Allergy and Immunology Commons^™

Resolution Of Patient’S Anaphylaxis To The Moderna Covid-19 Vaccine By Desensitization, Stefan M. Pienkowski, Marek M. Pienkowski

HCA Healthcare Journal of Medicine

Introduction

Management of patients with rare anaphylaxis to COVID-19 vaccines creates a challenge. Desensitization to medications and vaccines has proven to be effective in managing anaphylactic reactions in selected individuals with a high benefit-to-risk ratio. A previous report described the successful administration of the Moderna modified messenger RNA (MmRNA) COVID-19 vaccine via a graded dose protocol to a patient with previous anaphylaxis to the MmRNA vaccine. Our report describes successful desensitization to the MmRNA vaccine followed by administration of the full dose MmRNA vaccine.

Case Presentation

A patient with a history of chronic allergies and anaphylaxis due to insect sting …

Management Of Children With Food Allergies By Allergists In The United States, Aikaterini Anagnostou, Matthew Greenhawt, Jay A Lieberman, Christina E Ciaccio, Sayantani B Sindher, Blaine Creasy, Katherine Baran, Sachin Gupta, Anna Nowak-Wegrzyn

Faculty, Staff and Students Publications

BACKGROUND: Management of patients with food allergies is complex, especially in cases of patients with multiple and potentially severe food allergies. Although international guidelines exist for food allergy management, the role of the allergist in the decision-making process is key.

OBJECTIVE: Our aim was to investigate the management patterns and educational needs of practicing allergists treating patients with food allergies.

METHODS: An online survey was e-mailed to United States-based practicing allergists (N = 2833) in November-December 2021. The allergists were screened for managing 1 or more patients (including ≥25% pediatric patients) with food allergies per month. The allergists responded to …

10 Practical Priorities To Prevent And Manage Serious Allergic Reactions: Ga2len Anacare And Efa Anaphylaxis Manifesto, Antonella Muraro, Debra De Silva, Marcia Podesta, Aikaterini Anagnostou, Victoria Cardona, Susanne Halken, Pete Smith, Luciana Kase Tanno, Paul Turner, Margitta Worm, Montserrat Alvaro-Lozano, Stefania Arasi, Anna Asarnoj, Simona Barni, Kirsten Beyer, Lucy A Bilaver, Andrew Bird, Roberta Bonaguro, Helen A Brough, R Sharon Chinthrajah, Emma E Cook, Céline Demoulin, Antoine Deschildre, Timothy E Dribin, Motohiro Ebisawa, Montserrat Fernandez-Rivas, Alessandro Fiocchi, David M Fleischer, Eleanor Garrow, Jennifer Gerdts, Mattia Giovannini, Kirsi M Järvinen, Mary Kelly, Edward F Knol, Gideon Lack, Francesca Lazzarotto, Thuy-My Le, Stephanie Leonard, Jay Lieberman, Michael Makris, Lianne Mandelbaum, Mary Jane Marchisotto, Gustavo Andres Marino, Francesca Mori, Caroline Nilsson, Anna Nowak-Wegrzyn, Mikaela Odemyr, H N G Oude Elberink, Kati Palosuo, Nandinee Patel, Jennifer Pier, Sung Poblete, Rima Rachid, Pablo Rodríguez Del Río, Maria Said, Hugh A Sampson, Angel Sánchez Sanz, Sabine Schnadt, Fallon Schultz, Alice Toniolo, Julia E M Upton, Carina Venter, Brian P Vickery, Berber Vlieg-Boerstra, Julie Wang, Graham Roberts, Torsten Zuberbier, Ga2len Anacare Centres And Efa

Faculty, Staff and Students Publications

This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient-centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals. We encourage healthcare, education and food organisations to collaborate with people at risk of serious allergic reactions to tackle safety, anxiety and financial burdens for individuals and societies. Key priorities for prevention include awareness-raising campaigns for …

