1.Chlorhexidine: a hidden life-threatening allergen
Mara FERNANDES ; Tatiana LOURENÇO ; Anabela LOPES ; Amélia SPÍNOLA SANTOS ; Maria Conceição PEREIRA SANTOS ; Manuel PEREIRA BARBOSA
Asia Pacific Allergy 2019;9(4):e29-
Chlorhexidine is a commonly used antiseptic and disinfectant in the health-care setting. Anaphylaxis to chlorhexidine is a rare but potentially life-threatening complication. Epidemiologic data suggest that the cases of chlorhexidine allergy appears to be increasing. In this article we report a life-threatening anaphylactic shock with cardiorespiratory arrest, during urethral catheterization due to chlorhexidine. The authors also performed a literature review of PubMed library of anaphylactic cases reports due to this antiseptic between 2014 and 2018, demonstrating the increase in the number of cases occurring worldwide and the importance of detailed anamnesis and appropriate diagnostic workup of allergic reactions to disinfectants.
Anaphylaxis
;
Chlorhexidine
;
Disinfectants
;
Hypersensitivity
;
Urinary Catheterization
;
Urinary Catheters
2.Multiple food allergy – unexpected culprits
Cristina Isabel de Figueiredo ORNELAS ; Fátima CABRAL DUARTE ; Maria Conceição Galvão PEREIRA DOS SANTOS ; Manuel Augusto de Castro PEREIRA BARBOSA
Asia Pacific Allergy 2018;8(3):e30-
Food allergy has an estimated prevalence of 6%–8% in children. Meat allergy and multiple food allergy due to sensitization to cross-reactive components in infancy is, however, less frequent. A 5-year-old girl was referred to our department with a multiple food allergy history. She had severe immediate worsening of her atopic dermatitis with hen's egg (6 months) and cow's milk introduction (7 months). At the age of 9 months, she presented with recurrent and reproducible atopic dermatitis' worsening and lip edema with the introduction of different meats (chicken, turkey, cow, pork, and rabbit), having the same complaints with fish at 12 months (salmon and hake). At her first appointment she was avoiding hen's egg, cow's milk, meat, and fish (except fresh tuna, codfish, and pollock). We performed skin prick tests (commercial extract and prick-to-prick with whole food) and specific IgE, which revealed sensitization to hen's egg, raw meat (cow, pork, chicken, turkey, duck, lamb, goat, and rabbit; negative for cooked meat), codfish and cow's milk (mild). ISAC was performed, revealing sensitization to 3 cross-reactive components (serum albumins Bosd6, Canf3, and Feld2) and specific food components of chicken's egg/meat (Gald1, 2, 3, and 5), cod (Gadc1), hazelnut (Cora9), and kiwi (Actd1). We present a rare case of multiple food allergy in infancy, where sensitization to cross-reactive components was responsible for most of the children complaints. The detection of serum albumins' involvement was especially important, because it can possibly mean tolerance to these foods in well-cooked forms, substantially improving patient and family's quality of life.
Albumins
;
Chickens
;
Child
;
Child, Preschool
;
Corylus
;
Dermatitis, Atopic
;
Ducks
;
Edema
;
Female
;
Food Hypersensitivity
;
Goats
;
Humans
;
Hypersensitivity
;
Immunoglobulin E
;
Lip
;
Meat
;
Milk
;
Ovum
;
Prevalence
;
Quality of Life
;
Red Meat
;
Serum Albumin
;
Skin
;
Tuna
;
Turkey