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Allergy Advisor Digest - March 2013
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Hymenoptera of Afghanistan and the central command area of operations

Mouse allergen skin sensitization in asthmatic children of suburban, rural, and inner-city populations.

Allergy to coriander, celery, tomato: proposed new mechanism for food and exercise induced anaphylaxis.

IgE cross-reactivity between house dust mite allergens and Ascaris lumbricoides antigens.

Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time.

Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP.

House dust mite sensitization in toddlers predict persistent wheeze in children between eight to fourteen years old.

Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment.

First case report of anaphylaxis caused by Rajgira seed flour (Amaranthus paniculatus) from India

Tropomyosin from tilapia (Oreochromis mossambicus) as an allergen.

Persistent pollen exposure during infancy is associated with increased risk of subsequent childhood asthma and hayfever.

The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release.

Patch testing with 2.0% (0.60 mg/cm 2) formaldehyde instead of 1.0% (0.30 mg/cm 2) detects significantly more contact allergy.

Triphenyl phosphite, a new allergen in polyvinylchloride gloves.

What determines skin sensitization potency-myths, maybes and realities: The 500 molecular weight cut-off.

Allergies in high-risk schoolchildren after early intervention with cow's milk protein hydrolysates.

Testing children for allergies: why, how, who and when: An updated statement of EAACI.

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children.

Child and parental reports of bullying in a consecutive sample of children with food allergy.

Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.

Retrospective study of oral lichen planus and allergy to spearmint oil.

Multifaceted allergen avoidance during infancy reduces asthma during childhood with the effect persisting until age 18 years.

Abstracts shared in March 2013 Advisor Digest Newsletter

		Apirin intake in patients with food-dependent exercise-induced anaphylaxis.
		Dog saliva - an important source of dog allergens.
		A case of taurine-containing drink induced anaphylaxis.
		Chronic urticaria and use of statins.
		Proton pump inhibitors are associated with hypersensitivity reactions to drugs in hospitalized patients: a nested case-control in a retrospective cohort study.
		Microarray-based component-resolved diagnosis of latex allergy: isolated IgE-mediated sensitization to latexprofilin Hev b8 may act as confounder.
		Prenatal and postnatal bisphenol A exposure and asthma development among inner-city children.
		Identification of allergen-resolved threshold doses of carrot.
		IgE cross-reactivity between the major peanut allergen Ara h 2 and the nonhomologous allergens Ara h 1 and Ara h 3.
		Peach allergy in Spanish children: tolerance to the pulp and molecular sensitization profile.
		"Unresponsive" anaphylactic shock due to kiwifruit.

Hymenoptera of Afghanistan and the central command area of operations
Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting.

Hymenoptera of Afghanistan and the central command area of operations: Assessing the threat to deployed U.S. service members with insect venom hypersensitivity.
Turbyville JC, Dunford JC, Nelson MR.
Allergy Asthma Proc 2013 Mar;34(2):179-184

Mouse allergen skin sensitization in asthmatic children of suburban, rural, and inner-city populations.
Although previous studies report high prevalence of MA sensitization in inner-city asthmatic children, no data exist on its comparison with either suburban or rural children with asthma. This retrospective cohort study by chart review of all children (/=3 mm and erythema >/=5 mm. A total of 989 patients underwent allergy testing and 349 children were tested for MA with the overall positivity rate of 18.6% (65/349). In children with asthma (mean age, 12.8 years; SD +/- 3.19) who had MA testing (n = 166), the rate of positive skin test reactivity was 18% (n = 30). Inner-city asthmatic children had significantly greater MA sensitization compared with either suburban or rural children. MA sensitization is highly prevalent among children with asthma, especially in inner-city populations but also among suburban and rural children. Although most allergists do not routinely test for MA sensitization during the initial evaluation, it may be useful to include it in the allergy testing for children with asthma.

Mouse allergen skin sensitization in asthmatic children of suburban, rural, and inner-city populations.
Kailasnath VP, Raj S, Sublett JL.
Allergy Asthma Proc 2013 Mar;34(2):176-178

Allergy to coriander, celery, tomato: proposed new mechanism for food and exercise induced anaphylaxis.
Two cases of food and exercise-induced anaphylaxis (FEIA) in patients with a diagnosis of oral allergy syndrome (OAS) to the implicated foods. Patient A had FEIA attributed to fresh coriander and tomato and Patient B to fresh celery. These food allergens have been implicated in OAS and have structural antigenic similarity to that of birch and/or grass. Both patients' allergies were confirmed by fresh skin prick tests. In both cases, strenuous exercise was antecedent to the systemic anaphylaxis reaction and subsequent ingestion without exercise produced only local symptoms of perioral pruritus. The authors hypothesize that the inhibitory effects of exercise on gastric acid secretion decreases the digestion of oral allergens and preserves structural integrity, thereby allowing continued systemic absorption of the allergen whether it be profilins, lipid transfer proteins, or other antigenic determinants.

Proposed new mechanism for food and exercise induced anaphylaxis based on case studies.
Chen JY, Quirt J, Lee KJ.
Allergy Asthma Clin Immunol 2013;9(1):11

IgE cross-reactivity between house dust mite allergens and Ascaris lumbricoides antigens.
This study examined the cross-reactivity between the human roundworm Ascaris lumbricoides (Al) and three house dust mite (HDM) species (Blomia tropicalis (Bt), Dermatophagoides pteronyssinus (Dp), and Dermatophagoides farinae (Df )). This study showed the presence of multiple cross-reactive antigens in HDM and Al extracts. The potential role of paramyosin as a specific cross-reactive allergen present in HDMs and Al was shown. Al extracts among allergic (n=100) and ascariasis (n=60) subjects were measured through enzyme-linked immunosorbent assay (ELISA). Among allergic subjects, 70% exhibited Al-specific positive IgE-reactivity, while 20-28% of ascariasis subjects demonstrated HDM-specific positive IgE-reactivity. Multiple IgE-reactive components of HDM allergens (14-240 kDa) and Al antigens (15-250 kDa) were detected, indicating multi-allergen sensitization among the subjects tested. Al antigens can inhibit up to 92% of HDM-specific IgE-reactivity among allergic subjects, while up to 54% of Al-specific IgE-reactivity among ascariasis subjects was inhibited by HDM allergens. Positive rBlo t 11-fD-specific IgE reactivity was observed in 80% of the allergic subjects and 46% of the ascariasis subjects.

