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Journals Immunology and Allergy Clinics...

Immunology and Allergy Clinics of North America

https://read.qxmd.com/read/37758405/pediatric-and-hereditary-mastocytosis
#21
REVIEW
Joanna Renke, Ninela Irga-Jaworska, Magdalena Lange
To a large extent, the clinical picture of pediatric mastocytosis depends on the age at which it is diagnosed. A neonate with diffuse cutaneous mastocytosis may frequently present in a severe state requiring treatment. Toddlers may require long-term anti-mediator therapy, and this may lead to concerns such as organizing preschool education due to the need for epinephrine injections. A teenager may have to face cutaneous disease persistence or a diagnosis of systemic mastocytosis. Further studies are needed to refine the available treatment options and prognosis for different age groups...
November 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37758404/kit-mutations-and-other-genetic-defects-in-mastocytosis-implications-for-disease-pathology-and-targeted-therapies
#22
REVIEW
Yannick Chantran, Peter Valent, Michel Arock
A KIT activating mutation (usually KIT D816V) is detected in neoplastic cells in greater than 90% of indolent patients with systemic mastocytosis (SM). In more advanced variants of SM, additional genetic defects can be found in several myeloid malignancy-related genes, which can be detected by applying next-generation sequencing. Currently, the techniques recommended to detect the KIT D816V mutation and quantify the mutational burden in peripheral blood, bone marrow, or other organs/tissues are allele specific-quantitative PCR or droplet digital PCR...
November 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37758403/world-health-organization-classification-and-diagnosis-of-mastocytosis-update-2023-and-future-perspectives
#23
REVIEW
Peter Valent, Karl Sotlar, Hans-Peter Horny, Michel Arock, Cem Akin
Experts of the European Competence Network on Mastocytosis (ECNM) and the American Initiative on Mast Cell Disorders have discussed and updated diagnostic criteria and the classification of mastocytosis, based on new insights in the field and data collected in recent years, mostly within ECNM registry projects in which studies on several thousand cases have been performed. Based on this proposal, the World Health Organization has updated its classification of mastocytosis. This article discusses the revised classification of mastocytosis in light of a rapidly moving field and the advent of new diagnostic parameters, new prognostication tools, and new therapies...
November 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394264/anaphylaxis-angioedema-and-other-immunologic-emergencies
#24
EDITORIAL
R Gentry Wilkerson, Salvador Suau
No abstract text is available yet for this article.
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394263/autoimmune-connective-tissue-diseases-systemic-lupus-erythematosus-and-rheumatoid-arthritis
#25
REVIEW
Jonathan Rose
Systemic lupus erythematosus and rheumatoid arthritis are just 2 of several autoimmune connective tissue diseases that are primarily chronic in nature but can present to the emergency department by virtue of an acute exacerbation of disease. Beyond an acute exacerbation of disease, their predilection for invading multiple organ systems lends itself to the potential for patients presenting to the emergency department with either a single or isolated symptom or a myriad of signs and/or symptoms indicative of a degree of disease complexity and severity that warrant timely recognition and resuscitation...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394262/spondyloarthritides
#26
REVIEW
Hope A Taitt, Rithvik Balakrishnan
The spondyloarthritides are a diverse group of distinct yet interrelated disease processes with overlapping clinical features. They are ankylosing spondylitis, reactive arthritis, inflammatory bowel disease-associated arthritis, and psoriatic arthritis. Genetically, these disease processes have been linked by the presence of HLA-B27. They manifest with axial and peripheral symptoms, such as inflammatory back pain, enthesitis, oligoarthritis, and dactylitis. The onset of symptoms can begin before the age of 45; however, because of the wide range of signs and symptoms, diagnosis can be delayed, leading to unchecked inflammation, structural damage, and later, restriction in physical mobility...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394261/sarcoidosis
