BACKGROUND: Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized. METHOD: Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed. RESULTS: No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable. CONCLUSIONS: These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated.
- Klíčová slova
- COVID-19 vaccine, allergy test, anaphylaxis, mRNA vaccines, risk assessment,
- MeSH
- anafylaxe * diagnóza MeSH
- COVID-19 * prevence a kontrola MeSH
- léková alergie * diagnóza etiologie terapie MeSH
- lidé MeSH
- mRNA vakcíny MeSH
- syntetické vakcíny MeSH
- vakcíny proti COVID-19 * škodlivé účinky MeSH
- vakcíny * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- mRNA vakcíny MeSH
- syntetické vakcíny MeSH
- vakcíny proti COVID-19 * MeSH
- vakcíny * MeSH
BACKGROUND: Neuroblastoma is the most common extracranial solid tumour of childhood with extremely heterogeneous bio-logical and clinical behaviour. Despite advances in its treatment, the long-term prognosis of patients with a high-risk and relapsed neuroblastoma remains poor. The implementation of immunotherapy into the treatment protocols has the potential to improve it. Dinutuximab, a chimeric monoclonal antibody, leads to the apoptosis of tumour cells through binding to the GD2 receptor. The article aim is to present the first experience of our centre with dinutuximab treatment. PATIENTS AND METHODS: In 2018-2019, we administered 31 cycles of dinutuximab to seven patients. Five patients with high-risk neuroblastoma received dinutuximab in the first line, in two patients with relapse, dinutuximab was administered in the second line of treatment. To evaluate the toxicity of the treatment, the nursing records of patients during immunotherapy were retrospectively analysed. RESULTS: Two patients treated with dinutuximab in the first line are in complete remission, three patients achieved a partial response. Both patients with relapsed neuroblastoma were dia-gnosed with a second relapse after immunotherapy and died of disease progression. The treatment tolerance was acceptable in most patients - in six patients adverse events were managed with adequate supportive care. These were mainly symptoms of capillary leak syndrome, pain and hypersensitivity reactions. In one patient, the treatment was discontinued due to severe neurotoxicity. CONCLUSION: Dinutuximab has a proven benefit in the eradication of the minimal residual disease in the treatment of neuroblastoma. Immunotherapy is currently the standard for first-line treatment of high-risk neuroblastoma. Its role in the treatment of relapsed neuroblastoma is a subject of several ongoing studies as well as the optimization of therapeutic regimens. Dinutuximab administration is associated with a considerable risk of severe adverse reactions, so the treatment belongs to the hands of an experienced paediatric oncology centre.
- Klíčová slova
- anti-GD2, dinutuximab, monoclonal antibody, neuroblastoma, residual disease,
- MeSH
- antitumorózní látky škodlivé účinky terapeutické užití MeSH
- imunoterapie škodlivé účinky metody MeSH
- léková alergie etiologie MeSH
- lidé MeSH
- lokální recidiva nádoru farmakoterapie MeSH
- monoklonální protilátky škodlivé účinky terapeutické užití MeSH
- neuroblastom patologie terapie MeSH
- syndrom kapilárního úniku chemicky indukované MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antitumorózní látky MeSH
- dinutuximab MeSH Prohlížeč
- monoklonální protilátky MeSH
BACKGROUND: Rechallenge with oxaliplatin is common in the treatment of colorectal cancer and increases the risk of a detrimental oxaliplatin-induced immune reaction. Allergic reactions to oxaliplatin may be partially avoided by desensitization protocols involving immune suppressive drugs, slow administration and gradually increasing chemotherapeutic doses. However, non-IgE-mediated immunopathologic reactions to oxaliplatin remain challenging and may be potentially life-threatening. CASE PRESENTATION: Here we report two potentially fatal cases of type II hypersensitivity to oxaliplatin in metastatic colorectal cancer patients. Both patients manifested with severe thrombocytopenia, intravascular haemolysis, and acute kidney injury 4-6 h after oxaliplatin administration in a rechallenge setting. Serology revealed that the reactive entity for immune haemolysis was an IgG oxaliplatin-induced antibody. The course of anti-cancer treatment and severe adverse event after oxaliplatin rechallenge including diagnostic dilemma and the results of detailed routine clinical chemistry and hematology testing are described. Extended immunohaematology/serology testing revealed that the oxaliplatin-induced IgG antibody was present in the circulation prior to the onset of hypersensitivity, persisted for months and elicited cross-reactivity with other platinum agents. CONCLUSION: Development of type II hypersensitivity reaction manifesting as a sudden onset of severe thrombocytopenia and immune haemolysis must be considered in patients treated with oxaliplatin, especially those on long-term therapy or when rechallenged. Step-wise diagnosis involves clinical presentation, detection of haemolysis in patient's blood and/or urine, evaluation of platelet count, and direct anti-globulin Coombs test.
