Browsing by Author "Fernandes, Mara"
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- Chlorhexidine: a hidden life-threatening allergenPublication . Fernandes, Mara; Lourenço, Tatiana; Lopes, Anabela; Spínola Santos, Amélia; Pereira Santos, Maria Conceição; Pereira Barbosa, ManuelChlorhexidine is a commonly used antiseptic and disinfectant in the health-care setting. Anaphylaxis to chlorhexidine is a rare but potentially life-threatening complication. Epidemiologic data suggest that the cases of chlorhexidine allergy appears to be increasing. In this article we report a life-threatening anaphylactic shock with cardiorespiratory arrest, during urethral catheterization due to chlorhexidine. The authors also performed a literature review of PubMed library of anaphylactic cases reports due to this antiseptic between 2014 and 2018, demonstrating the increase in the number of cases occurring worldwide and the importance of detailed anamnesis and appropriate diagnostic workup of allergic reactions to disinfectants.
- Contribution of molecular diagnosis to bee venom allergic patients with systemic reactions during the build-up phase of bee venom immunotherapyPublication . Lourenço, Tatiana; Fernandes, Mara; Lopes, Anabela; Pedro, Elisa; Barbosa, Manuel Pereira; Santos, M. Conceição PereiraIntroduction: Bee venom (BV) allergy is one of the most common causes of severe anaphylaxis. Venom immunotherapy (VIT) is considered the most effective treatment, but systemic reactions may occur. This study aimed to characterize the sensitization profile by molecular components of patients with BV anaphylaxis under VIT and to evaluate whether systemic reactions during the build-up phase of VIT protocol are related to different sensitization patterns. Methods: A retrospective study of 30 patients under VIT for 1 year. The group of patients who reacted during the build-up phase (group A) was compared with the group with no reactions (group B). Specific IgE (sIgE) and IgG4 (sIgG4) for BV and recombinants (rApi m1, rApi m2, rApi m3, rApi m5, and rApi m10) were evaluated before and 1 year after VIT. Statistical analysis was performed using GraphPad Prism v5.01. Results: Men accounted for 80% of the sample, and mean age was 47 years (14-74 years). Group A consisted of 10 patients, and group B of 20 patients. Before VIT, sIgE to rApi m1 was detected in 86.7% of patients, rApi m2 in 46.7%, rApi m3 in 16.7%, rApi m5 in 43.3%, and rApi m10 in 70%. Positive results to at least 1 BV allergen were detected in 100%; 73% of patients were sensitized to >1 allergen, and 13.3% to all allergens. The profile of the two groups did not differ significantly before VIT, but group B showed a significant decrease in whole BV extract (p=0.045), rApi m 3 (p=0.017), and rApi m 10 (p=0.021) 1 year after VIT. Regarding sIgG4, there was a significant increase in rApi m1, which was not observed in other allergens, such as rApi m3 and rApi m10. Conclusion: The analysis of a panel of BV recombinants can improve diagnostic sensitivity, when compared to rApi m1 alone. There was no association between systemic reactions during the build-up phase of VIT and molecular sensitization profile. Nevertheless, it is important to study a greater number of patients.
- Síndrome alfa-gal: Dois casos clínicosPublication . Fernandes, Mara; Sousa, Filipa; Câmara, RitaIntrodução: Os casos descritos de alergia a carnes vermelhas têm vindo a aumentar e estão relacionados com a sensibilização à galactose -α -1,3 -galactose (alfa -gal). Casos clínicos: Os autores descrevem dois casos de alergia a carnes vermelhas por sensibilização a alfa -gal. Caso A: Sexo masculino, 47 anos, antecedentes de atopia, com vários episódios de urticária generalizada e angioedema do lábio entre 30 minutos a 6 horas após ingestão de carnes verme lhas. Os testes cutâneos foram positivos para carnes vermelhas e as IgE específicas positivas para carne de porco, vaca e alfa -gal. Caso B: Sexo masculino, 42 anos, sem antecedentes de atopia, com urticária generalizada e sensação de edema da orofaringe 6 horas após ingestão de carne de porco (> 10 episódios). Os testes cutâneos foram positivos para carne de porco e as IgE específicas positivas para carne de porco, vaca e alfa -gal. Após evicção de carnes verme lhas nenhum doente voltou a apresentar sintomas.
- Subcutaneous immunotherapy with aeroallergens - evaluation of adherence in real lifePublication . Lourenço, Tatiana; Fernandes, Mara; Lopes, Anabela; Pedro, ElisaIntroduction. Adherence in allergen immunotherapy is crucial for its efficacy. At least 3 years of treatment are recommended for achieving a long-term modifying effect. Objectives. To assess patient’s adherence and to identify determinant factors for allergen subcutaneous immunotherapy (SCIT) suspension in patients with respiratory allergy. Methods. Retrospective analysis of the medical record of patients submitted to SCIT between January 2013 and December 2016 in our Department. Results. 323 patients were included: 52% female; mean age 30 ± 13 years; average treatment time 19 ± 13 months. 52 patients (16%) stopped SCIT: 54% female; mean age 30 ± 9 years; average treatment time 12 ± 6 months; 67% dropped the treatment during the 1st year, 27% in the 2nd and 6% during the 3rd year of treatment. Adherence rate determined was 77%. The most frequent reasons for withdrawal were due to economic reasons (47.9%), followed by patients’ perception of no clinical improvement (23%) and change to sublingual immunotherapy (11.6%). Conclusion. Adherence rate in our study was 77%. Economic reasons were the main cause of abandonment in the first year, while the perception of non-improvement was the main reason for abandonment in subsequent years. Adequate information on SCIT prescribing and rigorous monitoring of patients during the treatment can improve adherence.