Background: Peach is a common food allergen source throughout Europe. The aim of this study was to characterize peach allergy in a Portuguese patient population. Methods: Thirty peach-allergic patients confirmed by double-blind placebo-controlled food challenges and 29 controls were included. All subjects completed a standardized questionnaire regarding symptoms and epidemiologic characteristics, skin prick tests with inhalant allergens and foods as well as specific IgE antibodies to peach, recombinant peach allergens rPru p 1, rPru p 3, rPru p 4 and cross-reactive carbohydrate determinants. Results: Thirty-seven percent of patients reported only oral allergy syndrome, while 37% reported generalized urticaria and/or angioedema, 17% localized contact urticaria and 10% anaphylaxis with peach. Sensitization to other Rosaceae fruits and tree nuts was present in 90 and 77% of the patients, respectively. Respiratory allergy history was associated with less severe symptoms (oral allergy syndrome or contact urticaria; p < 0.01) and positive skin prick test to peach peel or plum with more severe symptoms (urticaria and/or angioedema or anaphylaxis; p < 0.05). Ninety-seven percent were sensitized to Pru p 3, 13% to Pru p 4, 3% to Pru p 1 and 10% to cross-reactive carbohydrate determinants. Pru p 3 specific IgE was associated with Artemisia vulgaris sensitization and tree nut allergy (p < 0.05) but not with clinical severity. Conclusions: Half the patients reported systemic reactions to peach. Peach allergy appeared predominantly mediated by Pru p 3 but some patients were sensitized to Pru p 4. Applying a 0.10 kU_A/l cutoff level, the diagnostic value of combining the 3 recombinant allergens was noteworthy, with 100% sensitivity and 90% specificity.

Objective: to analyze component resolved diagnosis to Dermatophagoides pteronyssinus (Der p) in patients with respiratory allergy and its relationship with clinical severity in different geographical areas. Methods: 217patients (mean age 25.85±12.7 years; 51.16% females) were included, selected from 13 centers in Portugal (5 from North, n=65). All had allergic rhinitis, with or without asthma, and had positive skin prick tests to at least one dust mite.Specific IgE (sIgE) to Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p1, Der p 2, Der p 10 and Der p 23 were determined by ImmunoCAP. Statistical analysis(Mann Whitney U test) compared patients with rhinitis vs rhinitis and asthma; mild vsmoderate-to-severe rhinitis; North vs South. Results: Prevalence of sensitization was 98.2% to Der p, and 72.4%, 89.4%, 9.7% and 77% to Der p 1, Der p 2, Der p 10 and Der p 23, respectively. Corresponding median sIgE levelswere 8.56, 17.7, 0.01 and 3.95 kU A /L. sIgE to all allergens was higher in patients with moderate-to-severe rhinitis and rhinitis with asthma but not statistically significant (NSS). sIgE to Der p 2 was significantly higher in the South when compared with the North (p=0.0496). Conclusions: sensitization to Der p is the most common in Portugal. Der p 2 had the highest prevalence and median sIgE levels. All sIgE to molecular components were higher in more symptomatic patients (NSS). sIgE to Der p 2 was higher in the South, which may be related to the warmer temperature and/or the larger sample size.

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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.

SIT with this modified extract appears to be a relatively safe treatment, which can rapidly improve nasal allergenic tolerance, reduce symptom scores and improve subjective self-evaluation measured through VAS, reflecting a general improvement in patients' well-being.

Background. Ultra-rush (UR) are induction protocols used in venom immunotherapy (VIT). Objectives. To evaluate the adverse reactions during a 210-minutes UR and determine possible risk factors. Methods. Retrospective study of 129 patients submitted to UR with VIT in the last 20 years. Results. In 114 (88.4%) patients, the 101.1 μg maintenance dose was reached in 210 minutes. Systemic reactions (SR) occurred in 22% of patients (71% mild). There were no severe SR, late reactions or fatalities. Adrenaline was administered in 10% of all UR. The SR were more frequent with honey bee VIT and had greater severity in the patients with a previous severe systemic sting reaction. No significant difference in the risk of SR was found with other demographic, clinical or laboratory factors. There were 5% of large local reactions (LLR), these being more frequent in females. Conclusion. Most SR during UR were mild with no need for adrenaline treatment. The honey bee venom and the severity of the anaphylaxis during the field sting were the only SR's risk factors for systemic adverse reactions during the UR. VIT is usually administered by subcutaneous injections with aqueous extracts and comprises an induction phase and a maintenance phase necessary to ensure a sustained effect over time (1). Since its development, several induction protocols have been proposed for VIT. These protocols differ from one another in the time required to reach the maintenance dose and in the interval between the injections (8,9,10). The risk of a new systemic sting reaction implies the need for the patient to reach the protection dose as quickly as possible. Thus, slow, conventional protocols with an induction period of 4 to 6 months and intervals between doses of 3 to 7 days have been progressively replaced by faster protocols (11,12). The latest include cluster or rush-modified protocols in which induction lasts generally 6 weeks (administration of 2 injections separated for 30 minutes every 3 to 7 days), rush protocols in which the induction lasts less than a week and the ultra-rush (UR) protocols in which the induction may last from 120 minutes to 2 days with doses being administered at intervals ranging from 20 minutes to 2 hours (11,12,13).