- Klíčová slova
- Acute kidney injury, Chemotherapy rechallenge, Immune haemolytic anemia, Oxaliplatin, Type II hypersensitivity reaction,
- MeSH
- adenokarcinom komplikace diagnóza farmakoterapie MeSH
- akutní poškození ledvin MeSH
- antitumorózní látky škodlivé účinky terapeutické užití MeSH
- desenzibilizace imunologická MeSH
- hemolýza MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- léková alergie diagnóza farmakoterapie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory rekta komplikace diagnóza farmakoterapie MeSH
- nežádoucí účinky léčiv diagnóza farmakoterapie etiologie MeSH
- oxaliplatin škodlivé účinky terapeutické užití MeSH
- senioři MeSH
- trombocytopenie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antitumorózní látky MeSH
- hormony kůry nadledvin MeSH
- oxaliplatin MeSH
The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
- Klíčová slova
- documentation, drug allergy, drug hypersensitivity, education, prevention,
- MeSH
- čipové karty ve zdravotnictví * MeSH
- dokumentace * metody MeSH
- léková alergie diagnóza etiologie prevence a kontrola MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- antitumorózní látky škodlivé účinky MeSH
- cetuximab MeSH
- erbB receptory imunologie MeSH
- humanizované monoklonální protilátky MeSH
- intravenózní infuze MeSH
- léková alergie farmakoterapie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- monoklonální protilátky škodlivé účinky MeSH
- nádory jater komplikace farmakoterapie sekundární MeSH
- nádory ledvin komplikace farmakoterapie patologie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antitumorózní látky MeSH
- cetuximab MeSH
- erbB receptory MeSH
- humanizované monoklonální protilátky MeSH
- monoklonální protilátky MeSH
Heparin as an indirect anticoagulant is used in the clinical practice for more than 60 years. It is an effective drug, but it has limitations. To the side effects belong the heparin resistance, risk of bleeding (haemorrhage), hypersensitivity reactions and heparin-induced osteoporosis. The low-molecular-weight heparins exhibit fewer side effects, but it is still necessary to know about them.
- MeSH
- antikoagulancia škodlivé účinky MeSH
- heparin nízkomolekulární škodlivé účinky MeSH
- heparin škodlivé účinky MeSH
- krvácení chemicky indukované MeSH
- léková alergie etiologie MeSH
- léková rezistence MeSH
- lidé MeSH
- osteoporóza chemicky indukované MeSH
- předávkování léky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antikoagulancia MeSH
- heparin nízkomolekulární MeSH
- heparin MeSH
A 69-y-old woman with bioprosthetic endocarditis due to Listeria monocytogenes developed an allergic reaction after beginning ampicillin treatment. She was cured with the combination of trimethoprim-sulfamethoxazole, rifampicin and teicoplanin. No immune deficiency was found in the patient.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální endokarditida komplikace farmakoterapie mikrobiologie MeSH
- infekce spojené s protézou komplikace farmakoterapie mikrobiologie MeSH
- kombinace léků trimethoprim a sulfamethoxazol terapeutické užití MeSH
- kombinovaná farmakoterapie MeSH
- léková alergie etiologie MeSH
- lidé MeSH
- Listeria monocytogenes izolace a purifikace MeSH
- listeriové infekce komplikace farmakoterapie mikrobiologie MeSH
- peniciliny škodlivé účinky MeSH
- rifampin terapeutické užití MeSH
- senioři MeSH
- teikoplanin terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antibakteriální látky MeSH
- kombinace léků trimethoprim a sulfamethoxazol MeSH
- peniciliny MeSH
- rifampin MeSH
- teikoplanin MeSH
The Karviná district (northwestern part of North Moravia and Silesia) is typical by its industrial character, above all mining of black coal which is coked and which led to the devastation of the countryside. The ratio of light industry is low. In a small area (347 km2) there is a population of 824 inhabitants per km2. The population is concentrated in particular in urban agglomerations of the flat block type. Up to 1990 almost 55% of the population was employed in heavy industry. Due to its industrial activities, incl. metallurgical plants and ironworks in nearby Ostrava and Trinec, the district is one of the areas with a heavily contaminated atmosphere in particular with solid aerosol containing toxic metals (the values of solid aerosol varied on average between 100 and 150 micrograms/ml), the elevated values of Nox due to contamination from traffic and polyaromatic hydrocarbons were not negligible either during the investigation period. Since 1968 an endemic incidence of mycobacteria has been recorded which is due to Mycobacterium kansasii. At first only an occasional incidence was involved, since 1973 there has been a more substantial increase with a maximum in 1983 (64 cases) and thus up to 1995 there are 961 cases on records, incl. 787 (81.8%) in men and 174 (18.2%) in women. From the total number of recorded M. kansasii in 937 instances (97.3%) the lungs were affected (777 men, 160 women). The mean annual incidence was 34.3 cases, i.e. 12.03 per 100,000 population (28.1, i.e. 20/100,000 in men, 6.2, i.e. 4.28/100,000 in women). As to age, 78.8% of cases are recorded in the age bracket from 25 to 64 years (in men 81%, in