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Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis
Clinical&Experimental Allergy, EarlyView.
Source: Clinical and Experimental Allergy - June 20, 2018 Category: Allergy & Immunology Authors: W. Egner , T. M. Cook , T. Garcez , S. Marinho , H. Kemp , D. N. Lucas , K. Floss , S. Farooque , H. Torevell , M. Thomas , K. Ferguson , S. Nasser , S. Karanam , K. ‐L. Kong , N. McGuire , M. Bellamy , A. Warner , J. Source Type: research

Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project
Conclusions and Clinical RelevanceDiagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres.Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives.
Source: Clinical and Experimental Allergy - September 7, 2017 Category: Allergy & Immunology Authors: W. Egner, T. Cook, N. Harper, T. Garcez, S. Marinho, K. L. Kong, S. Nasser, M. Thomas, A. Warner, J. Hitchman, K. Floss, Tags: ORIGINAL ARTICLE Source Type: research

Specialist Peri ‐Operative Allergy Clinic Services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6)
Conclusions and Clinical RelevanceDiagnostic testing is not harmonised, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres.Poor access to services and patient information provision require attention. Harmonisation of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - August 8, 2017 Category: Allergy & Immunology Authors: William Egner, Tim Cook, Nigel Harper, Tomaz Garcez, Susana Marinho, KL Kong, Shuaib Nasser, Mark Thomas, Amena Warner, John Hitchman, Katharina Floss Tags: Original Article ‐Clinical Allergy Source Type: research

A 17 ‐year experience in perioperative anaphylaxis 1998–2015: harmonizing optimal detection of mast cell mediator release
Conclusions and Clinical RelevanceFuture studies should establish and compare the predictive performance characteristics of each strategy against clinical phenotypes. A single agreed definition of positive serial tryptases is needed to enable robust evaluation of diagnostic strategies. This could serve as a harmonized standard for comparative studies of case series from different centres.
Source: Clinical and Experimental Allergy - September 20, 2016 Category: Allergy & Immunology Authors: W. Egner, R. Sargur, A. Shrimpton, M. York, K. Green Tags: Original Article Source Type: research

A 17 year experience in Perioperative Anaphylaxis 1998 ‐2015: Harmonising optimal detection of Mast Cell mediator release
Conclusion and Clinical RelevanceFuture studies should establish and compare the predictive performance characteristics of each strategy against clinical phenotypes. A single agreed definition of positive serial tryptases is needed to enable robust evaluation of diagnostic strategies. This could serve as a harmonised standard for comparative studies of case series from different centres.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - July 29, 2016 Category: Allergy & Immunology Authors: William Egner, Ravishankar Sargur, Anna Shrimpton, Melanie York, Kevin Green Tags: Original Article ‐Clinical Allergy Source Type: research

Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re‐exposure
Conclusions & Clinical relevanceTime from reaction should be considered when interpreting specific IgE‐results. Specific IgE is >0.35kUA/l in most patients at time of reaction but should be repeated after a few weeks/months if negative. The optimal sampling time seems to be >1 month and <4 months. A value <0.35kUA/l neither excludes allergy nor implies loss of reactivity in previously sensitized patients. Re‐exposures are common, often iatrogenic, and can cause a rebound in specific IgE.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - April 14, 2016 Category: Allergy & Immunology Authors: M S Opstrup, L K Poulsen, H J Malling, B M Jensen, L H Garvey Tags: Original Article ‐Clinical Allergy Source Type: research

General anaesthesia‐induced anaphylaxis: impact of allergy testing on subsequent anaesthesia
Conclusion and Clinical RelevanceOur results confirm the practical impact of allergy testing in general anaesthesia‐induced anaphylaxis. By identification of the allergen, it is possible to avoid allergic anaphylaxis during subsequent anaesthesia. In most cases, recommended pre‐medication seems to prevent the recurrence of non‐allergic drug hypersensitivity reactions.
Source: Clinical and Experimental Allergy - December 23, 2015 Category: Allergy & Immunology Authors: A. Trautmann, C. Seidl, J. Stoevesandt, C. S. Seitz Tags: Original Article Source Type: research

General anesthesia‐induced anaphylaxis: impact of allergy testing on subsequent anesthesia
Conclusion and Clinical RelevanceOur results confirm the practical impact of allergy testing in general anesthesia‐induced anaphylaxis. By identification of the allergen it is possible to avoid allergic anaphylaxis during subsequent anesthesia. In most cases, recommended pre‐medication seem to prevent the recurrence of non‐allergic drug hypersensitivity reactions.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - September 1, 2015 Category: Allergy & Immunology Authors: Axel Trautmann, Cornelia Seidl, Johanna Stoevesandt, Cornelia S. Seitz Tags: Original Article‐Clinical Source Type: research

Clinical and diagnostic features of perioperative hypersensitivity to cefuroxime
ConclusionAll patients with confirmed hypersensitivity to cefuroxime reacted within 15 minutes of administration, but so did 65.5% of cefuroxime negative patients, making timing of administration an unreliable predictor of causation in the perioperative setting. Provocations were always positive when carried out in skin test positive patients; however 8 patients had positive provocations only, highlighting the need for provocation in skin test negative patients.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - November 14, 2014 Category: Allergy & Immunology Authors: I S Christiansen, M Krøigaard, H Mosbech, P S Skov, L K Poulsen, L H Garvey Tags: Original Article‐Clinical Allergy Source Type: research

Predictive value of allergy tests for neuromuscular blocking agents: tackling an unmet need
ConclusionSkin test and BAT have an excellent negative predictive value in our series. The uneventful re‐exposure of rocuronium in patients with an isolated positive sIgE result to rocuronium calls into question the predictive value of this assay and suggests sIgE serology to be less clinically predictive than the functional investigations relying upon activation of mast cells or basophils. The presence of a positive sIgE to substituted ammonium structures such as morphine does not preclude further use of benzylisoquinolines.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - May 21, 2014 Category: Allergy & Immunology Authors: J Leysen, A Uyttebroek, V Sabato, CH Bridts, LS Clerck, DG Ebo Tags: Original Article‐Clinical Allergy Source Type: research

The usefulness of plasma histamine and different tryptase cut‐off points in the diagnosis of peranesthetic hypersensitivity reactions.
ConclusionThe best criterion for discriminating IgE‐ and non IgE‐mediated hypersensitivity reactions in anesthesia was a tryptase value exceeding twice the basal one.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - November 18, 2013 Category: Allergy & Immunology Authors: F Berroa, A Lafuente, G Javaloyes, M Ferrer, R Moncada, MJ Goikoetxea, CM Urbain, ML Sanz, G Gastaminza Tags: Original Article‐Clinical Allergy Source Type: research

Prevalence of IgE against neuromuscular blocking agents in hairdressers and bakers
Conclusion and clinical relevancethe exposure to hair dressing professional occupational factors increases IgE‐sensitization to NMBAs and quaternary ammonium ions compounds used in hairdressing. Beside the pholcodine hypothesis, our study suggests that repetitive exposure to quaternary ammonium compounds used in hairdressing is a risk factor for NMBAs sensitization.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - August 23, 2013 Category: Allergy & Immunology Authors: Siwei Dong, Dovi Stéphanie Acouetey, Rosa‐Maria Guéant‐Rodriguez, Denis Zmirou‐Navier, Thomas Rémen, Miguel Blanca, Paul Michel Mertes, Jean‐Louis Guéant Tags: Original Article‐Clinical Mechanisms in Allergic Disease Source Type: research