Ga2len Anacare Consensus Statement: Potential Of Omalizumab In Food Allergy Management, Torsten Zuberbier, Antonella Muraro, Ulugbek Nurmatov, Stefania Arasi, Katarina Stevanovic, Aikaterini Anagnostou, Roberta Bonaguro, Sharon Chinthrajah, Gideon Lack, Alessandro Fiocchi, Thuy-My Le, Paul Turner, Montserrat Alvaro Lozano, Elizabeth Angier, Simona Barni, Phillippe Bégin, Barbara Ballmer-Weber, Victoria Cardona, Carsten Bindslev-Jensen, Antonella Cianferoni, Nicolette De Jong, Debra De Silva, Antoine Deschildre, Audrey Dunn Galvin, Motohiro Ebisawa, David M Fleischer, Jennifer Gerdts, Mattia Giovannini, Josefine Gradman, Susanne Halken, Syed Hasan Arshad, Ekaterina Khaleva, Susanne Lau, Richard Loh, Mika J Mäkelä, Mary Jane Marchisotto, Laura Morandini, Charlotte G Mortz, Caroline Nilsson, Anna Nowak-Wegrzyn, Marcia Podestà, Lars K Poulsen, Graham Roberts, Pablo Rodríguez Del Río, Hugh A Sampson, Angel Sánchez, Sabine Schnadt, Peter K Smith, Hania Szajewska, Natasa Teovska Mitrevska, Alice Toniolo, Carina Venter, Amena Warner, Gary W K Wong, Robert Wood, Margitta Worm

Faculty, Staff and Students Publications

Immunoglobulin E (IgE)‐mediated food allergies are the most common type of food allergy, often causing rapid symptoms after exposure to allergens posing a serious health risk and a high impact on patient's and caregiver's quality of life. Omalizumab, a humanized anti‐IgE monoclonal antibody, reduces allergic reactions by binding to circulating IgE. Omalizumab has been successfully used in allergic asthma, chronic rhinosinusitis with nasal polyps, and chronic urticaria, and was recently approved for treating IgE‐mediated food allergies by the US Food and Drug Administration (FDA). This GA2LEN ANACARE Consensus Statement presents our position on the use of omalizumab for treating IgE‐mediated …

A Case Of Severe Anaphylactic Reaction After Administration Of Diagnostic-Dose Ferumoxytol In A Pediatric Patient, Fam Ekladious, David Saul

Jefferson Hospital Staff Papers and Presentations

We describe a case of anaphylaxis during administration of intravenous (IV) ferumoxytol as a magnetic resonance imaging (MRI) contrast agent in a 4-year-old patient with complicated past medical history including YARS genetic mutation with resultant liver failure and deceased donor liver transplantation, stage IV chronic kidney disease (CKD), and hypertension. The patient was noted to have labored breathing 4 min after initiation of ferumoxytol infusion and was subsequently rapidly intubated and returned to the intensive care unit (ICU) for monitoring. Anaphylactic reactions to therapeutic doses of ferumoxytol led to issuance of a black box warning by the FDA in 2015. …

Preparing Patients For Oral Immunotherapy (Ppoint): International Delphi Consensus For Procedural Preparation And Consent, Douglas P Mack, Timothy E Dribin, Paul J Turner, Richard L Wasserman, Mariam A Hanna, Marcus Shaker, Mimi L K Tang, Pablo Rodríguez Del Río, Brad Sobolewski, Elissa M Abrams, Aikaterini Anagnostou, Stefania Arasi, Sakina Bajowala, Philippe Bégin, Scott B Cameron, Edmond S Chan, Sharon Chinthrajah, Andrew T Clark, Paul Detjen, George Du Toit, Motohiro Ebisawa, Arnon Elizur, Jeffrey M Factor, Justin Greiwe, Jonathan O'B Hourihane, Sarah W Hughes, Douglas H Jones, Antonella Muraro, Anna Nowak-Wegrzyn, Nandinee B Patel, Amy M Scurlock, Atul N Shah, Sayantani B Sindher, Stephen Tilles, Brian P Vickery, Julie Wang, Hugh H Windom, Matthew Greenhawt

Faculty, Staff and Students Publications

BACKGROUND: Despite the promise of oral immunotherapy (OIT) to treat food allergies, this procedure is associated with potential risk. There is no current agreement about what elements should be included in the preparatory or consent process.

