Progestogen Hypersensitivity in 24 Cases: Diagnosis, Management, and Proposed Renaming and Classification

Foer, Dinah; Buchheit, Kathleen M.; Gargiulo, Antonio R.; Lynch, Donna‐Marie; Castells, Mariana; Wickner, Paige G.

doi:10.1016/j.jaip.2016.03.003

Cited by 80 publications

(104 citation statements)

References 24 publications

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“…Oestradiol enhances IgE‐mediated release of b‐hexosaminidase from RBL‐2H3, BMMC and HMC‐1 mast cell lines and enhances IgE‐mediated histamine release from rat uterine mast cells (reviewed in reference ). Also, an autoimmune progesterone dermatitis or progesterone hypersensitivity, characterized by a dermatitis flare related to premenstrual or exogenous progesterone exposure, has been described …”

Section: Resultsmentioning

confidence: 99%

“…Also, an autoimmune progesterone dermatitis or progesterone hypersensitivity, characterized by a dermatitis flare related to premenstrual or exogenous progesterone exposure, has been described. 11,12 Dehydroepiandrosterone (DHEA) and its sulphate derivative (DHEA-S) are weak androgens produced by the adrenal gland that serves as the primary precursor in the biosynthesis of androgens and oestrogens. Kasperska-Zajak et al 13,14 observed a decreased serum concentration of DHEA-S in patients with chronic urticaria, and DHEA-S levels were significantly lower in symptomatic patients as compared to those with disease remission.…”

Section: Clinical Markers Of Severity and Time To Remissionmentioning

confidence: 99%

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Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

Sánchez‐Borges

Caballero‐Fonseca

Capriles‐Hulett

et al. 2017

Acad Dermatol Venereol

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Biomarkers useful for the evaluation and management of patients with chronic spontaneous urticaria (CSU) are not currently available. A review of various clinical and laboratory markers that have been studied to assess their value for determining the severity or predicting the evolution of disease in adult patients with CSU was carried out. A search of the medical literature on PubMed and MEDLINE including the terms urticaria, chronic urticaria, chronic idiopathic urticaria, CSU, severity, prognosis and treatment was performed. Based on our review of the literature, among the clinical markers studied, higher age at onset, being female, long disease duration and aspirin/NSAID hypersensitivity may be linked to both severe CSU and a long time to spontaneous remission. In addition, a positive autologous serum skin test (ASST) may be associated with severe CSU, and comorbidity of inducible urticaria and concomitant recurrent angio-oedema may be linked to longer CSU duration. Potential biomarkers of CSU severity and/or duration include basophil numbers and susceptibility to activation, inflammatory markers, markers of activation of the extrinsic coagulation pathway, immunoglobulin E and vitamin D. Although the described markers are promising, further studies on representative and well-characterized patient populations are needed to determine the value of these clinical and biological markers for predicting the severity and course of disease in patients with CSU.

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Section: Resultsmentioning

confidence: 99%

Section: Clinical Markers Of Severity and Time To Remissionmentioning

confidence: 99%

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

Sánchez‐Borges

Caballero‐Fonseca

Capriles‐Hulett

et al. 2017

Acad Dermatol Venereol

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“…Desensitization today is indicated when patients have HSRs mediated by mast cell activation to their first line therapy without comparable alternatives [3,4,5,26,30,38,39]. Desensitization is achieved by incrementally escalating the sub-optimal doses of the culprit drug until the required dose is reached, and DS induces a temporary tolerance which protects the patient from anaphylaxis [6,23,38].…”

Section: Drug Desensitization: a Revolutionary Approach To The Manmentioning

confidence: 99%

“…In terms of safety and efficacy, previously published data have shown that DS is the best option when indicated. Successful protocols have been described for different HSRs to culprit drugs, for example antibiotics, biologics, chemotherapy, progesterone, as well as many other treatments [6,23,27,39,40,41]. A cost/efficacy analysis was also shown by Sloane et al [6] indicating that DS does not increase health costs compared to standard treatment.…”

Section: Drug Desensitization: a Revolutionary Approach To The Manmentioning

confidence: 99%

Drug Hypersensitivity and Desensitizations: Mechanisms and New Approaches

Vecillas

Alenazy

Garcia-Neuer

et al. 2017

IJMS

Self Cite

113

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Drug hypersensitivity reactions (HSRs) are increasing in the 21st Century with the ever expanding availability of new therapeutic agents. Patients with cancer, chronic inflammatory diseases, cystic fibrosis, or diabetes can become allergic to their first line therapy after repeated exposures or through cross reactivity with environmental allergens. Avoidance of the offending allergenic drug may impact disease management, quality of life, and life expectancy. Precision medicine provides new tools for the understanding and management of hypersensitivity reactions (HSRs), as well as a personalized treatment approach for IgE (Immunoglobuline E) and non-IgE mediated HSRs with drug desensitization (DS). DS induces a temporary hyporesponsive state by incremental escalation of sub-optimal doses of the offending drug. In vitro models have shown evidence that IgE desensitization is an antigen-specific process which blocks calcium flux, impacts antigen/IgE/FcεRI complex internalization and prevents the acute and late phase reactions as well as mast cell mediator release. Through a “bench to bedside” approach, in vitro desensitization models help elucidate the molecular pathways involved in DS, providing new insights to improved desensitization protocols for all patients. The aim of this review is to summarize up to date information on the drug HSRs, the IgE mediated mechanisms of desensitization, and their clinical applications.

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“…Usually after 3 months of trials on medications such as antihistamine, corticosteroids and oral contraceptive pills, desensitisation can be considered on patients’ request or preference of allergists or immunotherapists. In a case series of 24 cases of catamenial anaphylactic patients, near 50% of the patients responds to medications starting from high-dose antihistamines, corticosteroids, combined oral contraceptive pills to IgE monoclonal antibody such as omalizumabs and depot GnRH analogue such as leuprolide 6. In the literature, two patients are managed with oral conjugated oestrogen 7 8…”

Section: Discussionmentioning

confidence: 99%

Catamenial anaphylaxis: a woman under monthly progesterone curse

Rasheed

Lin³

et al. 2018

BMJ Case Reports

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Catamenial or cyclical anaphylaxis is a complex clinical syndrome with poorly reported incidence and prevalence in the literature review. The underlying mechanism is still a myth although a few proposed hypotheses are stated. Early recognition of these symptoms will bring optimal treatment and prevent unnecessary intubation and complications. Here, we present a 48-year-old woman without significant medical and family history with recurrent angioedema in the setting of catamenial anaphylaxis or cyclical anaphylaxis in the setting of progesterone hypersensitivity.

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Progestogen Hypersensitivity in 24 Cases: Diagnosis, Management, and Proposed Renaming and Classification

Cited by 80 publications

References 24 publications

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

Drug Hypersensitivity and Desensitizations: Mechanisms and New Approaches

Catamenial anaphylaxis: a woman under monthly progesterone curse

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