women 68.9%). The highest specific morbidity in men is in the age group from 45-54 years (on average 73.13 per 100,000 per year), in women in the age group from 75 to 84 years (on average 9.75 per 100,000 per year). As to occupation, the ratio of mine employees at the time of contraction of the disease (incl. retired miners) was 52.2%), other workers 14.6%--all stigmatized by an increased dust concentration in other workplaces in heavy industry. As far as the domicile is concerned, the incidence was by far highest in Havírov (more than 56%), followed by Karviná (26.7%). These towns are inhabited mostly by miners. As to the mode of assessment 68.8% cases were diagnosed on account of pulmonary complaints and during dispensarization (stigmatization by dust) and 24.6% cases during preventive radiodiagnostic examinations of miners lungs. It did not prove possible to reveal the source. Interhuman transmission was not proved in any of the patients. The causal agent of the infection is most probably transmitted through water (by the aerogenic route). M. kansasii was isolated from drinking water (560 samples, in 7% M. kansasii was found), as well as in industrial water. In 1971-1995 a total of 1231 samples of industrial water were examined (scrapings and untreated water). From these M. kansasii was isolated in 43.7% (538 specimens). In soil samples (93) and small mouse-like rodents (187) M. kansasii was not detected. The authors confirm that the development of disease depends in a decisive way on the susceptibility of the individual which in turn depends in particular on exposure to dust with possible lung damage and contamination of the atmosphere. In the district there is a high incidence of recurring acute diseases of the airways in children, incl. allergies affecting the airways. In the towns of Karviná, Havírov, Orlová, Bohumín and Ceský Tĕsín there is a high ratio of children with reduced immunity. In November 1981 to January 1982 987 first form pupils were examined for postvaccination TB allergy (standard tuberculin and avian tuberculin were used). The reactivity to avian tuberculin was higher than to standard tuberculin (see results). The highest ratio of intense reactions (30%) was recorded in children from Havírov where there is also the highest specific (and simple) incidence in adults.
- MeSH
- atypické mykobakteriální infekce epidemiologie etiologie MeSH
- dítě MeSH
- dospělí MeSH
- endemické nemoci statistika a číselné údaje MeSH
- hornictví MeSH
- hutnictví MeSH
- incidence MeSH
- kojenec MeSH
- látky znečišťující vzduch škodlivé účinky MeSH
- léková alergie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- Mycobacterium kansasii * MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- surveillance populace MeSH
- tuberkulin škodlivé účinky MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- látky znečišťující vzduch MeSH
- tuberkulin MeSH
The effects of vitamin A (retinolum palmiticum) administered to pregnant mice on the cell-mediated immunity of the offspring were studied in random-bred ICR mice. Delayed-type hypersensitivity (DTH) to sheep red blood cells was assayed after immunization of the control and experimental young in the 4th postnatal week. The administration of vitamin A, in doses of 5,000 IU, on days 15-17 of pregnancy depressed DTH of the female offspring. On the other hand, the administration of single doses of 5,000 and 10,000 IU on the 16th day of pregnancy increased DTH in the offspring. The effects were correlated to the sex and body weight of the offspring, the highest DTH being observed in the female offspring with a low body weight.
- MeSH
- léková alergie etiologie MeSH
- myši inbrední ICR MeSH
- myši MeSH
- pozdní přecitlivělost chemicky indukované MeSH
- těhotenství MeSH
- vitamin A toxicita MeSH
- zpožděný efekt prenatální expozice * MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- vitamin A MeSH
In the introduction to the work the authors deal with the problems of the prevention of flebotromboses in patients operated on in the area of proximal part of the femur. They analyze ways of physical and pharmacological prevention and point out the potential undesirable effects and unusual complications in the treatment by means of Heparin and Kumarin derivatives--and namely the toxoallergic reaction to Heparin and the necrosis of skin and subcutis in case of the application of Kumarin drugs. In Kumarin necrosis the etiology of the which has not been, unequivocally elucidated, yet, they present views on the causes of its origin and describe the course of the Kumarin necrosis. They summarize predispositional factors which increase the risk of its occurrence and present their own observations of two cases. In the discussion they deal with the views on the etiology of the origin of this complication. In the conclusion they recommend the treatment in compliance with the latest findings.
- MeSH
- heparin škodlivé účinky MeSH
- kožní nemoci chemicky indukované MeSH
- léková alergie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nekróza MeSH
- pooperační komplikace prevence a kontrola MeSH
- senioři MeSH
- trombóza prevence a kontrola MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- heparin MeSH
