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Medicina
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Pitfalls and Challenges in Allergy Management
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Pitfalls and Challenges in Allergy Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Hematology and Immunology".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 13670

Special Issue Editors

Dr. Marcin Kurowski

E-Mail Website
Guest Editor
Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland
Interests: asthma; exercise-induced bronchoconstriction; allergic rhinitis; food allergy; urticaria and angioedema; molecular allergy diagnostics; biological treatment
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Radosław Gawlik

E-Mail Website
Guest Editor
Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
Interests: allergic diseases; airway obstruction; asthma inflammation; lung diseases; food allergy and hypersensitivity; asthma management exercise-induced allergy syndromes; anaphylaxis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Every allergist in his or her practice has at least once been confronted with a situation when an apparently obvious and easy case turns into a puzzling challenge. A discrepancy between a patient’s history and laboratory IgE results, a lack of efficiency or unusual side effects of the therapy, and an unusual and atypical manifestation of allergic disease (or vice verca) can help to address the question of whether an allergy or asthma mask other conditions.

In the Special Issue of “Medicina”, which is now seeking submissions, you may find the perfect platform to share your clinical experience and theoretical knowledge with the international community of allergists and immunologists.

We strongly encourage you to submit and share case reports, case series, review papers, and orignal papers

describing clinical situations and topics that sometimes bring substantial doubts and difficulties to our daily routine.

This new Special Issue of “Medicina” provides a perfect opportunity for sharing your expertise and knowledge on this topic.

Dr. Marcin Kurowski
Prof. Dr. Radosław Gawlik
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • allergy
  • asthma
  • rhinitis
  • signs and symptoms
  • diagnostic difficulties
  • response to treatment

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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7 pages, 467 KiB  
Article
Assessment of Hypersensitivity to House Dust Mites in Selected Skin Diseases Using the Basophil Activation Test: A Preliminary Study
by Magdalena Krupka Olek, Andrzej Bożek, Aleksandra Foks Ciekalska, Alicja Grzanka and Aleksandra Kawczyk-Krupka
Medicina 2024, 60(10), 1608; https://doi.org/10.3390/medicina60101608 - 1 Oct 2024
Viewed by 1294
Abstract
Background and Objectives: Allergy to dust mites (HDMs) plays an important role in atopic dermatitis (AD). However, the role of this allergy in other dermatoses is little known. The aim of this study was to assess hypersensitivity to HDMs in patients with [...] Read more.
Background and Objectives: Allergy to dust mites (HDMs) plays an important role in atopic dermatitis (AD). However, the role of this allergy in other dermatoses is little known. The aim of this study was to assess hypersensitivity to HDMs in patients with AD or hand disease using the basophil activation test. Material and Methods: A total of 52 patients with AD, 57 with hand eczema disease, and 68 healthy volunteers qualified for this study. Diagnosis was based on the Hanifin and Rajka criteria, dermatological assessment, and exclusion of other dermatoses. The participants underwent skin prick tests (SPTs), a basophil activation test (BAT) with D. pteronyssinus allergen extract, and the concentration of specific IgE (sIgE) for the same allergen in blood serum was determined. Results: Positive results in all tests (SPT, sIgE, and BAT) were obtained (24 (46.2%) patients with AD, 9 (15.8%) with hand disease, and none in the control group for p < 0.05). The results of the SPT, sIgE, and BAT correlated with each other in the AD and hand eczema groups (Spearmen correlation test, r = 0.72 or 0.85, p < 0.05). However, the BAT was positive more often than the SPT and sIgE for D. pteronyssinus. Conclusions: House dust mite hypersensitivity is common in patients with AD and eczema. The BAT may be more sensitive for assessing sensitization to house dust mites, especially in patients with hand eczema. Full article
(This article belongs to the Special Issue Pitfalls and Challenges in Allergy Management)
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Review

