Nov 2021
Sanavi SuzanCorresponding author
Abourayhan Polyclinic, Social Security Organization
A case report describes urticaria as an initial manifestation of COVID‑19. It outlines clinical course, differential diagnosis, and implications for testing and isolation.
May 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1059
I. Scott MRCS SusanneCorresponding author
Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen.
Allergic angioedema of the airways is a potentially life-threatening condition. The allergen can be difficult to identify. Treatment in the acute phase comprises of antihistamines, steroids, adrenaline and in severe cases prophylactic intubation. Allergic angioedema can be encountered in all medical specialties including odontology. It can develop fast and emergency treatment is lifesaving. Knowledge of symptoms and emergency treatment is important. We present a case of a 33-year-old female physician who in a matter of hours developed first an atypical urticarial eruption followed by angioedema of the upper airways. She was treated with antihistamines, as she refused other treatments due to lactation. The patient also refused further investigations, however she has not had any further episodes after discontinuing the ingestion of organic tea. Allergic reactions are unpredictable and have a large variety of triggers. The most likely trigger in this case was fungicide in the organic tea.
Sep 2022 DOI 10.14302/issn.2641-4538.jphi-22-4238
Bavbek SevimCorresponding author
Department of Chest Disease, Division of Allergy and Clinical Immunology, Ankara University, School of Medicine, Ankara, Turkey
The safety of cyclooxygenase (COX)-2 inhibitors has been tested in patients who had cross-reactive hypersensitivity reactions (HSRs) to nonsteroidal anti-inflammatory drugs (NSAIDs). However, these studies have been mainly done before the current classification of NSAID hypersensitivity and cross-reaction between COX-2 inhibitors has been rarely reported.We aimed to assess tolerability of COX-2 inhibitors and to evaluate the cross-reactivity between them in cross-reactive phenotype of NSAID hypersensitivity. The diagnosis was based on clinical features, reliable history of HSRs to at least two chemically different NSAIDs, and/or positive provocation tests with implicated NSAIDs in 151 patients. Single-blind, oral challenges with 1/4 and 3/4 divided doses of placebo, nimesulide, meloxicam, and celecoxib, as COX-2 inhibitors, were performed. The most common cross-reactive phenotype was NSAID-induced urticaria/angioedema (56.3%). Positive reactions to meloxicam, nimesulide, and celecoxib challenges were observed in 23/140 (16.4%), 7/33 (21.2%), and none of six patients, respectively. Overall, 24 patients were tested with two, one was tested with three COX-2 inhibitors. Six (31.6%) of 19 patients with meloxicam intolerance reacted to nimesulide provocation. Nimesulide, meloxicam, and celecoxib appeared safe alternatives in cross-reactive phenotypes of NSAID hypersensitivity. Although celecoxib has the most favorable tolerability, cross-reactivity among COX-2 inhibitors seems to be possible.