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  • 1
    ISSN: 1432-1076
    Keywords: Key words Latex allergy ; Spina bifida ; Fruit allergy ; Atopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Type 1 allergy against natural rubber latex is an increasing problem in health care workers and children with spina bifida or urogenital malformations. The aim of our study was to evaluate the prevalence of latex IgE antibodies and cross-reacting fruit antibodies in patients with spina bifida compared with atopic and non-atopic controls. Risk factors for sensitization should be determined. Sera of 148 patients with spina bifida and 98 controls (44 with atopy) were screened for IgE antibodies against latex, banana and kiwi by fluorescence enzyme immunoassay (CAP system). Atopies, allergic symptoms after latex contacts and the number of operations were compiled by a questionnaire. Patients with spina bifida developed latex IgE antibodies (≥0.7 kU/l) more frequently (40.5%) than atopic children (11.4%) or healthy controls (1.9%). All 18 symptomatic patients belonged to the spina bifida group and had high values of latex antibodies. The risk for developing latex antibodies increases with the number of operations. There was no difference in the history of atopic diseases and in a screening test of IgE antibodies against inhalative allergens between latex sensitized and not sensitized children with spina bifida. Antibodies against banana were more frequent in the latex sensitized children with spina bifida. (18.3% vs 3.4%, P = 0.002). Conclusion The high prevalence of latex antibodies in children with spina bifida justifies a primary prophylaxis by avoiding latex contacts, especially during anaesthesia and surgery, a correlation between the number of operations and the development of latex antibodies exists.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 53 (1998), S. 0 
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background The effect of latex prophylaxis has not been investigated in spina bifida children, a high-risk group for latex allergy. As repeated operations have been identified as a major cause of latex sensitization, we wanted to find out whether primary latex prophylaxis during surgery could prevent latex allergy in children with spina bifida. Methods In December 1995, we established latex-free surgery and anesthesia for all patients with spina bifida regardless of their sensitization to latex. Twelve children born after that date (mean age 1.2 years, mean ntmiber of operations 3.3, range 1 -7) were tested for specific IgE against latex until December 1997 (ImmunoCap, Pharmacia, Uppsala, Sweden) and compared with eight children born before December 1995 (mean age 1.3 years, mean number of operations 3.6, range 1–8), in whom a test for latex IgE had been done before the age of 2 years. Results Before we established primary prophylaxis, three of seven children with spina bifida (38%) were sensitized to latex until the age of 2 years. After the establishment of a latex-free operating theater for spina bifida patients, none of the 12 patients were sensitized to latex despite up to seven operations in each child. Conclusions Primary latex prophylaxis during surgery can prevent latex sensitization in young spina bifida patients.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Williams Beuren-Syndrom ; Nierenarterienstenose ; Renovaskuläre Hypertonie ; Key words Williams-Beuren-syndrom ; Renovascular hypertension ; Renal artery stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Patients with Williams-Beuren-Syndrome characterized by the combination of typical morphology, supravalvular aortic stenosis and mental retardation. The typical cardiac malformation, the supravalvular aortic stenosis may be absent. Progressive peripheral vascular lesions as renal artery stenosis, coronary vascular abnormalities and cerebrovascular ischemia were not commonly observed in the past. Case report: We present a 12 year old girl with Williams-Beuren-Syndrome without typical signs of cardiac involvement who developed renovascular hypertension after 9 years of follow up due to stenosis of a renal artery. It was successfully treated by aortorenal bypass. Discussion: In the absence of typical cardiac involvement Patients with Williams-Beuren Syndrome can develop progressive vascular lesions as renal artery stenosis, coronary artery stenosis or cerebro-vascular lesions. Therefore irrespective of cardiac involvement patients with Willliams-Beuren syndrome should be followed up with special regards to this complication.
    Notes: Zusammenfassung Patienten mit Williams-Beuren-Syndrom werden durch die klassischen Symptome der auffälligen Morphologie des Gesichts, der supravalvulären Aortenstenose und der mentalen Retardierung beschrieben. Die klassische kardiale Beteiligung in Form der supravalvulären Aortenstenose kann bei Patienten mit Williams-Beuren-Syndrom fehlen. Unabhängig davon können progressive periphere Gefäßveränderungen bestehen. Diese können z. B. als Nierenarterienstenose, Koronaranomalie oder zerebrovaskuläre Ischämie symptomatisch werden. Fallbericht: Wir berichten über 1 Patientin mit Williams-Beuren-Syndrom ohne die kardiale Veränderung der supravalvulären Aortenstenose, die im Alter von 10 Jahren eine schwere arterielle Hypertonie infolge einer einseitigen Nierenarterienstenose entwickelte. Die Anlage eines aortorenoarterialen Bypasses war eine effektive Behandlung. Diskussion: Auch beim Fehlen der klassischen Symptomen des Williams-Beuren-Syndroms müssen progrediente Gefäßveränderungen rechtzeitig erkannt und als bedeutsame Komplikationen des Krankheitsverlaufs bedacht werden.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 911-911 
    ISSN: 1433-0474
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 145 (1997), S. 109-113 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Carbamazepin ; Hypersensitivitätssyndrom ; Fieber ; Exanthem ; Lymphadenopathie ; Key words Carbamazepine ; Hypersensitivity syndrome ; Fever ; Skin rash ; Lymphadenopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary 2 weeks after initiation of carbamazepine therapy a 3 year old boy presented with skin rash, fever, lymphadenopathy, hepatosplenomegaly and nephritis. After exclusion of infectious diseases our differential diagnosis focussed on carbamazepine induced hypersensitivity syndrome. We found a positive lymphocyte transformation assay and patch test to carbamazepine, indicating a specific response, but no anti-carbamazepine antibody, no circulating immune complexes and no decrease in complement components. The hypersensitivity syndrome refers to a severe hypersensitivity response due to a idiosyncratic reaction. The origin is unknown. The similarity to other multisystem disorders is discussed. Discussion: Not only aromatic antiepileptic agents (carbamazepine, phenobarbital, phenytoin) sulfonamides but as well allopurinol and gold salts are associated with the syndrome. Withdrawal of the drug and treatment with corticosteroids usually lead to complete recovery.
    Notes: Zusammenfassung Wir berichten über einen 3 jährigen Jungen, der 2 Wochen nach Beginn einer antiepileptischen Behandlung an einem Carbamazepin-induzierten Hypersensitivitätssyndrom, bestehend aus therapieresistentem Fieber, polymorphem Exanthem, oropharyngealen Läsionen, generalisierter Lymphadenopathie, Hepatosplenomegalie und Nephritis, erkrankte. Wir fanden positive Lymphozytenstimulations- und Epikutantests auf Carbamazepin als Ausdruck einer spezifischen Überempfindlichkeit. Spezifische Anti-Carbamazepin-Antikörper, zirkulierende Immunkomplexe oder eine Komplementerniedrigung waren nicht nachweisbar. Es handelt sich um eine Überempfindlichkeitsreaktion unbekannter Ätiologie im Sinn einer Idiosynkrasie. Nach Ausschluß infektiöser Ursachen wird die Differentialdiagnose zu anderen Systemerkrankungen erörtert. Diskussion: Neben aromatischen Antikonvulsiva (Carbamazepin, Phenobarbital, Phenytoin) sind Sulfonamide und Goldsalze mögliche Auslöser eines Hypersensitivitätssyndroms. Absetzen des Induktors und systemische Kortikosteroide führen in der Regel zur vollständigen Remission.
    Type of Medium: Electronic Resource
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