Cytokine release syndrome after bronchoalveolar lavage

Case Report - Open access

Margaret Guerriero, Feras Ally, Keith R. Loeb & Viswam S. Nair. BMC Pulmonary Medicine volume 23, Article number: 391 (2023) 

Abstract

Background

Immunosuppressed bone marrow transplant patients with pulmonary infiltrates routinely undergo bronchoscopy with bronchoalveolar lavage (BAL) to investigate potential etiologies. Cytokine release syndrome after BAL is unreported in the literature in general and in this patient population.

Case presentation

BAL flow cytometry of mature, cytotoxic T cells
expressing CD38 and HLA-DR

We report on an allogeneic bone marrow transplant patient with non-infectious organizing pneumonia of the lungs who developed delayed and rapidly progressive shock and hypoxia post-procedure over the course of 12 h resulting in intensive care unit admission for supportive care.

Cost-effectiveness analysis of biologics for the treatment of chronic rhinosinusitis with nasal polyps in Canada

Yong, M., Kirubalingam, K., Desrosiers, M.Y. et al. Allergy Asthma Clin Immunol 19, 90 (2023). https://doi.org/10.1186/s13223-023-00823-1

Abstract

Background

Dupilumab, omalizumab, and mepolizumab are the three biologics currently approved for use in CRSwNP in Canada. Despite evidence of efficacy, their cost-effectiveness, which is a key factor influencing prescribing patterns, has not yet been compared to each other.

Methods

A cost-effectiveness model using quality-adjusted life years (QALYs) was constructed using a Decision Tree Markov analysis. A third-party healthcare payer perspective and a 10-year time horizon was used. A willingness-to-pay (WTP) threshold of 50,000 Canadian dollars (CAD) per QALY was used to determine cost-effectiveness. Dupilumab, omalizumab, and mepolizumab were each compared to each other.

Real-World Investigation of Eosinophilic-Associated Disease Overlap (REVEAL): Analysis of a US Claims Database.

Brailean A, Kwiatek J, Kielar D, Katial R, Wang X, Xu X, Kim YJ, Stokes M, Stirnadel-Farrant HA. Allergy Asthma Immunol Res. 2023 Sep;15(5):580-602. doi: 10.4168/aair.2023.15.5.580.

PURPOSE: The epidemiology of eosinophil-associated diseases (EADs) is not yet fully understood. While some studies have been conducted on stand-alone eosinophilic diseases, there is scarce evidence on the degree of overlap among rarer conditions.

METHODS: The retrospective Real-world inVestigation of Eosinophilic-Associated disease overLap (REVEAL) study used data from the Optum® Clinformatics® insurance claims database to describe and characterize disease overlap among 11 EADs: allergic bronchopulmonary aspergillosis, atopic dermatitis, chronic rhinosinusitis with nasal polyps, eosinophilic gastritis/gastroenteritis, eosinophilic granulomatosis with polyangiitis, eosinophilic esophagitis, bullous pemphigoid, chronic obstructive pulmonary disorder, chronic spontaneous urticaria, and non-cystic fibrosis bronchiectasis.

Quality of life and stigmatization in people with skin diseases in Europe: A large survey from the ‘burden of skin diseases’ EADV project

ORIGINAL ARTICLE - Open Access

Gisondi, P, Puig, L, Richard, MA, Paul, C, Nijsten, T, Taieb, C, et al. for the EADV Burden of Skin Diseases Project Team.  J Eur Acad Dermatol Venereol. 2023; 37(Suppl. 7): 6–14.

Abstract

Background

Several large studies on the burden of skin diseases have been performed in patients recruited in hospitals or clinical centres, thus missing people with skin diseases who do not undergo a clinical consultation.

Objectives

To evaluate the burden of the most common dermatological diseases in adult patients across Europe, in terms of quality of life, work life, and stigmatization.

Barriers to penicillin allergy de-labeling in the inpatient and outpatient settings: a qualitative study

• Research
• Open access

• Esra Alagoz, 
• Megan Saucke, 
• Prakash Balasubramanian, 
• Paul Lata, 
• Tyler Liebenstein & 
• Sujani Kakumanu 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 88 (2023) 

Abstract

Background

Current state of penicillin allergy de-labeling process for inpatients

Penicillin allergy is the most commonly reported drug allergy in the US. Despite evidence demonstrating that up to 90% of labels are incorrect, scalable interventions are not well established. As part of a larger mixed methods investigation, we conducted a qualitative study to describe the barriers to implementing a risk-based penicillin de-labeling protocol within a single site Veteran’s hospital.

Methods

We conducted individual and group interviews with multidisciplinary inpatient and outpatient healthcare teams.

Comparison of diagnostic efficiency of detecting IgG and IgE with immunoassay method in diagnosing ABPA: a meta-analysis

• Research- Open access

• Anlin Liu, 
• Wushu Chen, 
• Yining Wei, 
• Jinkai Liang, 
• Shuhong Liao, 
• Yijun Chen, 
• Yongming Li, 
• Xidong Wang, 
• Weisi Chen, 
• Ye Qiu, 
• Zhengtu Li & 
• Feng Ye 

BMC Pulmonary Medicine volume 23, Article number: 374 (2023) 

Abstract

Background

Hitherto, the bulk of diagnostic criteria regards Aspergillus-specific immunoglobulin E as a key item, and regard IgG as an auxiliary method in diagnose. Nevertheless, there is no conclusive study in summarize the performance of IgG and IgE diagnosing ABPA.

Methods

We conducted a systematic review to identify studies report results of IgE and IgG detection in diagnosing ABPA. QUADAS-2 tool was used to evaluate included studies, and we applied the HSROC model to calculate the pooled sensitivity and specificity.

Association between daily 1-km resolution levels of ambient air pollution and hospital visits for allergic diseases

He, B.-X., Ma, J.-J., Lai, H., Li, C.-G., Huang, L.-X., Huang, H.-N., Liu, X.-Q., Zhou, Z.-R., Xie, Y.-C., Kuang, P.-P., Ou, C.-Q. and Fu, Q.-L. (2023), Allergy. https://doi.org/10.1111/all.15904

To the Editor,

Allergic diseases are extremely common disorders. Air pollutants may play an important role in inducing and exacerbating symptoms, resulting in significant increases in hospital visits.1, 2 Previous studies commonly evaluated the effects of ambient air pollutants on allergic diseases based on population-average exposure data by averaging the levels of air pollutants at several air-monitoring stations.3, 4 Biased effect estimates may occur in these studies, since spatial gradients and individual variations in exposure were not considered. Herein, we aimed to assess the effects of ambient air pollution on outpatient visits for allergic diseases using individual exposure data.

Using the canadian egg ladder in children with food protein-induced enterocolitis syndrome: a case series

• Research
• Open access
• 
  

• Linlei Ye, 
• Tiffany Wong, 
• Elana Lavine, 
• Victoria E. Cook & 
• Stephanie C. Erdle 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 87 (2023) 

Abstract

Background

Current management of food protein-induced enterocolitis syndrome (FPIES) involves strict avoidance of the offending food for 12–18 months, followed by oral food challenge (OFC) under physician supervision. OFCs are resource-intensive and there is a lack of a universal standardized protocol for FPIES. Prolonged avoidance may increase the risk of IgE-mediated allergy, particularly in atopic patients. Food ladders have shown success in promoting accelerated tolerance in patients with IgE-mediated allergy. Our case series evaluated the safety of use of the Canadian Egg Ladder in patients with mild-to-moderate FPIES to egg.