IgE cross-reactivity between house dust mite allergens and Ascaris lumbricoides antigens.
Valmonte GR, Cauyan GA, Ramos JD.
Asia Pac Allergy 2012 Jan;2(1):35-44.

Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time.
Changes in paediatric anaphylaxis triggers in Singapore have been noted. A retrospective study of Singaporean children presenting with anaphylaxis between January 2005 and December 2009 were studied. One hundred and eight cases of anaphylaxis in 98 children were included. Food was the commonest trigger (63%), followed by drugs (30%), whilst 7% were idiopathic. Peanut was the top food trigger (19%), followed by egg (12%), shellfish (10%) and bird's nest (10%). Ibuprofen was the commonest cause of drug induced anaphylaxis (50%), followed by paracetamol (15%) and other nonsteroidal anti-inflammatory drugs (NSAIDs, 12%). The median age of presentation for all anaphylaxis cases was 7.9 years old (range 3.6 to 10.8 years), but food triggers occurred significantly earlier compared to drugs (median 4.9 years vs. 10.5 years). Mucocutaneous (91%) and respiratory features (88%) were the principal presenting symptoms. Drug anaphylaxis was more likely to result in hypotension compared to food anaphylaxis (21.9% vs. 2.7%. There were 4 reported cases (3.6%) of biphasic reaction occurring within 24 h of anaphylaxis. Peanuts allergy, almost absent a decade ago, is currently the top food trigger, whilst seafood and bird's nest continue to be an important cause of food anaphylaxis locally.

Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time.
Liew WK, Chiang WC, Goh AE, Lim HH, Chay OM, Chang S, Tan JH, Shih E, Kidon M.
Asia Pac Allergy 2013 Jan;3(1):29-34

Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP.
Patients may receive negative results from a specific IgE (sIgE) tests despite a documented history of systemic reaction to a Hymenoptera sting. Thus, further testing may be required using another serological method or venom skin prick tests to confirm allergy diagnosis and correct species. This study evaluated the sensitivity and the specificity of CAP and IMMULITE for detecting sIgE to Paper wasp (WA) and Yellow Jacket (YJ) venoms using patient clinical history as the comparator. Sera from 70 participants with a history of systemic reactions (SR) to WA and/or YJ stings were tested using CAP and IMMULITE. Fifty participants from this group had negative results on CAP. To assess specificity, sera from 71 participants who had never experienced either a WA or YJ sting were tested using CAP and IMMULITE. Fifty participants from this group tested positive using CAP. In participants with a history of systemic reaction to a Hymenoptera sting, yet who tested negative for WA and/or YJ sIgE according to CAP, the positivity rate according to IMMULITE was 20-42% using 0.10 IU(A)/mL as the limit of detection (LoD), per the manufacturer's specification. When the LoD for CAP (0.35 IU(A)/mL) was applied to the IMMULITE results, positivity according to IMMULITE was 14-26%. Overall, sensitivity, specificity, and agreement with SR were greater for IMMULITE than for CAP. For YJ: sensitivity (IMMULITE:CAP), 42.8%:28.5%; specificity, 53.5%:39.4%; agreement, 48.2%:34%. For WA, sensitivity (IMMULITE:CAP), 58.6%:28.5%; specificity, 49.3%:47.8%; agreement, 43.9%:38.3%.

Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP.
Watanabe M, Hirata H, Arima M, Hayashi Y, Chibana K, Yoshida N, Ikeno Y, Fukushima Y, Komura R, Okazaki K, Sugiyama K, Fukuda T.
Asia Pac Allergy 2012 Jul;2(3):195-202

House dust mite sensitization in toddlers predict persistent wheeze in children between eight to fourteen years old.
House dust mite sensitization at ages 2 to 5 years old in wheezing children predicts persistence of asthma after 4 to 9 years. This in turn may have benefits for management of asthma in this high-risk group

House dust mite sensitization in toddlers predict persistent wheeze in children between eight to fourteen years old.
Llanora GV, Ming LJ, Wei LM, van Bever HP.
Asia Pac Allergy 2012 Jul;2(3):181-186

Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment.
A 19-year-old man with Food-dependent exercise-induced anaphylaxis. The patient complained of urticaria, angioedema, dizziness and hypotension associated with exercise after ingestion of walnut-containing foods in a warm environment. Skin prick test and prick to prick test were positive for walnut antigen. The attack didn't occur by free running outside for 10 min 2 h after taking walnuts, and the temperature was about -2. Food-exercise test was done again in a warm environment based on prior history. Anaphylaxis was developed after exercise for 10 min in a warm environment after taking walnuts. Some environmental factors such as high temperature and high humidity or cold temperature may influence exercise-induced anaphylaxis.

Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment.
Jo EJ, Yang MS, Kim YJ, Kim HS, Kim MY, Kim SH, Cho SH, Min KU, Chang YS.
Asia Pac Allergy 2012 Apr;2(2):161-164

First case report of anaphylaxis caused by Rajgira seed flour (Amaranthus paniculatus) from India
A case of anaphylaxis to Amaranth grain (Amaranthus paniculatus) commonly known as Rajgira (Ramdana) in India. A 60 year old female suffered anaphylaxis after consuming Rajgira seed flour generally consumed during fasting. Food allergy to Amaranth seeds has not been reported so far. The patient reported with itching in the mouth, choking throat, redness and swelling of face and burning abdomen within 5 min of consuming Rajgira flour. SPT and oral challenge were positive and a high allergen specific serum IgE was demonstrated. Three IgE binding protein fractions were detected in roasted Rajgira seed flour extract.

First case report of anaphylaxis caused by Rajgira seed flour (Amaranthus paniculatus) from India: A clinico-immunologic evaluation.
Kasera R, Niphadkar PV, Saran A, Mathur C, Singh AB.
Asian Pac J Allergy Immunol 2013 Mar;31(1):79-83

Tropomyosin from tilapia (Oreochromis mossambicus) as an allergen.
Tilapia is among the most common fresh water fish species raised by fish farms and can cause allergic reactions upon ingestion. This study investigated important allergens in Tilapia. By immunoblotting using sera from 10 patients with confirmed tilapia allergy, idetifying d a number of allergens with apparent molecular weights 114 to 17 kD. All patients produced IgE against a 32 kD allergen, Ore m 4, which was identified as tropomyosin . Tilapia TM showed 53.5% homology to TM from shrimp. Homology was much higher to human TM isoform 5 (87.7%). TMs are the major allergens in allergy to crustaceans. Auto-antibodies against human TM isoform 5 have been implicated as a causative agent in inflammatory bowel disease (IBD). Intriguingly, six of the 10 tilapia allergic patients had also been diagnosed with IBD, corroborating a connection between allergy and IBD. The authors suggest that this is the first report of tropomyosin from vertebrates as an allergen.

Tropomyosin from tilapia (Oreochromis mossambicus) as an allergen.
Liu R, Holck AL, Yang E, Liu C, Xue W.
Clin Exp Allergy 2013 Mar;43(3):365-377

Persistent pollen exposure during infancy is associated with increased risk of subsequent childhood asthma and hayfever.
This study examined the association between higher ambient levels of pollen in the first 3-6 months of life and risk of eczema, sensitization to food and aeroallergens at 2 years and asthma or hayfever at age 6-7 years combined, using a birth cohort of 620 infants.The study concludes that persistent pollen exposure in infancy appears to increase the risk of asthma and hayfever in children. These results support the hypothesis that there is a critical window of opportunity in early development which may be important for modification of allergic outcomes.

Persistent pollen exposure during infancy is associated with increased risk of subsequent childhood asthma and hayfever.
Erbas B, Lowe AJ, Lodge CJ, Matheson MC, Hosking CS, Hill DJ, Vicendese D, Allen KJ, Abramson MJ, Dharmage SC.
Clin Exp Allergy 2013 Mar;43(3):337-343

The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release.
This worldwide selection of circulating coins covered countries with 75% of the world population, and shows that the majority of the world population lives in countries where coins release nickel. Pertinently, approximately 40% of circulating coin denominations do not release nickel

The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release.
Hamann CR, Hamann D, Hamann C, Thyssen JP, Liden C.
Contact Dermatitis 2013 Jan;68(1):15-22

Patch testing with 2.0% (0.60 mg/cm 2) formaldehyde instead of 1.0% (0.30 mg/cm 2) detects significantly more contact allergy.
On the basis of the results of this multicentre study, as well as of previous studies, it can be suggested that 2.0% (wt/vol) in water formaldehyde should be used in routine patch testing in the baseline series.

Patch testing with 2.0% (0.60 mg/cm 2) formaldehyde instead of 1.0% (0.30 mg/cm 2) detects significantly more contact allergy.
Ponten A, alto-Korte K, Agner T, Andersen KE, Gimenez-Arnau AM, Goncalo M, Goossens A, Johansen JD, Le Coz CJ, Maibach HI, Rustemeyer T, White IR, Bruze M.
Contact Dermatitis 2013 Jan;68(1):50-53

Triphenyl phosphite, a new allergen in polyvinylchloride gloves.
Patients were patch tested with the newly obtained test substances, plastics and glues series, and isocyanates and isocyanate prepolymers found in PVC gloves. Nine PVC glove samples for triphenyl phosphate and its derivatives. Two patients reacted to a technical PVC antioxidant and one of its components, triphenyl phosphite (TPP). Contact allergy to TPP was very strong in 1 patient, and was the main cause of her hand dermatitis, whereas the other patient also had other contact allergies explaining her symptoms. Three patients reacted to their PVC gloves, but the specific allergen was not identified. Six PVC glove samples contained TPP at concentrations of 0.004-0.099%. TPP transforms into triphenyl phosphate during storage.

Triphenyl phosphite, a new allergen in polyvinylchloride gloves.
Suuronen K, Pesonen M, Henriks-Eckerman ML, alto-Korte K.
Contact Dermatitis 2013 Jan;68(1):42-49

What determines skin sensitization potency-myths, maybes and realities: The 500 molecular weight cut-off.
It is widely accepted that there is a molecular weight (MW) cut-off of 500, such that single chemicals with MWs higher than 500 cannot be skin sensitizers. If true, this could serve as a useful principle for designing non-sensitizing chemicals. This study assessed whether the 500 MW cut-off is a myth or a reality. A database of 699 chemicals tested for skin sensitization in guinea pigs or mice was analysed to establish the number of tested chemicals with MW > 500, and to establish whether any of these were sensitizers. Only 13 (2%) of the 699 chemicals in the database have MW > 500. Of the 13 tested compounds with MW > 500 in the database, five are sensitizers and eight are non-sensitizers. The 500 MW cut-off for skin sensitization is a myth, probably derived from the widespread misconception that ability to efficiently penetrate the stratum corneum is a key determinant of sensitization potency. The scarcity of sensitizers with MW > 500 simply reflects the general scarcity of chemicals with MW > 500.