#27
REVIEW
Denrick Cooper, Salvador Suau
Sarcoidosis has a multitude of manifestations and affects the human body widely. Pulmonary complaints are most common; however, cardiac, optic, and neurologic manifestations carry high mortality and morbidity. Acute presentations in the emergency room can cause life-altering effects if not appropriately diagnosed and treated. Generally, less severe cases of sarcoidosis have a favorable prognosis and can be treated with steroid therapy. Resistant and more severe cases of the disease carry high mortality and morbidity...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394260/immune-based-therapies-what-the-emergency-physician-needs-to-know
#28
REVIEW
Sarah B Dubbs, Cheyenne Falat, Lauren Rosenblatt
Immunotherapy is a treatment modality that has a broad and rapidly growing range of applications to treat both chronic and acute diseases, including rheumatoid arthritis, Crohn disease, cancer, and COVID-19. Emergency physicians must be aware of the breadth of applications and be able to consider the effects of immunotherapies when patients on these treatments present to the hospital. This article provides a review of the mechanisms of action, indications for use, and potential complications of immunotherapy treatments that are relevant in the emergency care setting...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394259/mimics-of-allergy-and-angioedema-scombroid-mast-cell-activation-disorders-and-hereditary-alpha-tryptasemia
#29
REVIEW
Elizabeth G Thomas, Daniel James Thomas
Scombroid poisoning, systemic mastocytosis, and hereditary alpha tryptasemia all present with episodes that resemble allergic reactions. Knowledge regarding systemic mastocytosis and hereditary alpha tryptasemia is quickly evolving. Epidemiology, pathophysiology, and strategies to identify and diagnose are discussed. Evidence-based management in the emergency setting and beyond is also explored and summarized. Key differences are described between these events and allergic reactions.
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394258/hereditary-angioedema
#30
REVIEW
R Gentry Wilkerson, Joseph J Moellman
Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder that usual results from a decreased level of functional C1-INH and clinically manifests with intermittent attacks of swelling of the subcutaneous tissue or submucosal layers of the respiratory or gastrointestinal tracts. Laboratory studies and radiographic imaging have limited roles in evaluation of patients with acute attacks of HAE except when the diagnosis is uncertain and other processes must be ruled out. Treatment begins with assessment of the airway to determine the need for immediate intervention...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394257/angiotensin-converting-enzyme-inhibitor-induced-angioedema
#31
REVIEW
R Gentry Wilkerson, Michael E Winters
Angioedema is a well-recognized and potentially lethal complication of angiotensin-converting enzyme inhibitor (ACEi) therapy. In ACEi-induced angioedema, bradykinin accumulates due to a decrease in its metabolism by ACE, the enzyme that is primarily responsible for this function. The action of bradykinin at bradykinin type 2 receptors leads to increased vascular permeability and the accumulation of fluid in the subcutaneous and submucosal space. Patients with ACEi-induced angioedema are at risk for airway compromise because of the tendency for the face, lips, tongue, and airway structures to be affected...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394256/allergic-acute-coronary-syndrome-kounis-syndrome
#32
REVIEW
Leen Alblaihed, Maite Anna Huis In 't Veld
Acute coronary syndrome (ACS) in the setting of an allergic/immunologic reaction is known as Kounis syndrome. It is an underdiagnosed and underrecognized disease entity. One must keep a high index of suspicions when managing a patient presenting with cardiac as well as allergic symptoms. There are 3 main variants to the syndrome. Treating the allergic reaction may alleviate the pain; however, ACS guidelines should be followed if cardiac ischemia is present.
