Stefani Röseler

How to diagnose mould allergy? Comparison of skin prick tests with specific IgE results.

Diagnosis of mould allergy is complicated due to the heterogeneity of the test material and the decrease in the number of commercial mould skin test solutions that are currently available.

Potential health risk of allergenic pollen with climate change associated spreading capacity: Ragweed and olive sensitization in two German federal states.

BACKGROUND Global climate changes may influence the geographical spread of allergenic plants thus causing new allergen challenges. OBJECTIVE Allergy patients from two German federal states were compared for their status quo sensitization to ragweed, an establishing allergen, olive, a non-established allergen, and the native allergens birch, mugwort, and ash. METHODS Between 2011 and 2013, 476 adult allergy patients per region were recruited. Patients completed a questionnaire, participated in a medical interview, and underwent skin prick testing and blood withdrawal for analysis of specific IgE to allergen components (ISAC technology). Data on regional pollen load from 2006 to 2011 were acquired from the German Pollen Information Service Foundation. RESULTS Prick test reactivity to ragweed and ash, respectively, was lower in Bavaria than in NRW (ragweed: p=0.001, aOR=0.54; ash: p=0.001, aOR=0.59), whereas prick test reactivity to olive was higher (p=0.000, aOR=3.09). Prick test reactivity to birch and mugwort, respectively, did not significantly differ. 1% (1/127) of patients with prick test reactivity to ragweed showed sIgE to Amb a 1, and 65% (86/132) of olive-but-not-ash reactive patients showed sIgE to Ole e 1 (NRW: 67%, Bavaria: 65%; p=0.823, OR=0.91). Regional differences in sensitization pattern were neither explainable by cross-reactivity to pollen pan-allergens nor non-exposure variables nor by reported plant population or pollen data. CONCLUSIONS Spread of ragweed and particularly olive may result in prompt occurrence of allergic symptoms. Early identification of invasive allergens due to climate change does need time and spatial close meshed measurement of respective indicator allergens and sensitization pattern.

Individual risk assessment in the diagnosis of immediate type drug hypersensitivity reactions to betalactam and non-betalactam antibiotics using basophil activation test: a single center experience

Abstract Background: Drug hypersensitivity reactions of immediate type pose a challenging problem, especially, if standard diagnostic procedures do not lead to conclusive results. The aim of this investigation is to identify, whether basophil activation test (BAT) is able to provide additional benefit in the diagnostic evaluation of immediate type drug hypersensitivity reactions to antibiotics in comparison with the routine allergological diagnostic methods. Materials and methods: We investigated patients, who presented to the Department of Dermatology and Allergology of the University Hospital of RWTH Aachen in Germany for diagnostic workup of type I allergic reactions to antibiotics during the period from 2009 to 2012. The analysis was performed retrospectively based on patient records. The inclusion criteria were performed standard allergological in vivo diagnostic and a BAT as a part of diagnostic workup. Results: Eighty-two diagnostic investigations were performed in 52 patients. BAT was positive in 9 of 12 cases with a positive clinical history but negative skin test results. Furthermore, all patients who reported severe drug hypersensitivity reactions (anaphylactic reaction grade 2 and above) showed positive BAT (5/5), while only three of these five cases demonstrated a positive skin testing that led to the conclusion of possible immediate type drug hypersensitivity. Conclusions: Although skin tests remain the most important part of the primary diagnostic investigation, BAT is an additional valuable and sensitive in vitro test in the diagnostic procedure of immediate type allergic reactions to antibiotics. However, further standardized investigations are needed in order to calculate exact sensitivity and specificity of this diagnostic tool in both, adult and pediatric populations.