What determines skin sensitization potency-myths, maybes and realities. Part 1. The 500 molecular weight cut-off.
Roberts DW, Mekenyan OG, Dimitrov SD, Dimitrova GD.
Contact Dermatitis 2013 Jan;68(1):32-41

Allergies in high-risk schoolchildren after early intervention with cow's milk protein hydrolysates.
The long-term effect of nutritional intervention with hydrolysate infant formulas on allergic manifestations in high-risk children is uncertain. This study sought to investigate the effect of hydrolysate infant formulas on allergic phenotypes in children with family history of allergies at school age. Data from participants of the prospective German Infant Nutritional Intervention study after 10 years of follow-up was studied. At birth, children were randomly assigned to receive, for the first 4 months, one of 4 blinded formulas as breast milk substitute, if necessary: partially hydrolyzed whey formula (pHF-W), extensively hydrolyzed whey formula (eHF-W), extensively hydrolyzed casein formula (eHF-C), or standard cow's milk formula. Outcomes were parent-reported, physician-diagnosed allergic diseases. Log-binomial regression models were used for statistical analysis. The significant preventive effect on the cumulative incidence of allergic diseases, particularly AD, with pHF-W and eHF-C persisted until 10 years without rebound, whereas eHF-W showed no significant risk reduction. There is insufficient evidence of ongoing preventive activity at 7 to 10 years of age.

Allergies in high-risk schoolchildren after early intervention with cow's milk protein hydrolysates: 10-year results from the German Infant Nutritional Intervention (GINI) study.
von BA, Filipiak-Pittroff B, Kramer U, Hoffmann B, Link E, Beckmann C, Hoffmann U, Reinhardt D, Grubl A, Heinrich J, Wichmann HE, Bauer CP, Koletzko S, Berdel D.
J Allergy Clin Immunol 2013 Mar 15;

Testing children for allergies: why, how, who and when: An updated statement of EAACI.
Allergic diseases are common in childhood and can cause a significant morbidity and impaired quality-of-life of the children and their families. Adequate allergy testing is the prerequisite for optimal care, including allergen avoidance, pharmacotherapy and immunotherapy. Children with persisting or recurrent or severe symptoms suggestive for allergy should undergo an appropriate diagnostic work-up, irrespective of their age. Adequate allergy testing may also allow defining allergic trigger in common symptoms. We provide here evidence-based guidance on when and how to test for allergy in children based on common presenting symptoms suggestive of allergic diseases

Testing children for allergies: why, how, who and when: An updated statement of the European Academy of Allergy and Clinical Immunology (EAACI) Section on Pediatrics and the EAACI-Clemens von Pirquet Foundation.
Eigenmann PA, tanaskovic-Markovic M, O'B HJ, Lack G, Lau S, Matricardi PM, Muraro A, Namazova BL, Nieto A, Papadopoulos NG, Rethy LA, Roberts G, Rudzeviciene O, Wahn U, Wickman M, Host A.
Pediatr Allergy Immunol 2013 Mar;24(2):195-209

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children.
Hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently reported reaction to drugs. They can be induced by pharmacological mechanisms (cyclooxygenase inhibition), with patients classified as cross-intolerant (CI), or by specific immunological mechanisms, IgE or T cell, with patients classified as selective reactors (SR). This study analysed a large group of children with a history of NSAID hypersensitivity diagnosed by drug provocation test (DPT). In these children, CI hypersensitivity to NSAIDs was the most frequent type of hypersensitivity reaction. Ibuprofen was the drug most often involved, angio-oedema the most common entity, and frequently associated with atopy. DPT proved a safe approach for diagnosing these patients.

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children.
Zambonino MA, Torres MJ, Munoz C, Requena G, Mayorga C, Posadas T, Urda A, Blanca M, Corzo JL.
Pediatr Allergy Immunol 2013 Mar;24(2):151-159

Child and parental reports of bullying in a consecutive sample of children with food allergy.
This study sought to quantify the extent, methods, and correlates of bullying in a cohort of food-allergic children. Of 251 families who completed the surveys, 45.4% of the children and 36.3% of their parents indicated that the child had been bullied or harassed for any reason, and 31.5% of the children and 24.7% of the parents reported bullying specifically due to food allergy (FA), frequently including threats with foods, primarily by classmates. Bullying was significantly associated with decreased quality of life (QoL) and increased distress in parents and children, independent of the reported severity of the allergy. A greater frequency of bullying was related to poorer QoL. Parents knew about the child-reported bullying in only 52.1% of the cases. Parental knowledge of bullying was associated with better QoL and less distress in the bullied children.

Child and parental reports of bullying in a consecutive sample of children with food allergy.
Shemesh E, Annunziato RA, Ambrose MA, Ravid NL, Mullarkey C, Rubes M, Chuang K, Sicherer M, Sicherer SH.
Pediatrics 2013 Jan;131(1):e10-e17

Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.
A case of a life-threatening shock mimicking successively anaphylactic, cardiogenic, and septic shock, which was finally related to disulfiram ethanol reaction. Disulfiram ethanol reaction is known to provoke unpleasant symptoms through vasodilatation in various organs. However, extreme manifestations of vasodilatory shock may lead to circulatory failure and lactic acidosis. Because of large prevalence of alcoholism and disulfiram medication, emergency physicians and medical specialists should be aware of this life-threatening condition, with its misleading presentation.

Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.
Bourcier S, Mongardon N, Daviaud F, Moachon L, Arnould MA, Perruche F, Pene F, Cariou A.
Am J Emerg Med 2013 Jan;31(1):270-273

Retrospective study of oral lichen planus and allergy to spearmint oil.
Oral lichen planus (OLP) is a chronic inflammatory disorder with significant morbidity, associated with symptoms of pain and local discomfort. The concept of contact allergy aggravating or inducing OLP is recognised, and reported allergens include amalgam, metals used in dental restoration and flavourings. To date there has been only one case report of a contact allergy to spearmint oil in a patient with a 3-year history of OLP. This study retrospectively reviewed positive spearmint oil patch test data over a period of 11 years. In total 73 patients of the 1467 tested for allergy to spearmint oil had positive patch tests. The total number of patches tested during this time was 6134. Of the 73 positive reactions, 19 (26%) were classified as relevant, in that the patients had a history of using spearmint oil-containing products. Coexisting OLP and a spearmint allergy were found in 14 of these 19 patients. All patients had erosive OLP and were female. Patients, especially women, with OLP recalcitrant to treatment should be patch tested to flavourings, especially spearmint oil. The authors believe that spearmint allergy should be considered a cause of OLP, or at least, of oral lichenoid reactions.

Retrospective study of oral lichen planus and allergy to spearmint oil.
Gunatheesan S, Tam MM, Tate B, Tversky J, Nixon R.
Australas J Dermatol 2012 Aug;53(3):224-228

Multifaceted allergen avoidance during infancy reduces asthma during childhood with the effect persisting until age 18 years.
This study concludes that comprehensive allergen avoidance in the first year of life is effective in preventing asthma onset in individuals considered at high risk due to heredity. The effect occurs in the early years, but persists through to adulthood.

Multifaceted allergen avoidance during infancy reduces asthma during childhood with the effect persisting until age 18 years.
Scott M, Roberts G, Kurukulaaratchy RJ, Matthews S, Nove A, Arshad SH.
Thorax 2012 Dec;67(12):1046-1051

Allergen-, Food allergy-, Intolerance-related articles

Lifestyle and nickel allergy in a Swedish adolescent population: effects of piercing, tattooing and orthodontic appliances.
Fors R, Persson M, Bergstrom E, Stenlund H, Stymne B, Stenberg B. Acta Derm Venereol 2012 Nov;92(6):664-668

Limited influence of aspirin intake on mast cell activation in patients with food-dependent exercise-induced anaphylaxis: comparison using skin prick and histamine release tests.
Fukunaga A, Shimizu H, Tanaka M, Kikuzawa A, Tsujimoto M, Sekimukai A, Yamashita J, Horikawa T, Nishigori C. Acta Derm Venereol 2012 Sep;92(5):480-483

Dog saliva - an important source of dog allergens.
Polovic N, Waden K, Binnmyr J, Hamsten C, Gronneberg R, Palmberg C, Milcic-Matic N, Bergman T, Gronlund H, van HM. Allergy 2013 Mar 7;

Clinical relevance of sensitization to cross-reactive lipocalin Can f 6.
Jakob T, Hilger C, Hentges F. Allergy 2013 Mar 7;

A pragmatic approach to beta-lactam use in patients with penicillin allergy.
Zhu LL, Song P, Zhou Q. Allergy Asthma Proc 2013 Mar;34(2):193

Hymenoptera of Afghanistan and the central command area of operations: Assessing the threat to deployed U.S. service members with insect venom hypersensitivity.
Turbyville JC, Dunford JC, Nelson MR. Allergy Asthma Proc 2013 Mar;34(2):179-184

Mouse allergen skin sensitization in asthmatic children of suburban, rural, and inner-city populations.
Kailasnath VP, Raj S, Sublett JL. Allergy Asthma Proc 2013 Mar;34(2):176-178

Approach to patients with aspirin hypersensitivity and acute cardiovascular emergencies.
White AA, Stevenson DD, Woessner KM, Simon RA. Allergy Asthma Proc 2013 Mar;34(2):138-142

Anaphylaxis in the allergist's office: Preparing your office and staff for medical emergencies.
Wallace DV. Allergy Asthma Proc 2013 Mar;34(2):120-131

Anaphylaxis: Diagnostic criteria and epidemiology.
Samant SA, Campbell RL, Li JT. Allergy Asthma Proc 2013 Mar;34(2):115-119

Proposed new mechanism for food and exercise induced anaphylaxis based on case studies.
Chen JY, Quirt J, Lee KJ. Allergy Asthma Clin Immunol 2013;9(1):11

Asthmatic airway neutrophilia after allergen challenge is associated with the glutathione S-transferase M1 genotype.
Hoskins A, Reiss S, Wu P, Chen N, Han W, Do RH, Abdolrasulnia R, Dworski R. Am J Respir Crit Care Med 2013 Jan 1;187(1):34-41

Immediate hypersensitivity to cisatracurium. Value of skin tests. [French]
Monnin M, Lonjaret L, Fourcade O, Geeraerts T. Ann Fr Anesth Reanim 2012 Oct;31(10):824-825

Anaphylaxis and biphasic reaction in a children hospital. [Japanese]
Nagano C, Ishiguro A, Yotani N, Sakai H, Fujiwara T, Ohya Y. Arerugi 2013 Feb;62(2):163-170

Measures for anaphylaxis and role of epipen(R). [Japanese]
Ebisawa M, Nishima S, Akiyama K, Pawankar R. Arerugi 2013 Feb;62(2):144-154

Hypersensitivity manifestations to the fruit mango.
Sareen R, Shah A. Asia Pac Allergy 2011 Apr;1(1):43-49

IgE cross-reactivity between house dust mite allergens and Ascaris lumbricoides antigens.
Valmonte GR, Cauyan GA, Ramos JD. Asia Pac Allergy 2012 Jan;2(1):35-44.

