Ketotifen use in a patient with fire ant hypersensitivity and mast cell activation syndrome
| Autor: | Kelly H. Simpson, Ashish Asawa, Rana S. Bonds |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Allergy medicine.medical_specialty Allergen immunotherapy Erythema Immunology Mast cell activation syndrome Immunoglobulin E parasitic diseases Anti-Allergic Agents medicine Immunology and Allergy Animals Humans Mast Cells Ketotifen Local Reaction Anaphylaxis Montelukast biology business.industry Ant Venoms Ants Pruritus Syndrome medicine.disease Dermatology Asthma biology.protein Histamine H1 Antagonists Female medicine.symptom business Mastocytosis medicine.drug |
| Zdroj: | Annals of allergy, asthmaimmunology : official publication of the American College of Allergy, Asthma,Immunology. 114(6) |
| ISSN: | 1534-4436 |
| Popis: | A 43-year-old white woman residing in Texas with a medical history of persistent asthma controlled on 2 inhalations of 230 mg of fluticasoneand21mgof salmeterolhydrofluoroalkane twiceadayand 10 mg of montelukast by mouth once a day and allergic rhinitis on allergen immunotherapy presented to an allergy and immunology clinicwithahistoryofasystemic reaction thought tobesecondary toa wood ant (Formica rufa) bite. Immediately after enduring the ant bite, the patient noted erythema, pruritus, and swelling at the bite site. The symptoms rapidly progressed to shortness of breath and wheezing. Diphenhydramine alleviatedher large local reaction andheralbuterol metered dose inhaler resolved her respiratory symptoms. She also noted that occasionally she experienced a non-triggered flushing sensation and cheek erythema not associated with insect bites. Although there has been 1 reported case of an anaphylactic reaction to wood ant,1 it is far less common than hypersensitivity reactions to imported fire ant (IFA). There is no commercially available F rufawhole-body or venom extract to assess for wood ant hypersensitivity. Furthermore, IFA hypersensitivity is a significant cause of insect venom-induced anaphylaxis in the southeastern region of the United States and is endemic in the area in which the patient resides.2,3 Given the rarity of hypersensitivity reactions to wood ants in the literature and the prevalence of IFA and IFA hypersensitivity in the region where the patient resides, the authors assessed for IFA hypersensitivity by checking a specific IFA IgE. A subsequent laboratory evaluation completed by her allergist showed an elevated IFA (Solenopsis invicta) IgE of 1.16 kU/L (positive 0.35 kU/L). Given her history of stinging insect hypersensitivity, her baseline serum tryptase level was checked and was elevated at 13.8 mg/L (normal range 0.4e10.9 mg/L). Owing to her elevated specific IFA IgE and history of systemic reaction to an ant bite, the patient was started on IFA |
| Databáze: | OpenAIRE |
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