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394255/evaluation-and-management-of-food-allergies-in-the-emergency-department
#33
REVIEW
Genevieve Schult Krajewski, Thomas Krajewski
Food allergies are a common and serious cause of illness, accounting for an increasing number of emergency department visits annually. Although definite diagnosis lays outside of an emergency department visit, the clinical management of the most serious food allergies highlights emergency care. The staple of acute care remains epinephrine in association with antihistamines and steroids. The greatest threat remains undertreatment for this group of disorders and underutilization of epinephrine. Those who have been treated for a food allergy need a follow-up allergist evaluation, guidance of food avoidance, and avoidance of foods with cross-sensitivities as well as ready access to epinephrine...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394254/drug-hypersensitivity-reactions
#34
REVIEW
R Gentry Wilkerson
Drug hypersensitivity reactions are a diverse group of reactions mediated by the immune system after exposure to a drug. The Gell and Coombs classification divides immunologic DHRs into 4 major pathophysiologic categories based on immunologic mechanism. Anaphylaxis is a Type I hypersensitivity reaction that requires immediate recognition and treatment. Severe cutaneous adverse reactions (SCARs) are a group of dermatologic diseases that result from a Type IV hypersensitivity process and include drug reaction with eosinophilia and systemic symptom (DRESS) syndrome, Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP)...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394253/anaphylaxis-after-the-emergency-department
#35
REVIEW
Nicholas P Gorham
After treating the acute anaphylactic reaction, the clinician's next task is to prevent a recurrence. The patient should be observed in the ED. How long this observation period should last depends on their clinical course, risk factors, and social support. All patients should be discharged with a prescription for 2 epinephrine autoinjectors and counseled on appropriate use. The patient should also receive education on the signs and symptoms of anaphylaxis and avoiding triggers. The patient should follow-up with an allergy specialist who can confirm triggers and provide immunotherapy as indicated...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394252/anaphylaxis-emergency-department-treatment
#36
REVIEW
Kelly McHugh, Zachary Repanshek
Anaphylaxis is a potentially life-threatening, multisystem allergic reaction that can cause airway, breathing, or circulatory compromise. Intramuscular epinephrine is the immediate treatment of all patients. Intravenous epinephrine should be used in patients in shock, either as a bolus or infusion, along with fluid resuscitation. Airway obstruction must be recognized, and early intubation may be necessary. For shock that is refractory to epinephrine, additional vasopressors may be needed. Disposition depends on patient presentation and response to treatment...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37394251/overview-of-allergy-and-anaphylaxis
#37
REVIEW
Timothy E Dribin, Megan S Motosue, Ronna L Campbell
Allergic reactions and anaphylaxis occur on a severity continuum from mild and self-limited to potentially life-threatening or fatal reactions. Anaphylaxis is typically a multiorgan phenomenon involving a broad range of effector cells and mediators. Emergency department visits for anaphylaxis are increasing, especially among children. There is a broad differential diagnosis for anaphylaxis, and the diagnosis of anaphylaxis can be aided by the use of the National Institutes of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network clinical diagnostic criteria...
August 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37055097/interstitial-lung-disease-150-years-of-progress
#38
EDITORIAL
Joshua J Solomon, Kevin K Brown
No abstract text is available yet for this article.
May 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37055096/clinically-relevant-biomarkers-in-connective-tissue-disease-associated-interstitial-lung-disease
#39
REVIEW
Janelle Vu Pugashetti, Dinesh Khanna, Ella A Kazerooni, Justin Oldham
Interstitial lung disease (ILD) complicates connective tissue disease (CTD) with variable incidence and is a leading cause of death in these patients. To improve CTD-ILD outcomes, early recognition and management of ILD is critical. Blood-based and radiologic biomarkers that assist in the diagnosis CTD-ILD have long been studied. Recent studies, including -omic investigations, have also begun to identify biomarkers that may help prognosticate such patients. This review provides an overview of clinically relevant biomarkers in patients with CTD-ILD, highlighting recent advances to assist in the diagnosis and prognostication of CTD-ILD...
May 2023: Immunology and Allergy Clinics of North America
https://read.qxmd.com/read/37055095/post-covid-interstitial-lung-disease-the-tip-of-the-iceberg
#40
REVIEW
Namrata Kewalramani, Kerri-Marie Heenan, Denise McKeegan, Nazia Chaudhuri
The proportion of symptomatic patients with post-coronavirus 2019 (COVID-19) condition (long COVID) represents a significant burden on the individual as well as on the health care systems. A greater understanding of the natural evolution of symptoms over a longer period and the impacts of interventions will improve our understanding of the long-term impacts of the COVID-19 disease. This review will discuss the emerging evidence for the development of post-COVID interstitial lung disease focusing on the pathophysiological mechanisms, incidence, diagnosis, and impact of this potentially new and emerging respiratory disease...
May 2023: Immunology and Allergy Clinics of North America
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