Erratum: Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP.
Watanabe M, Hirata H, Arima M, Hayashi Y, Chibana K, Yoshida N, Ikeno Y, Fukushima Y, Komura R, Okazaki K, Sugiyama K, Fukuda T. Asia Pac Allergy 2013 Jan;3(1):74

A case of taurine-containing drink induced anaphylaxis.
Lee SE, Lee SY, Jo EJ, Kim MY, Yang MS, Chang YS, Kim SH. Asia Pac Allergy 2013 Jan;3(1):70-73

Diagnosis of food allergies: the impact of oral food challenge testing.
Ito K. Asia Pac Allergy 2013 Jan;3(1):59-69

Association of house dust mite-specific IgE with asthma control, medications and household pets.
Albano PM, Ramos JD. Asia Pac Allergy 2011 Oct;1(3):145-151

Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis.
Panjabi C, Shah A. Asia Pac Allergy 2011 Oct;1(3):130-137

Milk allergy in the neonatal intensive care unit: comparison between premature and full-term neonates.
Morita Y, Iwakura H, Ohtsuka H, Kohno Y, Shimojo N. Asia Pac Allergy 2013 Jan;3(1):35-41

Food allergy in Asia: how does it compare?
Lee AJ, Thalayasingam M, Lee BW. Asia Pac Allergy 2013 Jan;3(1):3-14

Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time.
Liew WK, Chiang WC, Goh AE, Lim HH, Chay OM, Chang S, Tan JH, Shih E, Kidon M. Asia Pac Allergy 2013 Jan;3(1):29-34

The management of food allergy in Indonesia.
Munasir Z, Muktiarti D. Asia Pac Allergy 2013 Jan;3(1):23-28

IgE mediated food allergy in Korean children: focused on plant food allergy.
Lee SY. Asia Pac Allergy 2013 Jan;3(1):15-22

Biphasic anaphylaxis to gemifloxacin.
Yilmaz I, Dogan S, Tutar N, Kanbay A, Buyukoglan H, Demir R. Asia Pac Allergy 2012 Oct;2(4):280-282

Immediate hypersensitivity reactions to IV non-ionic iodinated contrast in computed tomography.
Ho J, Kingston RJ, Young N, Katelaris CH, Sindhusake D. Asia Pac Allergy 2012 Oct;2(4):242-247

Eosinophilic esophagitis: which role for food and inhalant allergens?
Ridolo E, Montagni M, Olivieri E, Rogkakou A, De' Angelis GL, Canonica GW. Asia Pac Allergy 2012 Oct;2(4):237-241

Chronic urticaria and use of statins.
Khan S. Asia Pac Allergy 2012 Jul;2(3):227-229

Recent progress of elucidating the mechanisms of drug hypersensitivity.
Hashizume H. Asia Pac Allergy 2012 Jul;2(3):203-209

Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP.
Watanabe M, Hirata H, Arima M, Hayashi Y, Chibana K, Yoshida N, Ikeno Y, Fukushima Y, Komura R, Okazaki K, Sugiyama K, Fukuda T. Asia Pac Allergy 2012 Jul;2(3):195-202

House dust mite sensitization in toddlers predict persistent wheeze in children between eight to fourteen years old.
Llanora GV, Ming LJ, Wei LM, van Bever HP. Asia Pac Allergy 2012 Jul;2(3):181-186

Occupational asthma in Japan.
Dobashi K. Asia Pac Allergy 2012 Jul;2(3):173-180

Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment.
Jo EJ, Yang MS, Kim YJ, Kim HS, Kim MY, Kim SH, Cho SH, Min KU, Chang YS. Asia Pac Allergy 2012 Apr;2(2):161-164

Immunoglobulin E-binding reactivities of natural pollen grain extracts from selected grass species in the Philippines.
Cabauatan CR, Ramos JD. Asia Pac Allergy 2012 Apr;2(2):136-143

Anaphylaxis to Patent Blue V: a case series.
Manson AL, Juneja R, Self R, Farquhar-Smith P, Macneill F, Seneviratne SL. Asia Pac Allergy 2012 Jan;2(1):86-89

Human seminal plasma allergy: successful pregnancy after prophylactic anti-histamine treatment.
Song WJ, Kim DI, Kim MH, Yang MS, Kim YJ, Kim SH, Cho SH, Min KU, Chang YS. Asia Pac Allergy 2011 Oct;1(3):168-171

First case report of anaphylaxis caused by Rajgira seed flour (Amaranthus paniculatus) from India: A clinico-immunologic evaluation.
Kasera R, Niphadkar PV, Saran A, Mathur C, Singh AB. Asian Pac J Allergy Immunol 2013 Mar;31(1):79-83

Correlation between skin prick test and MAST-immunoblot results in patients with chronic rhinitis.
Kim YH, Yu BJ, Kim WJ, Kim JE, Lee GH, Lee KA, Cho JH. Asian Pac J Allergy Immunol 2013 Mar;31(1):20-25

Barley gamma3-hordein: glycosylation at an atypical site, disulfide bridge analysis, and reactivity with IgE from patients allergic to wheat.
Snegaroff J, Bouchez I, Smaali MA, Pecquet C, Raison-Peyron N, Jolivet P, Lauriere M. Biochim Biophys Acta 2013 Jan;1834(1):395-403

Tropomyosin from tilapia (Oreochromis mossambicus) as an allergen.
Liu R, Holck AL, Yang E, Liu C, Xue W. Clin Exp Allergy 2013 Mar;43(3):365-377