OBJECTIVE: We developed consensus recommendations about the OIT process considerations and patient-specific factors that should be addressed before initiating OIT and developed a consensus OIT consent process and information form.

METHODS: We convened a 36-member Preparing Patients for Oral Immunotherapy (PPOINT) panel of allergy experts to develop a consensus OIT patient preparation, informed consent process, and framework form. Consensus for themes and statements was …

Development Of Ige-Mediated Food Allergies In Children With History Of Food Protein-Induced Allergic Proctocolitis: A Series Of Five Cases, Kim L. Tran, Elizabeth L. Wisner, George M. Jeha, Luke A. Wall

School of Medicine Faculty Publications

Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated allergic condition that presents with hematochezia in otherwise healthy infants. It is most commonly induced by cow's milk protein via breast milk or formula. The prognosis for FPIAP is generally considered favorable with most infants achieving symptomatic resolution after diet modification. Most infants go on to tolerate the offending foods by 1–3 years of age. Over 8 years at our institution, five patients were identified and noted to have FPIAP to cow's milk during infancy with subsequent development of IgE-mediated allergic reaction to cow's milk and other foods. All five cases developed …

Development Of A Mini Pig Model Of Peanut Allergy, Akhilesh Kumar Shakya, Brittany Backus, Lazar D Nesovic, Malini Mallick, Olivia Banister, Carla M Davis, Sara Anvari, Harvinder Singh Gill

Faculty, Staff and Students Publications

INTRODUCTION: The prevalence of peanut allergies is increasing, emphasizing the need for an animal model to enhance our understanding of peanut allergy pathogenesis and to advance diagnostic tools and therapeutic interventions. While mice are frequently used as model organisms, their allergic responses do not fully mirror those observed in humans, warranting the exploration of a higher animal model. The porcine gastrointestinal system closely resembles that of humans, and exhibits allergy symptoms akin to human responses, making pigs a promising model for peanut allergy research.

METHODS: In this study we compared two allergen sensitization protocols involving either topical allergen application after …

Kounis Syndrome – Anaphylaxis-Induced Acute Coronary Syndrome, Austin T. Thacker Do, Brachman Herzig Oms, Brendan Robinson Do, Ahad Anjum Do

Advances in Clinical Medical Research and Healthcare Delivery

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions.

Case Report: Anaphylactic Reaction To Magnesium Sulfate, Nicholas Coan, Kelly Schiers, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 65-year-old female who prior to being discharged from the hospital developed an anaphylactic reaction after receiving an intravenous magnesium sulfate infusion. After extensive literature review, there are few documented hypersensitivity reactions documented. This case report is to highlight a known human response, anaphylaxis, but in response to the repletion of an essential electrolyte to human life, magnesium.

Suspected Anaphylactic Reaction Following Second Dose Of The Pfizer-Biontech (Bnt162b2) Coronavirus Vaccine In A Geriatric Female, Angelina Hong, Giezy Sardinas

HCA Healthcare Journal of Medicine

Anaphylaxis is a rare but serious adverse reaction that can occur following mRNA-based vaccination against coronavirus (COVID-19). This is a case of a geriatric patient presenting with hypotension and an urticarial rash with bullous lesions following a syncopal episode with incontinence. She received the second dose of the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine three days prior, and first developed the skin abnormalities the morning after receiving the vaccine. She had no past history of anaphylaxis or allergies to vaccinations.

Her presentation met the diagnostic criteria for anaphylaxis, according to the World Allergy Organization: she had acute onset illness involving the skin …

An Investigation Of Healthcare Supports For Those With Food Allergy In Ireland, Joseph Bolger, Nicola Blake, Sneha Vinod

International Undergraduate Journal of Health Sciences

Introduction: In Ireland, around 5% of children and 3% adults have food allergy (134,000 people). This current paper describes a survey that was carried out on a subset of service-users with the aim of identifying whether there is a need for increased specialist medical services and/or for a funded charity such as Anaphylaxis Ireland, defunct since 2015.