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31 pages, 3355 KiB  
Review
Inborn Errors of Immunity Presenting with Early-Onset Severe Atopy
by Nipat Chuleerarux, Nadia Makkoukdji, Travis Satnarine, Jessica Elise Kuhn, Tanawin Nopsopon, Peerada Valyasevi, Fernanda Bellodi Schmidt, Gary Kleiner and Melissa Gans
Medicina 2025, 61(1), 62; https://doi.org/10.3390/medicina61010062 - 2 Jan 2025
Viewed by 1890
Abstract
Inborn errors of immunity (IEIs), also known as primary immunodeficiencies, are a group of genetic disorders affecting the development and function of the immune system. While IEIs traditionally present with recurrent infections, an increasing number of cases manifest with early-onset severe atopy, including [...] Read more.
Inborn errors of immunity (IEIs), also known as primary immunodeficiencies, are a group of genetic disorders affecting the development and function of the immune system. While IEIs traditionally present with recurrent infections, an increasing number of cases manifest with early-onset severe atopy, including atopic dermatitis, food allergies, asthma, and allergic rhinitis—features that are often overlooked. This can lead to delayed diagnosis and treatment, which is crucial for IEI patients due to the risk of severe infections. We conducted a literature search and reviewed all IEIs that can present with early-onset severe atopy. The hallmark features of these disorders often include early-onset, persistent, and severe atopic dermatitis, food allergies, and recurrent episodes of asthma, which may be refractory to treatments. Additionally, we discuss the importance of recognizing such severe atopy as a potential indicator of an underlying immune deficiency, particularly when accompanied by unusual infections, growth failure, or autoimmunity. This review aims to raise awareness of this association and emphasize the need for early diagnosis and genetic testing in patients with atypical or treatment-resistant allergic diseases, allowing for more timely diagnosis of underlying immunodeficiencies and appropriate treatments. Full article
(This article belongs to the Special Issue Pitfalls and Challenges in Allergy Management)
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10 pages, 1191 KiB  
Review
Tryptase: The Silent Witness of Past and Ongoing Systemic Events
by Irena Oštrić Pavlović, Sara Radović, Danka Krtinić, Jelena Spirić, Nataša Kusić, Antonije Veličković and Vesna Tomić-Spirić
Medicina 2024, 60(9), 1380; https://doi.org/10.3390/medicina60091380 - 23 Aug 2024
Viewed by 2057
Abstract
Introduction: Tryptase is an important biomarker widely used in the laboratory confirmation of severe hypersensitivity reactions, especially anaphylaxis. It also plays a crucial role in the diagnosis, risk stratification, management and prognostic evaluation of many other mast cell-related conditions. Aim: This paper aims [...] Read more.
Introduction: Tryptase is an important biomarker widely used in the laboratory confirmation of severe hypersensitivity reactions, especially anaphylaxis. It also plays a crucial role in the diagnosis, risk stratification, management and prognostic evaluation of many other mast cell-related conditions. Aim: This paper aims to highlight the role of serum tryptase, both in allergic disorders and other mast cell-related conditions. Two clinical cases regarding timely serum tryptase acquisition (in drug hypersensitivity reactions during the imaging procedure and perioperative anaphylaxis) are meant to emphasize the clinical potential of this protease. Method: We performed a comprehensive literature search of the PubMed/Medline and Scopus databases. From a total of 640 subject related publications, dating from 1940 to 2024, 45 articles written in English were selected. Literature search results: Total serum tryptase is a simple, cost-effective analysis with a normal baseline tryptase (sBT) level below 8.4 µg/L. Elevated sBT can indicate hereditary alpha-tryptasemia (HαT), mastocytosis and other non-allergic disorders. Patients with higher sBT levels, especially with insect venom allergy, have an increased risk of severe reactions and thereby require a prolonged treatment. All immediate systemic hypersensitivity reactions require a correlation between serum acute tryptase (sAT) and sBT. According to the guidelines, measuring sAT 30 min to 2 h after the symptom onset and sBT 24 h after the resolution, using the 20 + 2 rule and an sAT/sBT ratio of 1.685, improves the diagnostic accuracy in anaphylaxis. Conclusions: Tryptase levels should be acquired in all cases with clinical suspicion of MC degranulation. Given the increasing clinical relevance, elevated baseline serum tryptase levels require a multidisciplinary approach and further investigation. Full article
(This article belongs to the Special Issue Pitfalls and Challenges in Allergy Management)
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10 pages, 917 KiB  
Review
Challenges in Local Allergic Rhinitis Diagnosis, Management, and Research: Current Concepts and Future Perspectives
by Mohamad Mahdi Mortada and Marcin Kurowski
Medicina 2023, 59(5), 929; https://doi.org/10.3390/medicina59050929 - 11 May 2023
Cited by 10 | Viewed by 4614
Abstract
Local allergic rhinitis (LAR) is diagnosed based on the presence of clinical symptoms such as rhinorrhea, sneezing, and nasal itching using negative skin prick testing and serum IgE assessment. Several novel studies have shown that it is possible to use the assessment of [...] Read more.
Local allergic rhinitis (LAR) is diagnosed based on the presence of clinical symptoms such as rhinorrhea, sneezing, and nasal itching using negative skin prick testing and serum IgE assessment. Several novel studies have shown that it is possible to use the assessment of nasal sIgE (specific immunoglobulin E) secretion as an additional diagnostic criterion for local allergic rhinitis. Additionally, allergen immunotherapy is a promising—albeit still not fully assessed and evaluated—future method of managing patients with LAR. In this review, the historical background, epidemiology, and main pathophysiological mechanisms of LAR shall be presented. Additionally, we address the current state of knowledge based on selected articles regarding the assessment of the local mucosal IgE presence in response to exposure to such allergens as mites, pollen, molds, and others. The impact of LAR on quality of life as well as the possible options of management (including allergen immunotherapy (AIT), which showed promising results) will then be presented. Full article
(This article belongs to the Special Issue Pitfalls and Challenges in Allergy Management)
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Other