Introduction: Severe systemic reactions (SR) to allergen subcutaneous immunotherapy (SCIT) are rare but local reactions (LR) are common. We aimed to characterize the type of reactions and safety profile.Methods: Retrospective analysis of medical record from patients under SCIT between 2013- 2016.Results: Total of 7372 SCIT injections in 323 patients: 52% female; mean age 30 years(SD 13); mean treatment time 19 months(SD 13). There were 57 patients (17.6% of population, 70% female) with at least one adverse reaction, for 93 reactions described(1.3% injections). There were 79 LR(1.1% injections) in 46(14.2%) patients: 36 in build-up, 43 in maintenance. There were 14 SR(0.19% injections) in 12(3.7%) patients: 12 in build-up, 2 in maintenance. All SR were grade 1. The majority of reactions were caused by mite SCIT(69.9%). Conclusion:SCIT is safe and well tolerated, with no report of SR grade>1.

Table of contentsOral AbstractsO1 Functionally distinct HMGB1 isoforms correlate with physiological processes in drug-induced SJS/TENDaniel F. Carr, Wen-Hung Chung, Rosalind E. Jenkiins, Mas Chaponda, Gospel Nwikue, Elena M. Cornejo Castro, Daniel J. Antoine, Munir PirmohamedO2 Hypersensitivity reactions to beta-lactams, does the t cell recognition pattern influence the clinical picture?Natascha Wuillemin, Dolores Dina, Klara K. Eriksson, Daniel YerlyO3 Specific binding characteristics of HLA alleles associated with nevirapine hypersensitivityRebecca Pavlos, Elizabeth Mckinnin, David Ostrov, Bjoern Peters, Soren Buus, David Koelle, Abha Chopra, Craig Rive, Alec Redwood, Susana Restrepo, Austin Bracey, Jing Yuan, Silvana Gaudieri, Mary Carrington, David Haas, Simon Mallal, Elizabeth PhillipsO4 Do we need to measure total ige for the interpretation of analytical results of ImmunoCAP dnd 3gAllergy specific IgE?Douwe De Boer, Paul Menheere, Chris Nieuwhof, Judith BonsO5 Neutrophil activation in systemic anaphylaxis: results from the multicentric NASA studyFriederike Jonsson, Luc De Chaisemartin, Vanessa Granger, Caitlin Gillis, Aurelie Gouel, Catherine Neukirch, Fadia Dib, Pascale Roland Nicaise, Dan Longrois, Florence Tubach, Sylvie Martin, Pierre Bruhns, NASA Study GroupO6 Purpuric drug eruptions due to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for non-small-cell lung cancer (NSCLC): a clinic-pathological study of 32 casesKai-Lung Chen, Shu-Ling Liao, Yi-Shuan Sheen, Yung-Tsu Cho, Che-Wen Yang, Jau-Yu Liau, Chia-Yu ChuPoster presentations: Poster Walk 1—Anaphylaxis (P01–P09)P1 Anaphylactic reactions during anaesthesia and the perioperative periodRita Aguiar, Anabela Lopes, Natália Fernandes, Leonor Viegas, M. A. Pereira-BarbosaP2 Anaphylaxis to chlorhexidine: is there a cross-reactivity to alexidine?Antonia Bünter, Nisha Gupta, Tatjana Pecaric Petkovic, Nicole Wirth, Werner J. Pichler, Oliver HausmannP3 Cefotaxime-induced severe anaphylaxis in a neonateMehtap Yazicioglu, Pinar G. Ozdemir, Gokce Ciplak, Ozkan KayaP4 Clinical features and diagnosis of anaphylaxis resulting from exposure to chlorhexidinePeter John CookeP5 Drug-induced anaphylaxis: five-year single-center surveyInês Mota, Ângela Gaspar, Filipe Benito-Garcia, Marta Chambel, Mário Morais-AlmeidaP6 Intraoperative severe anaphylactic reaction due to patent blue v dyeLuis Marques, Eva Alcoceba, Silvia LaraP7 Kounis syndrome in the setting of anaphylaxis to diclofenacLeonor Carneiro-Leão, Carmen Botelho, Eunice Dias-Castro, Josefina CernadasP8 Perioperative anaphylaxis audit: Royal Melbourne HospitalKatherine Nicholls, William Lay, Olivia Smith, Christine Collins, Gary Unglik, Kymble Spriggs, Priscilla Auyeung, Jeremy McComish, Jo A. DouglassP9 Recurrent peri-operative anaphylaxis: a perfect stormJonny G. Peter, Paul PotterPoster Walk 2: DH regions and patient groups (P10–P19)P10 A rare presentation of amoxicillin allergy in a young childFabrícia Carolino, Eunice Dias De Castro, Josefina R. CernadasP11 Adverse drug reactions in ...