24-yr-old nurse, who had worked at a University Hospital for 2 yr, experienced chest tightness, dizziness, generalized urticaria, abdominal pain, and diarrhea 10 min after administering a piperacillin injection. She had previously suffered from atopic dermatitis. A skin prick test for common inhalant allergens was entirely negative; in contrast, her serum total IgE was elevated (283 IU/mL). A high level of piperacillin-specific serum IgE was detected by ELISA using piperacillin-HSA conjugate. Significant inhibition upon addition of both free piperacillin and piperacillin-HSA conjugate was detected by inhibition ELISA. These data suggest that piperacillin exposure in the workplace can induce occupational anaphylaxis and urticaria mediated by an interaction of IgE with the hapten of piperacillin.
Anaphylaxis/*chemically induced/immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Hospitals, University ; Humans ; Immunoglobulin E/*blood/immunology ; Intensive Care Units ; Occupational Diseases/*chemically induced/immunology ; *Occupational Exposure ; Piperacillin/*immunology ; Serum Albumin/*immunology ; Urticaria/immunology ; Young Adult

It has recently been reported that interleukin-4 (IL-4) is required for the production of IgE, and anti-IL-4 monoclonal antibody (mAb) inhibits in vivo IgE responses. These suggest that blocking of IL-4 activity may be useful for the prevention or treatment of immediate hypersensitivity disorders. In this study we investigated whether anti-IL-4 has a regulatory role in chicken-gamma globulin (CGG)-induced active systemic anaphylaxis. Multiple injections of anti-IL-4 (up to 40 mg/mouse) failed to protect the mice from fatal anaphylaxis. Anti-IL-4 strongly suppressed CGG-specific IgE response (>90%) without any suppressive effect on CGG-specific IgG (IgG1, IgG2a, IgG2b, and IgG3) responses. Because these data suggest the possibility that fatal anaphylaxis could be induced by IgG antibodies, we examined the possibility using anti-CGG polyclonal and the subclasses of IgG monoclonal antibodies. Passive sensitization of mice with polyclonal antibodies elicited severe and fatal anaphylactic shock; about 50% of the mice died. The activity of antibodies was not diminished by heat treatment (56 degrees C, 2h), suggesting that the anaphylaxis was not mediated by IgE. Shock was also elicited by each subclass of IgG mAb; of these, IgG1 was the most effective. Combination of the IgG subclasses elicited more exaggerated shock; about 30% of mice died. These data indicate that IgG antibodies are themselves sufficient to induce systemic anaphylaxis. Therefore, the failure of anti-IL-4 to prevent active anaphylaxis is probably due to the inability of anti-IL-4 to suppress the production of IgG antibodies.
Anaphylaxis/*immunology/prevention & control ; Animal ; Antibodies, Anti-Idiotypic/immunology ; Antibodies, Monoclonal/*immunology/therapeutic use ; Chickens ; Female ; Gamma-Globulins ; Immunoglobulin E/*immunology ; Immunoglobulin G/*immunology ; Interleukin-4/*immunology/therapeutic use ; Mice ; Mice, Inbred BALB C ; Support, Non-U.S. Gov't

BACKGROUNDAnaphylactic reactions during anesthesia and operation are common and life threatening. Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs. The purpose of this study was to assess cellular allergen stimulation test (CAST) as a diagnostic instrument in immunoglobulin E (IgE)- and non-IgE-mediated anaphylactic reactions.

METHODSThis study included 25 patients who developed perioperative anaphylactic reactions and 10 subjects that tolerated anesthetics and other drugs during perioperative period from September 2009 to October 2013 in Peking Union Medical College Hospital. We performed skin tests and flow cytometric analysis of basophil activation-based CAST in all subjects.

RESULTSOf the 25 patients, 17 had IgE-mediated anaphylactic reactions (causative agent identified by skin tests) and 8 had non-IgE-mediated anaphylactic reactions (negative skin tests). CAST showed a sensitivity of 42.9%, specificity of 90%, and negative predictive value of 80.6% for neuromuscular blocking agents.

CONCLUSIONSCAST may be useful for the diagnosis of anaphylactic reactions during perioperative period. Our findings call for further investigation to increase the sensitivity of the test.

Adult ; Allergens ; immunology ; Anaphylaxis ; diagnosis ; Drug Hypersensitivity ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period ; Skin Tests ; methods ; Young Adult

We experienced a case of immunoglobulin E (IgE) mediated anaphylaxis to levodropropizine. The patient was an 18-year old Korean woman. After taking the common cold medication including acetaminophen, domperidone, and levodropropizine, skin rash, angioedema and anaphylaxis were developed immediately. As she was tolerable to acetaminophen alone, we thought the culprit agent was maybe a levodropropizine tablet. To confirm the culprit, she underwent skin prick test and oral drug provocation test with the suspected one. Finally we detected levodropropizine specific IgE and confirmed the specificity by inhibition enzyme-linked immunosorbent assay (ELISA).
Adolescent ; Anaphylaxis/*chemically induced/*immunology ; Antitussive Agents/*adverse effects ; Bronchial Provocation Tests ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E/*immunology ; Propylene Glycols/*adverse effects ; Skin Tests

OBJECTIVE: To establish an anaphylactic shock model induced by human mixed serum in guinea pigs. METHODS: Eighteen guinea pigs were divided into two groups: sensitized and control, The sensitized group were immunized intracutaneously with human mixed serum and then induced by endocardiac injection after 3 weeks. RESULTS: Symptoms of anaphylactic shock appeared in the sensitized group. The level of serum IgE were increased in the sensitized group significantly. CONCLUSIONS An animal model of anaphylactic shock wer established successfully. It provide a tool for both forensic study and anaphylactic shock therapy.
Allergens ; Anaphylaxis/immunology* ; Animals ; Death, Sudden ; Disease Models, Animal ; Female ; Forensic Medicine ; Guinea Pigs ; Humans ; Immunoglobulin G/blood* ; Male ; Radioimmunoassay ; Random Allocation ; Serum/immunology*