Proton pump inhibitors are associated with hypersensitivity reactions to drugs in hospitalized patients: a nested case-control in a retrospective cohort study.
Ramirez E, Cabanas R, Laserna LS, Fiandor A, Tong H, Prior N, Calderon O, Medrano N, Bobolea I, Frias J, Quirce S. Clin Exp Allergy 2013 Mar;43(3):344-352

Persistent pollen exposure during infancy is associated with increased risk of subsequent childhood asthma and hayfever.
Erbas B, Lowe AJ, Lodge CJ, Matheson MC, Hosking CS, Hill DJ, Vicendese D, Allen KJ, Abramson MJ, Dharmage SC. Clin Exp Allergy 2013 Mar;43(3):337-343

Facilitation of drug hypersensitivity reactions - the role of acid suppression?
Thien F, Puy RM. Clin Exp Allergy 2013 Mar;43(3):271-272

The epidemiology of anaphylaxis in Europe: protocol for a systematic review.
Panesar SS, Nwaru B, Hickstein L, Rader T, Hamadah H, Ali DF, Patel B, Muraro A, Roberts G, Worm M, Sheikh A, Wierzoch A. Clin Transl Allergy 2013 Mar 28;3(1):9

Microarray-based component-resolved diagnosis of latex allergy: isolated IgE-mediated sensitization to latexprofilin Hev b8 may act as confounder.
Schuler S, Ferrari G, Schmid-Grendelmeier P, Harr T. Clin Transl Allergy 2013 Mar 28;3(1):11

Preventing food allergy: protocol for a rapid systematic review.
Silva DD, Panesar SS, Thusu S, Rader T, Halken S, Muraro A, Sheikh A. Clin Transl Allergy 2013 Mar 28;3(1):10

Coin exposure may cause allergic nickel dermatitis: a review.
Thyssen JP, Gawkrodger DJ, White IR, Julander A, Menne T, Liden C. Contact Dermatitis 2013 Jan;68(1):3-14

Nickel, chromium and cobalt sensitization in a patch test population in north-eastern Italy (1996-2010).
Rui F, Bovenzi M, Prodi A, Belloni FA, Romano I, Corradin MT, Larese FF. Contact Dermatitis 2013 Jan;68(1):23-31

Lymphomatoid dermatitis caused by contact with textile dyes.
Narganes LM, Sambucety PS, Gonzalez IR, Rivas MO, Prieto MA. Contact Dermatitis 2013 Jan;68(1):62-64

Severe allergic dermatitis caused by lanolin alcohol as part of an ointment base in propolis cream.
Fellinger C, Hemmer W, Wantke F, Wohrl S, Jarisch R. Contact Dermatitis 2013 Jan;68(1):59-61

Blocking T helper 1/T helper 17 pathways has no effect on patch testing.
Nosbaum A, Rozieres A, Balme B, Goujon C, Nicolas JF, Berard F. Contact Dermatitis 2013 Jan;68(1):58-59

Severe cutaneous allergic reactions following topical antifungal therapy.
Tang MM, Corti MA, Stirnimann R, Pelivani N, Yawalkar N, Borradori L, Simon D. Contact Dermatitis 2013 Jan;68(1):56-57

Allergic contact dermatitis caused by latex (natural rubber)-free gloves in healthcare workers.
Baeck M, Cawet B, Tennstedt D, Goossens A. Contact Dermatitis 2013 Jan;68(1):54-55

The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release.
Hamann CR, Hamann D, Hamann C, Thyssen JP, Liden C. Contact Dermatitis 2013 Jan;68(1):15-22

Is there a flip-side to nickel use in coins?
Liden C, Thyssen JP, White IR. Contact Dermatitis 2013 Jan;68(1):1-2

Patch testing with 2.0% (0.60 mg/cm 2) formaldehyde instead of 1.0% (0.30 mg/cm 2) detects significantly more contact allergy.
Ponten A, alto-Korte K, Agner T, Andersen KE, Gimenez-Arnau AM, Goncalo M, Goossens A, Johansen JD, Le Coz CJ, Maibach HI, Rustemeyer T, White IR, Bruze M. Contact Dermatitis 2013 Jan;68(1):50-53

Triphenyl phosphite, a new allergen in polyvinylchloride gloves.
Suuronen K, Pesonen M, Henriks-Eckerman ML, alto-Korte K. Contact Dermatitis 2013 Jan;68(1):42-49

What determines skin sensitization potency-myths, maybes and realities. Part 1. The 500 molecular weight cut-off.
Roberts DW, Mekenyan OG, Dimitrov SD, Dimitrova GD. Contact Dermatitis 2013 Jan;68(1):32-41

Growth and nutritional concerns in children with food allergy.
Mehta H, Groetch M, Wang J. Curr Opin Allergy Clin Immunol 2013 Mar 17;

Contact allergies in musicians. [German]
Gasenzer ER, Neugebauer EA. Dtsch Med Wochenschr 2012 Dec;137(51-52):2715-2721

Food-dependent exercise-induced anaphylaxis due to wheat in a young woman.
Ahanchian H, Farid R, Ansari E, Kianifar HR, Jabbari AF, Jafari SA, Purreza R, Noorizadeh S. Iran J Allergy Asthma Immunol 2013 Mar;12(1):93-95

The frequency of common allergens in allergic rhinitis among the patients referred to the allergy clinic of qods hospital in Qazvin during 2007-2010
Manuchehr Mahram, Ameneh Barikani and Negin Nejatian J Aller Ther 2013;4(1):130.

