Results from two in vitro assays, Pharmacia CAP system(CAP) and fluoroallergosorbent test(FAST), for detecting serum specific IgE to three allergens, mugwort, Derraatophagoides pteronyssinus, and eat epithelium, were compared with skin prick test(SPT) results in 53 atopie dermatitis patients with positive SPT and 25 non-atopic controls. Using SPT results as the reference standards, CAP achieved higher sensitivity than FAST in determination of three allergens. CAP for measuring total IgE and eosinophil cationic protein(ECP) was also compared with FAST and ECP radioimmunoassay(RIA), respectively. In comparison of two assays for total serum IgE, the values obtained with CAP were significantly higher than those with FAST. In comparison of CAP and RIA for measuring ECP, the values obrained with CAP were significantly higher than those with RIA and the differences between ECP values of two assays were significant in high ECP group(>8.3 micro gram/1). These results suggest that CAP is the preferred test and seems to be more appropriate method for detection of specific IgE and ECP in patients with allergic digeases.
Allergens ; Artemisia ; Dermatitis ; Eosinophil Cationic Protein* ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Radioimmunoassay* ; Skin

A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

To evaulate the possible pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, we measured house dust mite(HDM)-specific IgA antibody in 3% saline-induced sputum from 23 HDM-sensitive asthmatics, 4 atopic asthmatics without mite-sensitivity, 6 non-atopic asthmatics, and 13 non-atopic, non-asthmatic controls (including 6 non-atopic healthy controls, 4 patients with chronic bronchitis, and 3 patients with rheumatoid arthritis) by ELISA. We also measured HDM-specific IgA antibody in serum and numbers of eosinophils in sputum. 1) Levels of HDM-specific IgA antibody in sputum from mite-sensitive asthmatics were significantly higher than those from non-atopic, non-asthmatic controls and non-atopic asthmatics(p<0.05). Levels of HDM-specific IgA antibody in sputum from atopic asthmatics without mite-sensitivity were significantly higher than those from non-atopic, non-asthmatic controls (p<0.05), however HDM-specific IgA/albumin raito was not significantly different between two groups (p>0.05). 2) The ratio of HDM-specific IgA antibody to albumin in sputum was not significantly different in mite-sensitive asthmatics with sputum eosinophila (> or = 5% of 200 counted leukocytes) and those without sputum eosinophilia (p>0.05). 3) The ratio of HDM-specific IgA to albumin in sputum from asthmatics was higher than that of serum. 4) There was no significant correlation of HDM-specific IgA/albumin ratios between serum and sputum (p>0.05). 5) When comparing sputum and saliva samples from 7 mite-sensitive asthmatics, levels of HDM-specific IgA antibody in sputum were significantly higher than those in saliva (p<0.05). In conclusion, HDM-specific IgA anti-body was increased in sputum from HDM-sensitive asthmatics, and it might be locally produced from bronchial mucosa. To evlauate the pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, further studies might be needed.
Bronchitis, Chronic ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin A* ; Mucous Membrane ; Saliva ; Sputum*

We have studied male patients with cosmetic allergy in patch test during 5 years from September, 1982 to August, 1986 (Group A) and during 7 1/2 years from March, 1988 to August, 1995 (Group B). The results are as follows. 1. In Group A, 7 patients were diagnosed as contact allergy due to cosmetics. In Group 13, 30 patients were diagnosed as contact allergy to cosmetics. 2. Sixteen patients were positive to only cosmetic related allergens. Two patients were positive to only their own cosmetic products. Nineteen patients were positive to both cosmetic related allergens and their own cosmetic products. 3. The age of patients with cosmetic allergy ranged from 10 to 70 years with a peak in the fifties. The patients more than 50 years were about 40% of all patients. 4. The most frequently, affected area was face(n=31) followed by neck(n=6) and scalp (n = 6 ). 5. Twenty four patients with cosmetic allergy had eczematous skin lesions. Thirteen patients had pigmented skin lesions and pigmented contact dermatitis was suspected. Two out of 13 patients with pig men ted skin lesions were positive in photopatch test. 6. Cosmetic related allergens showing frequent positive reactions were paraphenylene-aliamine, fragnance mix, balsam of Peru, benzyl salicylate, amerchol L101, oakmoss absolute, musk muskene. 7. Cosmetic products showing frequent positive reactions were skin care products, hair dye, soap, after shave lotion, shampoo and toothpaste. In conclusion, cosmetic allergy in men seems to increase in our society.
Allergens ; Dermatitis, Contact ; Hair ; Humans ; Hypersensitivity* ; Male* ; Patch Tests ; Peru ; Scalp ; Skin ; Skin Care ; Soaps ; Toothpastes

Idiopathic anaphylaxis is a life-threatening systemic reaction of unknown cause. The pathophysiology has not been established, although it has been postulated that the clinical manifestations of idiopathic anaphylaxis may result from the chemical mediators released by mast cells or basophils. The diagnosis of idiopathic anaphylaxis is made after an appropriate allergic evaluation and exclusion of provocative triggers. We report an unusual case of idiopathic anaphylaxis manifesting with periodically repeated urticaria, angioedema, dyspnea, and hypotension. His symptoms were not related to known causes of anaphylaxis such as foods, drugs, insect stings, or exercise. Other diseases simulating anaphylaxis were excluded by careful history, physical examination, and relevant diagnostic tests. High dose prednisolone, hydroxyzine, salbutamol, ketotifen, and methotrexate were prescribed to prevent recurrent episodes, but the symptoms relapsed 5 months after cessation of the treatment.
Albuterol ; Anaphylaxis* ; Angioedema ; Basophils ; Diagnosis ; Diagnostic Tests, Routine ; Dyspnea ; Hydroxyzine ; Hypotension ; Insect Bites and Stings ; Ketotifen ; Mast Cells ; Methotrexate ; Physical Examination ; Prednisolone ; Urticaria

Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to drug allergy. The clinical manifestation may be nonspecific, and the diagnosis is seldom suspected or established during the life. So in most of the reported patients, the diagnosis was made at autopsy. Although, retrospectively, more than 90% of the patients described have had clinically recognizable cardiac involvement before death, tole clinical suspicion of hypersensitivity myocarditis is rare. The presence of nonspecific cardiac finding in a patient receiving any drug associated with hypersensitivity should alert the clinician to the possibility of drug related myocarditis. We experienced a case of hypersensitivity myocarditis accompanying allergic skin lesion in a 58 years old man with a history of taking cefadroxil. Fortunately, the outcome was favorable, therefore we do not have histologic confirmation of the diagnosis.
Autopsy ; Cefadroxil ; Diagnosis ; Drug Hypersensitivity ; Humans ; Hypersensitivity* ; Middle Aged ; Myocarditis ; Myocardium ; Retrospective Studies ; Skin

We studied sputum eosinophil count of patients with chronic cough. Differential count of sputum cells(simple direct smear with Wright stain) were successfully examined in 44(73%) among 60 patients with chronic cough. The patients were divided according to PC2O value; 20(45%) patients had increased airway hyper responsiveness(AHR) (PC2O < 24mg/ml), remained 24 Patients did not have any evidence of airway AHR. Age, sex, duration and severity of symptoms, serum total IgE and positive skin test reaction were not different between two groups. In patients with increased AHR, increased sputum eosinophil ratio(10%) was found in 11 patients (55%) and increased peripheral blood eosinophil ratio(>5%) was found in 66% of patients with increased AHR. In patients without increased AHR, increased sputum eosinophil ratio was found in three patients(12%) and increased peripheral blood eosinophil ratio was found in 24%. This discrepancy between two groups was statisticalla significant(p<0.01). In regarding to sputum eosinophilia, increased sputum eosinophil ratio was in 14(32%) of 44 patients with chronic cough. Eleven patients(78%) of them had increased AHR. Only nine(30%) among 30 patients without sputum eosinophilia had increased AHR. These discrepancies between two groups were statistically significant(p<0.01). To predict AHR, sputum eosinophilia has 55% of sensitivity and 88% of specificity. Significant positive correlation between peripheral blood eosinophil ratio and sputum eosinophil ratio was found in patients with cough-variant asthma (r=0.76, p<0.01), We suggest that simple direct smear for sputum eosinophil count could be an useful test to diagnose the patients with chronic cough.
Asthma ; Cough* ; Eosinophilia ; Eosinophils* ; Humans ; Immunoglobulin E ; Sensitivity and Specificity ; Skin Tests ; Sputum*

Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10~20% of adult asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an alternative method for diagnosis of ASA-sensitive asthma. To further understand the characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA -sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation test (BPT). Most were female (male to female ratio was 27:73). Twenty (53%) of them had no previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients, late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 mg/ml and most (68.3%) had a positive response after the inhalation of 180 mg/ml. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient. None showed a positive response to sodium benzoate. After the avoidance from ASA/ NSAIDs with administration of anti-asthmatic medications, symptom and medication scores reduced in 26(87%) patients among 30 followed patients. They were classified into the improved group: four (13%) patients belonged to the not-improved group. There were no significant differences in clinical characteristics between the improved and not- improved group (p>0.05). In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA -sensitive asthma and be used to screen the causative agent for asthmatic patients with intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Bronchoconstriction ; Diagnosis ; Female ; Humans ; Inhalation ; Nasal Polyps ; Sodium Benzoate ; Tartrazine

Although basic mechanisms of atopic dermatitis remain largely speculative, many studies on pathogenesis suggest the importance of food and inhalent allergens. To evaluate the frequency of food and house dust mite hypersensitivity and differences in this frequency according to ages, we measured the levels of specific IgE antibodies to egg white, egg yolk, milk, soy, and house dust mites in 119 children with atopic dermatitis. The results showed that 53% of patients had positive RAST to any one kind of allergens. The frequency of food and house dust mite hypersensitivity were 34.5%, 30.3 %, respectively. Among allergens, house dust mites and egg white are the most prevalent allergens in all atopic dermatitis patients. The Prevalence of egg white is most common under the age of 2 years, but those of house dust mites are the dust mites are the highest in the ages of 5-12 years. In conclusion, we recommend an egg restriction diet in atopic dermatitis patients who are less than 2 years old when their symptoms do not improve with general skin care.
Allergens ; Antibodies ; Antigens, Dermatophagoides ; Child* ; Child, Preschool ; Dermatitis, Atopic* ; Diet ; Dust* ; Egg White ; Egg Yolk ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mites ; Ovum ; Prevalence ; Pyroglyphidae* ; Skin Care ; Soy Milk