Occupational generalized urticaria and anaphylaxis after inhalation of cefuroxime in a nurse

We present the case of a 53 years old nonatopic female nurse who experienced repeated anaphylactic reactions at work without involvement in drug-specific tasks such as crushing of tablets or preparation of injections. The causal allergen was not identified until a further severe anaphylactic reaction occurred after oral use of cefuroxime during a respiratory infection. Sensitization to cefuroxime was demonstrated by specific IgE, basophil activation test and skin prick test. An inhalation challenge with a dosimeter induced generalized urticaria after a cumulative dose of about 10 μg of the drug, but no asthmatic reaction. Complete exposure cessation was initiated and a 1-year follow-up was without further allergic reactions. We conclude that work-related systemic allergic reactions to β-lactam antibiotics may occur in nurses after inhalation of low doses and without perceived association with drug-specific tasks like handling of antibiotics.

Bird-egg syndrome: a variant of secondary food allergies

J. Staub Center for Internal Medicine, Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany anti-allergic treatment and the patient described strict avoidance of all foods containing egg since his 21st birthday. The symptoms first occurred at the age of 15 years; prior to that, the regular consumption of eggs and egg products had produced no complications. During the diagnostic workup, the patient reported allergic asthma at the age of 12 after coming into brief contact with a domestic budgerigar.

Vogel-Ei-Syndrom: eine Variante sekundärer Nahrungsmittelallergien

Hintergrund Das Vogel-Ei-Syndrom stellt eine seltene Variante sekundärer Nahrungsmittelallergien dar: Eine Sensibilisierung erfolgt meist primär inhalativ über Federn und Kot von Ziervögeln. Aufgrund einer Kreuzreaktion zwischen Vogelfedern beziehungsweise -kot und Allergenen des Eigelbs und Geflügelfleisches [1] entwickelt sich eine sekundäre Nahrungsmittelallergie gegen Eigelb und gegebenenfalls rohes Geflügelfleisch [2], bedingt durch das teilweise hitzelabile Gal d 5 [3, 4, 5].

Doppelsensibilisierung auf PR-10- und PR-14-Proteine@@@Double sensitization to PR10 and PR-14 proteins

ZusammenfassungEine Patientin mit bekanntem oralem Allergiesyndrom auf Haselnüsse und Pfirsiche entwickelte eine Anaphylaxie nach Verzehr von Haselnüssen und Pfirsichen. Obschon Anaphylaxien auf Bet-v1-Homologe beschrieben sind, zeigte sich in der weiteren Diagnostik eine Sensibilisierung auf Lipidtransferproteine, die für ihre schwereren Reaktionen bekannt sind. Doppelsensibilisierungen auf sowohl PR-10- als auch PR-14-Proteine sollten mit untersucht werden und scheinen auch in unseren Breitengraden zunehmend bekannt zu werden.AbstractA patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.A patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.

Doppelsensibilisierung auf PR-10- und PR-14-Proteine

ZusammenfassungEine Patientin mit bekanntem oralem Allergiesyndrom auf Haselnüsse und Pfirsiche entwickelte eine Anaphylaxie nach Verzehr von Haselnüssen und Pfirsichen. Obschon Anaphylaxien auf Bet-v1-Homologe beschrieben sind, zeigte sich in der weiteren Diagnostik eine Sensibilisierung auf Lipidtransferproteine, die für ihre schwereren Reaktionen bekannt sind. Doppelsensibilisierungen auf sowohl PR-10- als auch PR-14-Proteine sollten mit untersucht werden und scheinen auch in unseren Breitengraden zunehmend bekannt zu werden.AbstractA patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.A patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.

[Double sensitization to PR10 and PR-14 proteins].

ZusammenfassungEine Patientin mit bekanntem oralem Allergiesyndrom auf Haselnüsse und Pfirsiche entwickelte eine Anaphylaxie nach Verzehr von Haselnüssen und Pfirsichen. Obschon Anaphylaxien auf Bet-v1-Homologe beschrieben sind, zeigte sich in der weiteren Diagnostik eine Sensibilisierung auf Lipidtransferproteine, die für ihre schwereren Reaktionen bekannt sind. Doppelsensibilisierungen auf sowohl PR-10- als auch PR-14-Proteine sollten mit untersucht werden und scheinen auch in unseren Breitengraden zunehmend bekannt zu werden.AbstractA patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.A patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.