Browsing by Author "Faria, E"
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- Adverse drug reactions in adults attending different consultationsPublication . Sousa, N; Machado, D; Faria, E; Chieira, C
- Anafilaxia perioperatória em Coimbra: Experiência da consulta de alergia a fármacosPublication . Faria, E; Sousa, N; Geraldes, L; Santos, A; Chieira, CBackground: The incidence of peri-operative anaphylactic reactions ranges from 1:10,000 to 1:20,000. It is crucial to identify the risk factors, the trigger agent and to fi nd adequate alternatives. Aims: To characterise patients with peri-operative anaphylactic reactions. Methods: We performed a retrospective study of patients with suspected adverse peri-operative reactions to anaesthetic drugs, observed in a Drug Allergy Outpatients Clinic from 1994 to 2005. Anaphylaxis was diagnosed based on the clinical history and skin tests to latex, neuromuscular blocking agents (NMBA), hypnotics, opioids and antibiotics. Specifi c IgE to latex was performed in patients with positive skin-prick-tests. Results: We evaluated the clinical charts of 45 patients with adverse peri-operative reactions, 39 of whom were female. Anaphylaxis was diagnosed in 16 patients (35.6%), 15 females, mean age 36.3 years. The remaining patients had non-anaphylactic (28.8%) or not well-characterised reactions (35.6%). In terms of severity, 50% presented grade III and 50% grade IV anaphylaxis. Skin-prick-tests were positive to latex in three patients and negative to all anaesthetic drugs. Intradermal skin tests were positive in 10 out of 16 patients with anaphylactic reactions: 10 to NMBA [atracurium (n = 8), vecuronium (n = 4), suxamethonium (n = 4) and pancuronium (n = 2)], one to fentanyl, one to thiopental and one to cefuroxime. In three cases, the culprit agent was not identifi ed. In four patients, at least one alternative NMBA, with no skin test reactivity, was found. Of these four patients, two underwent further surgical procedures without adverse reactions. Five patients had previously had two or more anaesthetic procedures and four had presented adverse reactions in prior surgeries. Conclusions: In our study the most common causes of anaphylaxis were NMBAs (62.5%) and latex (18.7%), in line with that described in the literature. In 81% of patients with anaphylactic reactions, skin tests were positive to at least one anaesthetic drug or to latex. A high incidence of severe anaphylaxis was found, probably because cases with less severe clinical signs were not referred to our clinic. The results emphasise the need for systematic evaluation of anaphylactic reactions during anaesthesia. This can be achieved by the creation of a specialised Allergo-Anaesthesia Clinic, as has been the case in our Department.
- Arthritis and X-linked agammaglobulinemiaPublication . Machado, P; Santos, A; Faria, E; Silva, J; Malcata, AB; Chieira, CPrimary immunodeficiencies are defined as genetically determined functional and/or quantitative abnormalities in one or more of the components of the immune system. Immunodeficiency and arthritis can be related, although the mechanisms are not always clear. Different causes for immunodeficiency can secondarily be found in patients with arthritis; on the other hand, arthritis can be a manifestation of primary immunodeficiency. Arthritis occurs chiefly in humoral primary immunodeficiencies, namely in X-linked agammaglobulinemia and common variable immunodeficiency, and may be one of the warning signs for primary immunodeficiency. We report a case of arthritis as the presenting feature of X-linked agammaglobulinemia. In X-linked agammaglobulinemia, arthritis may be a consequence of infection, most notably by Mycoplasma, or of immune dysfunction itself. In children, and occasionally in young adults, a combination of arthritis and hypogammaglobulinemia should suggest primary immunodeficiency, although other causes of hypogammaglobulinemia must be excluded. Physicians evaluating patients with arthritis should be aware of this fact so that an early diagnosis can be pursued as it is of extreme importance in the optimal management and prognosis of these patients.
- Caracterização dos doentes com síndrome de alergia múltipla a fármacosPublication . Faria, E; Carrapatoso, I; Loureiro, C; Todo-Bom, A; Chieira, C
- Chronic rhinosinusitis with nasal polyps in allergic patientsPublication . Sousa, N; Santos, A; Loureiro, G; Tavares, B; Loureiro, C; Faria, E; Chieira, C
- Comparison between skin prick tests and ImmunoCAP ISAC in the determination of sensitisation to aeroallergensPublication . Sousa, N; Almeida, E; Machado, D; Rodrigues, F; Carrapatoso, I; Faria, E; Ribeiro, H; Chieira, C
- Contribution of in vitro methods to the study of fruit allergy clinical patternsPublication . Sousa, N; Carrapatoso, I; Faria, E; Ribeiro, F; Rodrigues, F; Ribeiro, H; Chieira, C
- A Curious Case of Exercise-Induced Wheat Allergy in AdulthoodPublication . Carrapatoso, I; Santos, AF; Faria, E; Segorbe-Luís, A
- Deflazacort: a possible alternative in corticosteroid allergyPublication . Sousa, NG; Faria, E; Carrapatoso, I; Almeida, E; Geraldes, E; Chieira, C