Immediate type hypersensitivity

Chen W, Mempel M. Schober W, Behrendt H, Ring 50 J Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 2008 63 1418-1427. 

Himly M, Jahn-Schmid B, Pittertschatscher K, Bohle B, Grubmayr K, Ferreira F, Ebner H, Ebner C IgE-mediated immediate-type hypersensitivity to the pyrazolone drug propyphenazone. J Allergy Chn Immunol 2003 111 882-888. 

For penicillin-allergic (nonanaphylactoid type) patients cefazolin 6 g/24 hours IV in 3 equally divided doses 6 IB Consider skin testing for oxacillin-susceptible staphylococci and questionable history of immediate-type hypersensitivity to penicillin cephalosporins should be avoided in patients with anaphylactoid-type hypersensitivity to P-lactams vancomycin should be used in these cases ... 

Vancomycin is effective and is the drug of choice for the patient with a history of immediate-type hypersensitivity reaction to penicillin. When vancomycin is used, the addition of gentamicin is not recommended. 

If a patient has a mild, delayed allergy to penicillin, first-generation cephalosporins are effective alternatives but should be avoided in patients with an immediate-type hypersensitivity reaction. 

Penicillin G 24 million units/24 h IV in four to six equally divided doses may be used in place of nafcillin or oxacillin if strain is penicillin susceptible (minimum inhibitory concentration 0,1 mcg/mL) and does not produce /5-lactamase vancomycin should be used in patients with immediate-type hypersensitivity reactions to beta-lactam antibiotics (see Table 37-3 for dosing guidelines) cefazolin may be substituted for nafcillin or oxacillin in patients with non-immediate-type hypersensitivity reactions to penicillins... 

In summary, chemical contact sensitization will be favored by the selective activation of Thl and Tel cells, whereas immediate type hypersensitivity reactions such as chemical respiratory hypersensitivity are apparently associated with the preferential activation of Th2 (and possibly Tc2) type cells. 

Abarelix, degarelix Approved for advanced prostate cancer can cause immediate-type hypersensitivity reactions ... 

Insulin allergy, an immediate type hypersensitivity, is a rare condition in which local or systemic urticaria results from histamine release from tissue mast cells sensitized by anti-insulin IgE antibodies. In severe cases, anaphylaxis results. Because sensitivity is often to noninsulin protein contaminants, the human and analog insulins have markedly reduced the incidence of insulin allergy, especially local reactions. 

Goetzl, E.J., Voice, J.K., Shen, S. et al. 2001. Enhanced delayed-type hypersensitivity and diminished immediate-type hypersensitivity in mice lacking the inducible VPAC2 receptor for vasoactive intestinal peptide. Proc Natl Acad Sci USA 98 13854-13859. 

There are two main sensitization reactions-immedi-ate and delayed hypersensitivity. Immediate type hypersensitivity is the result of antibody-allergen interaction occurring in the skin the reaction that develops is known as allergic contact urticaria. Delayed type hypersensitivity is the result of cell-mediated immunity and is the most frequently reported side effect of topical drugs. Both epidermal and dermal cells play pivotal roles in irritation and sensitization. Keratinocytes... 

Shahar E, Krivoy N, Pollack S. Effective acute desensitization for immediate-type hypersensitivity to human granulocyte-monocyte colony stimulating factor. Ann Allergy Asthma Immunol 1999 83(6 Pt l) 543-6. 

Edelman R, Wasserman SS, Kublin JG, Bodison SA, Nardin EH, Oliveira GA, Ansari S, Diggs CL, Kashala OL, Schmeckpeper BJ, Hamilton RG. Immediate-type hypersensitivity and other clinical reactions in volunteers immunized with a synthetic multi-antigen peptide vaccine (PfCS-MAPlNYU) against Plasmodium falciparum sporozoites. Vaccine 2002 21(3-4) 269-80. 

Isolated cutaneous leukocytoclastic vasculitis occurs infrequently in patients taking methotrexate, and an immediate-type hypersensitivity reaction has been thought to be involved, in view of prompt recurrence after drug readministration or a positive mast cell degranulation test as recorded in several patients (SEDA-21, 388) (SEDA-22, 417) (72). 

Negligible cross-reactivity has been reported in both animal and human studies involving hapten inhibition, skin tests, and treatment of penicillin-allergic patients with therapeutic doses of aztreonam (12,14-19). Aztreonam therefore seems to be a safe alternative for patients with penicillin allergy. However, the numbers of safely treated patients reported are still small, and immediate type hypersensitivity to aztreonam has been reported in patients with penicillin allergy (20-23). 

Severe anaphylaxis occurred in an 18-year-old woman and a 15-year-old man when polyhexanide was used to clean surgical wounds (2). Immediate-type hypersensitivity to polyhexanide was suggested by positive skin prick tests. Both patients had previously been exposed to chlorhexidine, but skin tests with chlorhexidine were negative. 

Oxybenzone is the most frequently used benzophenone in sunscreens, estimated to be present in 20-30% of commercial products. Phototoxicity and allergic contact dermatitis have been described, but reports of immediate-type hypersensitivity are scarce. 

Immediate-type hypersensitivity Clarithromycin or azithromycin or trimethoprim-sulfamethoxazole Non immediate-type hypersensitivity / -Lactamase-stable cephalosporin High-dose amoxicillin with clavulanate or / -lactamase-stable cephalosporin... 

Cephalosporins should be avoided in patients with immediate type hypersensitivity to penicillin... 

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