Hypersensitivity to molybdenum as a possible trigger of ANA-negative systemic lupus erythematosus.

Federmann, M; Morell, B; G, Graetz; Wyss, M; Elsner, P.; Thiessen, R von; Wüthrich, B; Grob, David

doi:10.1136/ard.53.6.403

Cited by 30 publications

(9 citation statements)

References 12 publications

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“…Also using Na 3 Data with respect to the relevance of the LTT in chromium hypersensitivity are still conflicting [52,53]. A single case was reported [54] of a woman who developed lupus-like symptoms after implantation of metal plates, with a positive patch test to Mo and a positive LTT with Mo. Symptoms resolved after removal of the plates.…”

Section: Ltt For the Diagnosis Of Metal-induced Allergic Disordersmentioning

confidence: 99%

Diagnostic relevance of the lymphocyte transformation test for sensitization to beryllium and other metals (IUPAC Technical Report)

Klein¹,

Schwenk²,

Heinrich‐Ramm³

et al. 2004

Pure and Applied Chemistry

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The lymphocyte transformation test (LTT) has been proven useful especially in the diagnosis of drug-induced allergic disorders. It is an in vitro test which is based on the fact that lymphocytes, which have been sensitized by a certain antigen, transform into blasts and proliferate when they are again exposed to this antigen. This proliferation is determined by measurement of the incorporation of [3H ]-thymidine or bromodeoxyuridine into replicating DNA. The test has the advantage over skin tests of avoiding re-exposure of individuals, and it was, therefore, hoped that it may also help to diagnose metal allergies and especially sensitization toward beryllium. However, the LTT measures only the sensitization of lymphocytes, but not the effector reaction, i.e., there may be positive results in exposed individuals even in the absence of clinical symptoms. There are several reports evaluating the LTT toward gold salts (Au), amalgam (Hg), nickel (Ni), beryllium (Be), and several other metals. With metals other than Be, the LTT appears to be of little use. In contrast, the LTT with Be may, indeed, define patients at risk of developing chronic beryllium disease (CBD), which affects mainly the respiratory tract and may even cause death. Beryllium sensitization progresses to CBD at a rate of 7-11 % per year. Since the Be-LTT can detect sensitization in workers who have not yet developed a disease it is an important diagnostic tool to detect individuals at risk. In conclusion, the LTT can detect a cell-mediated immunological response of an individual to metals. However, for most metals its usefulness is questionable, with the exception of Be; a positive Be-LTT can identify not only patients with CBD, but also persons at risk of developing CBD in later years.

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Section: Ltt For the Diagnosis Of Metal-induced Allergic Disordersmentioning

confidence: 99%

Diagnostic relevance of the lymphocyte transformation test for sensitization to beryllium and other metals (IUPAC Technical Report)

Klein¹,

Schwenk²,

Heinrich‐Ramm³

et al. 2004

Pure and Applied Chemistry

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“…Heavy metals and silica/quartz dust may also precipitate autoimmunity. The former induces kidney disease and lupus‐like syndromes in animals, as reviewed by Bigazzi et al ., 28 but human evidence is limited to case reports such as one concerning molybdenum contained in cervical metal plates 29 . The latter has been linked to SLE and lupus‐like syndromes in data from several mines and manufacturing plants 30,31 …”

Section: Discussionmentioning

confidence: 99%

“…The former induces kidney disease and lupuslike syndromes in animals, as reviewed by Bigazzi et al ., 28 but human evidence is limited to case reports such as one concerning molybdenum contained in cervical metal plates. 29 The latter has been linked to SLE and lupus-like syndromes in data from several mines and manufacturing plants. 30,31 Tobacco and tobacco smoke, which contain hydrazines, have been associated with an increased risk of SLE in some 32 but not all studies.…”

mentioning

confidence: 99%

Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents: A review, with special focus on the development of subacute cutaneous lupus erythematosus in a genetically predisposed individual

et al. 2004

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Exogenous agents implicated in or suspected of precipitating subacute cutaneous lupus erythematosus (SCLE) and lupus erythematosus (LE) are reviewed. An illustrative case of environmentally induced SCLE is presented. A previously healthy 30-year male homozygous for the tumor necrosis factor-alpha (TNF-alpha) 308. A promoter allele developed SCLE after spending several hours removing fertilizer- and pesticide-containing hay from an agricultural barn in the springtime. The cutaneous eruption soon resolved, only to reappear 3 weeks later on the day the patient re-entered the barn. An environmental agent present in the barn, coupled with springtime ultraviolet light, likely triggered the disease in this immunogenetically susceptible individual.

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“…138 Hypersensitivity to molybdenum has been implicated to induce a syndrome resembling systemic lupus erythematosus. 139 Contact allergy to gold has been associated with increased incidence of restenosis when patients are stented with goldplated stents and these stents have been abandoned. 140 On the other hand, the titan stent, which is a stainless steel stent coated with titanium-nitride oxide (TINOX) can prevent discharge of nickel, chromium, and molybdenum and it seems promising in eliminating local allergy and inflammation.…”

Section: Hypersensitivity To Metalsmentioning

confidence: 99%

Coronary Stents, Hypersensitivity Reactions, and the Kounis Syndrome

Kounis¹,

Hahalis²,

Theoharides³

2007

J Interven Cardiology

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The use of drug-eluting stents (DES) for the treatment of coronary stenosis has increased sharply and now accounts for more than 75% of all coronary stents utilized. However, concern has been increasing that DES could be associated with stent thrombosis, paradoxical coronary vasoconstriction, and hypersensitivity reactions. Components of currently used DES have been reported to induce, either separately or synergistically, hypersensitivity reactions and possibly lead to cardiac events. DES-activated intracoronary mast cells could release histamine, arachidonic acid metabolites, proteolytic enzymes, as well as a variety of cytokines, chemokines, and platelet-activating factor (PAF) leading to local inflammation and thrombosis. These events may be more common than suspected because it is hard to document them, unless they become systemic, in which case they manifest themselves as the "Kounis syndrome," characterized by the concurrence of acute coronary events with hypersensitivity reactions. Recognition of this problem may lead to better vigilance, as well as new DES with mast cell blocking molecules that may also be disease modifying.

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Hypersensitivity to molybdenum as a possible trigger of ANA-negative systemic lupus erythematosus.

Cited by 30 publications

References 12 publications

Diagnostic relevance of the lymphocyte transformation test for sensitization to beryllium and other metals (IUPAC Technical Report)

Diagnostic relevance of the lymphocyte transformation test for sensitization to beryllium and other metals (IUPAC Technical Report)

Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents: A review, with special focus on the development of subacute cutaneous lupus erythematosus in a genetically predisposed individual

Coronary Stents, Hypersensitivity Reactions, and the Kounis Syndrome

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