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6 pages, 267 KiB  
Case Report
Ciprofloxacin-Induced Anaphylactic Reaction Followed by Negative Provocation Test in Response to Levofloxacin: A Case Report
by Marija Kurtov, Paula Kilić, Lucija Ikić, Karlo Kurtov, Gordan Dorčić, Marko Vodanović, Marinko Artuković and Marina Ikić Matijašević
Medicina 2023, 59(10), 1784; https://doi.org/10.3390/medicina59101784 - 7 Oct 2023
Cited by 3 | Viewed by 2917
Abstract
Fluoroquinolones are a commonly prescribed class of antibiotics due to their broad spectrum of antimicrobial activity, favorable pharmacokinetic properties, ability to switch from parenteral to oral administration, and global availability. After beta-lactams, they are the second most common antibiotic class associated with drug [...] Read more.
Fluoroquinolones are a commonly prescribed class of antibiotics due to their broad spectrum of antimicrobial activity, favorable pharmacokinetic properties, ability to switch from parenteral to oral administration, and global availability. After beta-lactams, they are the second most common antibiotic class associated with drug allergies. The mechanism of fluoroquinolone-induced hypersensitivity reactions has not yet been fully understood, so the true incidence of hypersensitivity reactions remains unknown. Cross-reactivity between fluoroquinolones has been the subject of conflicting and limited clinical research. Due to their similar chemical structure, some argue for close cross-reactivity within the group. However, recent studies have produced contradictory results. We present the case of a young patient who had an anaphylactic reaction to ciprofloxacin but was tolerant to levofloxacin, as determined via a skin prick test followed by a drug provocation test. Our findings support the notion that there is little cross-reactivity between fluoroquinolones. Consequently, exposure to another fluoroquinolone in a hospital setting may be beneficial, particularly for patients who lack adequate antibiotic alternatives. However, additional research on this subject is required. Full article
(This article belongs to the Special Issue Pitfalls and Challenges in Allergy Management)
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