Allergy/Immunology
- Alpha-gal syndrome: Recognizing and managing a tick-bite–related meat allergy
Alpha-gal syndrome is an emerging allergic condition in which immunoglobulin E–mediated symptoms are triggered a few hours after an affected person consumes mammalian meat.
- All sulfa drugs are not created equal
Misinformation about “sulfa allergy” can result in unnecessary avoidance of useful medications and the prescription of less effective alternatives.
- Can my patient with a ‘sulfa allergy’ receive celecoxib or other nonantimicrobial sulfonamides?
There is no cross-reactivity between antimicrobial and nonantimicrobial sulfonamides, and patients with a history of immunoglobulin E–mediated reaction to a sulfonamide antibiotic can receive nonantimicrobial sulfonamides.
- 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.