Allergies in high-risk schoolchildren after early intervention with cow's milk protein hydrolysates: 10-year results from the German Infant Nutritional Intervention (GINI) study.
von BA, Filipiak-Pittroff B, Kramer U, Hoffmann B, Link E, Beckmann C, Hoffmann U, Reinhardt D, Grubl A, Heinrich J, Wichmann HE, Bauer CP, Koletzko S, Berdel D. J Allergy Clin Immunol 2013 Mar 15;

Prenatal and postnatal bisphenol A exposure and asthma development among inner-city children.
Donohue KM, Miller RL, Perzanowski MS, Just AC, Hoepner LA, Arunajadai S, Canfield S, Resnick D, Calafat AM, Perera FP, Whyatt RM. J Allergy Clin Immunol 2013 Mar;131(3):736-742

Identification of allergen-resolved threshold doses of carrot (Daucus carota) by means of oral challenge and ELISA.
Foetisch K, Scheurer S, Vieths S, Hanschmann KM, Lidholm J, Mahler V. J Allergy Clin Immunol 2013 Mar 13;

Natural history of cow's milk allergy.
Spergel JM. J Allergy Clin Immunol 2013 Mar;131(3):813-814

Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: A prospective study on the food cause of the disease.
Lucendo AJ, Arias A, Gonzalez-Cervera J, Yague-Compadre JL, Guagnozzi D, Angueira T, Jimenez-Contreras S, Gonzalez-Castillo S, Rodriguez-Domingez B, De Rezende LC, Tenias JM. J Allergy Clin Immunol 2013 Mar;131(3):797-804

Can the levels of Can f 1 in indoor environments be evaluated without considering passive transport of allergen indoors?
Liccardi G, Salzillo A, Piccolo A, D'Amato M, D'Amato G. J Allergy Clin Immunol 2013 Mar 1;

IgE cross-reactivity between the major peanut allergen Ara h 2 and the nonhomologous allergens Ara h 1 and Ara h 3.
Bublin M, Kostadinova M, Radauer C, Hafner C, Szepfalusi Z, Varga EM, Maleki SJ, Hoffmann-Sommergruber K, Breiteneder H. J Allergy Clin Immunol 2013 Mar 2;

Systemic contact dermatitis in a gold-allergic patient after treatment with an oral homeopathic drug.
Malinauskiene L, Isaksson M, Bruze M. J Am Acad Dermatol 2013 Feb;68(2):e58

Anaphylactic shock in a patient with mastocytosis.
Lee SS, Unglik GA, Mar AW. Med J Aust 2012 Nov 5;197(9):520-521

Occupational allergic rhinoconjunctivitis and bronchial asthma induced by goat cheese.
Sastre I, Rodriguez-Perez R, Garcia F, Juste S, Moneo I, Caballero ML. Occup Environ Med 2013 Feb;70(2):141-142

A computer based asthma hazard prediction model and new molecular weight agents in occupational asthma.
Pralong JA, Seed MJ, Yasri R, Agius RM, Cartier A, Labrecque M. Occup Environ Med 2013 Jan;70(1):70

Testing children for allergies: why, how, who and when: An updated statement of the European Academy of Allergy and Clinical Immunology (EAACI) Section on Pediatrics and the EAACI-Clemens von Pirquet Foundation.
Eigenmann PA, tanaskovic-Markovic M, O'B HJ, Lack G, Lau S, Matricardi PM, Muraro A, Namazova BL, Nieto A, Papadopoulos NG, Rethy LA, Roberts G, Rudzeviciene O, Wahn U, Wickman M, Host A. Pediatr Allergy Immunol 2013 Mar;24(2):195-209

Peach allergy in Spanish children: tolerance to the pulp and molecular sensitization profile.
Boyano-Martinez T, Pedrosa M, Belver T, Quirce S, Garcia-Ara C. Pediatr Allergy Immunol 2013 Mar;24(2):168-172

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children.
Zambonino MA, Torres MJ, Munoz C, Requena G, Mayorga C, Posadas T, Urda A, Blanca M, Corzo JL. Pediatr Allergy Immunol 2013 Mar;24(2):151-159

Child and parental reports of bullying in a consecutive sample of children with food allergy.
Shemesh E, Annunziato RA, Ambrose MA, Ravid NL, Mullarkey C, Rubes M, Chuang K, Sicherer M, Sicherer SH. Pediatrics 2013 Jan;131(1):e10-e17

Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.
Bourcier S, Mongardon N, Daviaud F, Moachon L, Arnould MA, Perruche F, Pene F, Cariou A. Am J Emerg Med 2013 Jan;31(1):270-273

Factors associated with shock in anaphylaxis.
Park HJ, Kim SH. Am J Emerg Med 2012 Nov;30(9):1674-1678

Anaphylactic shock due to kiwifruit.
Zhu T, Zhou D, Shu Q. Am J Emerg Med 2012 Nov;30(9):2096-2

Status epilepticus after myelography with iohexol (Omnipaque).
Alimohammadi H, Abdalvand A, Safari S, Mazinanian A. Am J Emerg Med 2012 Nov;30(9):2092-2093

Allergic contact dermatitis to topical preparations of bufexamac.
Pan Y, Nixon R. Australas J Dermatol 2012 Aug;53(3):207-210

Retrospective study of oral lichen planus and allergy to spearmint oil.
Gunatheesan S, Tam MM, Tate B, Tversky J, Nixon R. Australas J Dermatol 2012 Aug;53(3):224-228

Hydroxyurea induced dermatomyositis-like eruption.
Zappala TM, Rodins K, Muir J. Australas J Dermatol 2012 Aug;53(3):e58-e60

Multifaceted allergen avoidance during infancy reduces asthma during childhood with the effect persisting until age 18 years.
Scott M, Roberts G, Kurukulaaratchy RJ, Matthews S, Nove A, Arshad SH. Thorax 2012 Dec;67(12):1046-1051

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