Allergy/Immunology
- Celiac disease in the ‘nonclassic’ patient
Adherence to a strict gluten-free diet is not easy, and even strict adherence does not guarantee relief of all symptoms. We need to be as certain as possible that trying the diet makes sense—and that is the real challenge.
- Celiac disease: Who should I test, and how?
First-degree relatives of patients with celiac disease and patients with dermatitis herpetiformis, type 1 diabetes mellitus, and autoimmune thyroid disease are among those for whom testing is advisable.
- Reincarnating autoimmunity: Immune-related adverse events as new diseases
The range of adverse events is broad. Any organ can be affected, and any naturally occurring autoimmune process can be mimicked by the massive inflammation generated by checkpoint inhibition.
- Oral hyperpigmentation with weakness and salt-craving
The patient’s primary care physician had attributed the hyperpigmentation on the lower lip and inner cheek to pen ink.
- Does my patient need an allergy evaluation for penicillin allergy?
In patients with reported penicillin allergy, obtaining a detailed allergy history directly from the patient is the essential first step.
- Anaphylaxis: Highlights from the practice parameter update
The update addresses diagnostic criteria, treatment options, prevention of recurrences, and patient education on avoiding triggers and using self-injectable epinephrine.
- Anaphylaxis: Expanding our perspective
Anaphylaxis is not always the extreme scenario we learned about in medical school. There is a range of far milder allergic infusion reactions that are nonetheless anaphylaxis.
- A perspective on discussing COVID-19 vaccines: Efficacy and adverse effects
Physicians should be vigilant and open-minded regarding possible adverse reactions to the vaccines, and should take time to discuss the demonstrated efficacy of vaccines with patients.
- COVID-19 vaccine-induced cellulitis and myositis
The day after receiving the second dose of the mRNA vaccine, redness and pain developed at the injection site, eventually involving the whole left arm and shoulder.
- Updated guidelines for immune thrombocytopenic purpura: Expanded management options
The aim is to help practitioners decide on inpatient vs outpatient management, thresholds for initiating treatment, and options for second-line treatment in adults.