Clinical and functional differences among patients with idiopathic anaphylaxis

被引:0
作者
Alonso, MAT
Domínguez, JS
Sánchez-Hernández, JJ
Frances, CP
Caballer, BD
机构
[1] Hosp Gen Albacete, Secc Alergia, Albacete 02006, Spain
[2] Univ Autonoma Madrid, Fdn Jimenez Diaz, Serv Alergia, Madrid 28040, Spain
[3] Univ Autonoma Madrid, Fac Med, Dept Med Prevent & Salud Publ, Madrid 28030, Spain
关键词
idiopathic; anaphylaxis; angiodema; generalised; codeine; releasability; atopy; urticaria;
D O I
暂无
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: There are no studies assesing whether patients with idiopathic anaphylaxis are a heterogenous population. Objective: A study has been carried out to assess whether clinical and functional differences (mast cell releasability) exist between two sub-types of Idiopathic Anaphylaxis (Generalized Idiopathic Anaphylaxis -IA-G and Idiopathic Anaphylaxis with angioedema -IA-A-) Methods: Patients were selected from the Idiopathic Anaphylaxis (IA) patient population of Hospital General de Albacete (Albacete, Spain) and this data were collected between 1990 and 1995. This series is composed of 81 patients. In the interest of seeing whether an IA classification is warranted between IA-G and IA-A, a logistic regression model was constructed in order to know if differences exist between IA-G and IA-A. To evaluate mast cell releaseability in different groups (IA-G, IA-A, atopic patients, urticaria and healthy subjects) we analyzed the log 10 wheal area produced by four consecutive concentrations of codeine (from 90 to 3,3 mg/ml). In those patients with IA-G, the variable urticaria was controlled, but not in those with IA-A. A parallel line assay was used to study the differenes arising among all groups. When the conditions of parallelism and linearity were not fulfilled, a Hotelling's T2 test was performed. Results: In the logistic regression equation total IgE, with an O.R. of 1.006 (95% C.I 1.001-101) favoured the presence of IA-G; whereas the presence of urticaria did not favour the presence of IA-G, with an O.R. of 0.159 (95% C.I. 0.04-0.507). IA-G and IA-A patients showed a higher cutaneous reaction to codeine than atopic patients: (p=0.005 and p=0.001 respectively). However, IA-G patients had a lower reaction to codeine than those patients with urticaria (p= 0.048). No differences were observed among patients with IA-A and patients with urticaria, as was the case between IA-A and IA-G patients with respect to cutaneous response to codeine. Conclusion: Apparently, IA-G patients appear to be closely related to the presence of atopy, while IA-A patients are closely related to the presence of urticaria. Along with other unknown factors, an enhanced mast cell releaseabiltiy may explain these episodes of Idiopathic Anaphylaxis among atopic patients.
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收藏
页码:177 / 186
页数:10
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