Materials & Methods: These needs were assessed via an online survey using Google Forms. The survey was conducted from 17-27th February 2020. There were 31 questions in total, relating to topics such as symptoms, clinical wait times, satisfaction with care provided and demand …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021, Iujhs Full Issue

International Undergraduate Journal of Health Sciences

The full June 2021 issue (Volume 1, Issue 1) of the International Undergraduate Journal of Health Sciences

Changing Guidelines: Recommendation Of Early Peanut Introduction For Prevention Of Peanut Allergy In Infants With Severe Eczema, Alexandra H. Zetye

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. New Eng J Med. 2015;372(9):803-813. https://doi.org/10.1056/nejmoa1414850

Anaphylaxis Diagnosis And Management In The Emergency Department Of A Tertiary Hospital In The Philippines, Michelle Joy De Vera, Iris Conela Tagaro

Ateneo School of Medicine and Public Health Publications

Background:
In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.

Objective:
Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.

Methods:
Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the …

Tilapia Consumption And Scombroid Poisoning., Ehizogie Edigin, Prasanth Lingamaneni, Juan Sarmiento, Hafeez Shaka, Sanjay A Patel

Ambulatory and Primary Care Articles

Scombroid poisoning, also known as histamine fish poisoning, typically occurs after eating dark meat fish. Higher levels of histidine, which is converted to histamine, causes anaphylaxis-like symptoms upon ingestion. There are few reported cases of scombroid in humans secondary to light meat fish. We present a case secondary to tilapia consumption.

Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown Phd, Alexei Gonzalez-Estrada Md

Appalachian Student Research Forum

Rationale: The purpose of this study is to investigate the stored stability of dilutions of neuromuscular blocking agents (NMBAs), namely cisatracurium, rocuronium, and vecuronium, for skin prick/intradermal testing.

Methods: Concentrations of NMBAs were monitored by liquid chromatography-mass spectrometry (LC-MS/MS) for a period of 14 days. Dilutions of NMBAs were prepared in saline by factors of 10x, 100x, 1,000x, 10,000x, and 100,000x as sensitivity of the assay allowed. Diluted drug products were stored in a laboratory refrigerator until sampling. On sampling days, aliquots of each dilution were removed and compared to a freshly prepared set of reference dilutions.

Results: The results …

The Effects Of Allergies And Anaphylaxis On The Body And Mind: A Survey Of Opinions And Knowledge On These Disorders, Kathryn E. O'Brien

Honors Program: Student Scholarship & Creative Works

Despite common knowledge, allergies and anaphylaxis are considered disabilities. As such, these disorders affect the daily lives of those who have them, including one's mental health. In this paper, all the nuances of allergies and anaphylaxis will be discussed as the etiology and scientific aspects of allergies, anaphylaxis, and hypersensitivity are distinguished from one another. Furthermore, the findings are reported from two surveys; an assessment of how well educated and prepared teachers are for students with allergies and whether other students with food allergies have had similar experiences to the author's and those described in research by other studies concerning …

Presentation Of Allergen In Different Food Preparations Affects The Nature Of The Allergic Reaction: A Case Series, K. E. C. Grimshaw, R. M. King, Julie A. Nordlee, S. L. Hefle, John O. Warner, J. O.'B. Hourihane

Department of Food Science and Technology: Faculty Publications

Background: Characterization of fatal and nonfatal reactions to food indicates that the majority of reactions are due to the ingestion of prepared foods rather than the nonprocessed allergen. In an ongoing study that used a double-blind placebo-controlled food challenge to investigate peanut allergy and clinical symptoms, the observed reaction severity in four of the first six subjects was greater than anticipated. We hypothesized that this was due to differences in the composition of the challenge vehicle.

Objective: The aim was to investigate whether the severity of observed challenge reactions would be repeated on rechallenge with a lower fat …