Allergy/Immunology

As these medications enter the mainstream, understanding the complement system and the benefits and risks of therapeutic blockade has become crucial for optimal patient care.

Now that our understanding of complement has evolved to therapeutic targeting of components of the cascade in a wide range of diseases, it is time to give the complement system another look.

The data and recommendations about corticosteroid pretreatment vary by medication class and the individual medication, necessitating a medication- and patient-specific approach.

It is widely accepted that corticosteroids can partially prevent infusion reactions to intravenous diagnostic and therapeutic agents, but evidence to support this concept is scant.

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.

Misinformation about “sulfa allergy” can result in unnecessary avoidance of useful medications and the prescription of less effective alternatives.

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.

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.

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.

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.