Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, OPT should be performed in case of negativity on skin tests.
Background: The success of subcutaneous immunotherapy (SCIT) mostly
depends on regular injections. Our aim was to investigate adherence to
SCIT with aeroallergens during the COVID-19 pandemic and demonstrate
clinical consequences of treatment disruptions in real-life. Methods:
Visual analogue scale for quality of life (VAS-QoL), VAS for symptom
scores (VAS-symptom), medication scores (MSs) and total symptom scores
(TSS-6) were recorded during the pandemic in 327 adult allergic rhinitis
and/or asthmatic patients receiving maintenance SCIT and these scores
were compared with the pre-pandemic data. Patients were grouped
according to SCIT administration intervals; no delay (Group 1),
<2 months (Group 2), and ≥2 month intervals (Group 3).
Results: 104 (31.8%) patients (Group 3) were considered as non-adherent
which was mostly related to receiving SCIT with HDMs and using public
transportation for reaching the hospital. Median MS, VAS-symptom and
TSS-6 scores of Group 3 patients during the pandemic were higher than
the pre-pandemic scores (p=0.005, p<0.001, p<0.001,
respectively) whereas median VAS-QoL scores of Group 3 during the
pandemic were lower than the pre-pandemic scores (p<0.001).
Median TSS-6 and VAS-symptom scores were the highest in Group 3 compared
to other groups (p<0.001 for each comparison). Median VAS-QoL
scores were the lowest in Group 3 compared to Group 1 and Group 2
(p<0.001, p=0.043, respectively). Conclusion: When precautions
in allergy clinics are carefully applied, adherence to SCIT can be high
during a pandemic. Patients must be warned about adhering to SCIT
injections since delays in SCIT administration can deteriorate clinical
symptoms.
Gaucher disease is the most common lysosomal storage disorder, and enzyme replacement therapy, such as administration of imiglucerase, is the standard therapy. Anaphylaxis to imiglucerase is rarely reported. Here, we report a 26-year-old female who was diagnosed with type 1 Gaucher disease and referred to our Allergy Outpatient Clinic because of an anaphylactic reaction due to imiglucerase enzyme therapy. A desensitization protocol was administered with two different dilutions with an increasing rate of administration delivered in 10 consecutive steps by intravenous infusion in an intensive care setting. No reactions occurred during the procedure, and the total final dose of 2,000 U was successfully administered. To our knowledge, this is the first adult case with successful desensitization to imiglucerase. Desensitization protocols to drugs in chronic disease patients for whom no alternative therapies are available can be lifesaving.
Background: Hereditary angioedema (HAE) attacks can be provoked with
psychological factors. The aim of this study was to assess the effects
of anxiety, depression and stress related to COVID-19 pandemic on
disease activity of HAE patients during the quarantine period (QP) and
the return to normal period (RTNP). Methods: This prospective study was
conducted between March 2020 and September 2020 in four allergy centres.
Demographic, clinical features and mental health status were evaluated
in QP (from March to the beginning of June) and RTNP (from June to the
beginning of September) was applied by the government. The 10-point
visual analogue scale (VAS10) was used to define the severity of HAE
attacks. Depression-Anxiety- Stress Scale-21 (DASS-21) and Fear of
Covid-19 (FC-19) scales were performed to assess mental health status.
Results: 139 HAE patients were included in the study. In QP, median
attack numbers and median VAS10 scores were 5 (min-max: 0-45) and 6
(min-max: 0-10), respectively. HAE attack numbers, DASS-21 stress,
anxiety, depression and total DASS-21 scores, as well as FC-19 scores
were higher in QP than RTNP (p= 0.001, p <0,001, p = 0,001, p
<0,001, p <0.001, p<0.001, respectively).
However, there was no difference in attack severity scores between the
two periods (p>0.05). Conclusions: This study revealed that
the restriction measures during Covid-19 outbreak causes an increase in
the number of HAE attacks in relation to anxiety, depression, stress and
fear of Covid-19 pandemic. Therefore, it is important to provide
psychological support to HAE patients during the pandemic.
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