- BMC Pulmonary Medicine
- Case report
- Open Access
- Open Peer Review
Abstract
Background
Immunoglobulin G4-related disease (IgG4-RD) encompasses a group of immune-mediated disorders that are gaining increasing recognition.
February 3, 2019
IgG4-related disease can present as recurrent spontaneous hemothorax: a case report
January 29, 2019
Anaphylaxis to intravenous gelatin‐based solutions: a case series examining clinical features and severity
Original Article
Free Access
Free Access
Summary
The proportion of patients receiving intravenous gelatin‐based colloids has increased in the last decade due to safety concerns about starch‐based products. Recent research suggests hypersensitivity reactions to intravenous gelatin‐based solutions occur at similar rates per administration as non‐depolarising neuromuscular blocking agents such as rocuronium (6.2/100,000 administrations).
Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma
- Research article Open Access Open Peer Review
- Claire A. Cox
- ,
- Ilse M. Boudewijn,
- Sebastiaan J. Vroegop,
- Siebrig Schokker,
- Anne J. Lexmond,
- Henderik W. Frijlink,
- Paul Hagedoorn,
- Judith M. Vonk,
- Martijn P. Farenhorst,
- Nick H. T. ten Hacken,
- Huib A. M. Kerstjens and
- Maarten van den Berge
BMC Pulmonary Medicine201919:23
Abstract
Background
Bronchial provocation is often used to confirm asthma. Dyspnea sensation, however, associates poorly with the evoked drop in FEV1. Provocation tests only use the large airways parameter FEV1, although dyspnea is associated with both large- and small airways dysfunction.
January 23, 2019
Indoor bacterial load and its correlation to physical indoor air quality parameters in public primary schools
- Multidisciplinary Respiratory Medicine
- Original research article
- Open Access
Abstract
Background
Poor indoor air quality is a great problem in schools due to a high number of students per classroom, insufficient outside air supply, poor construction and maintenance of school buildings. Bacteria in the indoor air environment pose a serious health problem. Determination of bacterial load in the indoor environment is necessary to estimate the health hazard and to create standards for indoor air quality control. This is especially important in such densely populated facilities like schools.
January 18, 2019
Dermatomyositis associated with omalizumab therapy for severe asthma: a case report
- Allergy, Asthma & Clinical Immunology
- Case report
- Open Access
Allergy, Asthma & Clinical Immunology201915:4
Abstract
Background
Omalizumab is a humanized monoclonal antibody widely used for treatment of persistent allergic asthma and antihistamine-refractory chronic urticaria. Immediate adverse events to omalizumab are well characterized. Delayed anaphylactoid and serum sickness-like reactions have also been described; however, their relationship to the drug remains uncertain, and the frequency is unknown.
Case presentation
We present a case of a 59-year old female who developed amyopathic dermatomyositis (DM) after receiving omalizumab infusions for steroid-refractory severe asthma. After 6 months of omalizumab, the patient developed an erythematous, intensely pruritic cutaneous eruption. Skin biopsy indicated nonspecific features of dermatitis. However, neither topical corticosteroids nor gabapentin and maximal doses of multiple antihistamines gave her relief. On follow-up clinical exam 8 months later, she had classic cutaneous features of dermatomyositis, with confirmatory repeat skin biopsy. Laboratory investigations revealed negative myositis specific antibodies, positive antinuclear antibody, and negative anti-histone antibodies. Creatine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase levels and C-reactive protein were also within normal limits. These findings supported the clinical impression of amyopathic DM. The patient’s symptoms improved with oral corticosteroid therapy. A malignancy screen was negative. There was no evidence of end organ dysfunction.
Conclusions
Dermatomyositis is not a known adverse effect of omalizumab therapy. DM has a low incidence, but potentially life threatening consequences. Amyopathic DM may represent up to 21% of cases of DM, with similar risks of malignancy and end organ dysfunction. DM has been associated with biologic therapy. Using the Naranjo adverse drug reaction (ADR) probability scale, our patient had a “probable” omalizumab related ADR. A more likely explanation is that the patient had underlying DM that remained occult due to chronic corticosteroid therapy. Our case highlights the need for clinical vigilance and maintenance of a broad differential when patients on biologic therapies present with cutaneous eruptions. In our patient, the cutaneous clinical features of DM became pronounced over serial assessments. Laboratory markers may be deceptively normal, as in amyotrophic DM, or confounded by ongoing corticosteroid therapy. There are important clinical implications of prompt diagnosis, given the association of DM with end organ disease including interstitial lung disease, and possible concomitant malignancy.
December 29, 2018
Superior effect of MP-AzeFlu than azelastine or fluticasone propionate alone on reducing inflammatory markers
- Allergy, Asthma & Clinical Immunology
- Research
- Open Access
Abstract
Background
MP-AzeFlu, intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP), is superior to AZE or FP alone for treatment of allergic rhinitis (AR). However, the precise anti-inflammatory mechanism of action of MP-AzeFlu has not been characterized.
Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice
- Allergy, Asthma & Clinical Immunology
- Research
- Open Access
Abstract
Background
Cold-induced urticaria is a significant condition, especially among young females. Despite the morbidity of this disease, studies that fully characterize the disease are limited.
December 28, 2018
Airway reversibility in asthma and phenotypes of Th2-biomarkers, lung function and disease control
- Research
- Open Access Allergy, Asthma & Clinical Immunology
- Jianghong Wei,
- Libing Ma,
- Jiying Wang,
- Qing Xu,
- Meixi Chen,
- Ming Jiang,
- Miao Luo,
- Jingjie Wu,
- Weiwei She,
- Shuyuan Chu
Abstract
Background
High bronchodilator reversibility in adult asthma is associated with distinct clinical characteristics. In this study, we aim to make a comparison with T-helper 2 (Th2)-related biomarkers, lung function and asthma control between asthmatic patients with high airway reversibility (HR) and low airway reversibility (LR).
December 19, 2018
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