A Protocol for Induction of Tolerance to Apomorphine in Patients With Parkinson Disease and Hypersensitivity to Apomorphine

D Gutiérrez-Fernández, A Moreno-Ancillo, A Foncubierta-Fernández, F Medina-Varo, JA Andrés-García, MJ Fernández-Anguita
2016 Journal of investigational allergology & clinical immunology  
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more » ... ta R, Angel-Pereira D, Ureña-Tavera A, Zamora-Verduga M, Lopez-Gonzalez P, Berges-Gimeno MP. Delving into cornerstones of hypersensitivity to antineoplastic and biological agents: value of diagnostic tools prior to desensitization. Allergy. 2015;70(7):784-94. 4. Castells MC, Tennant NM, Sloane DE, Hsu FI, Barrett NA, Hong DI, Laidlaw TM, Legere HJ, Nallamshetty SN, Palis RI, Rao JJ, Berlin ST, Campos SM, Matulonis UA. Hypersensitivity reactions to chemotherapy: outcomes and safety of rapid desensitization in 413 cases. J Allergy ClinImmunol. 2008;122(3):574-80. 5. Abu-Amna M, Hassoun G, Hadad S, Haim N, Bar-Sela G. Successful Desensitization Protocol for Hypersensitivity Reaction Caused by Irinotecan in a Patient With Metastatic Colorectal Cancer. Clin Colorectal Cancer. 2015;14(4):e49-51. 6. Castells Guitart MC. Rapid drug desensitization for hypersensitivity reactions to chemotherapy and monoclonal antibodies in the 21st century. J Investig Allergol Clin Immunol. 2014;24(2):72-9. 7. Breslow RG, Caiado J, Castells MC. Acetylsalicylic acid and montelukast block mast cell mediator-related symptoms during rapid desensitization. Ann Allergy Asthma Immunol. 2009;102(2):155-60. immunoblotting assay. In addition, after the allergic reaction, all patients tolerated poultry meat, indicating that a-livetin (quail albumin) was not involved in any of these cases. The difficulty in obtaining a QE yolk sample without QE white contamination, as reported elsewhere [7], could explain the positive results for QE yolk in the SPPT and immunoblotting assay. Although allergy to QE-with or without HE sensitivityhas been reported [2,3,8,9], ours is the first case series in which the causative proteins were identified. We found only 1 case of non-IgE-mediated food hypersensitivity reaction to QE [10]. In conclusion, in the 5 patients we report, the main QE allergen is ovalbumin. Although proteins from HE and QE showed cross-reactivity, patients commonly tolerate HE consumption even when they have QE allergy. Since patients with QE allergy can show different HE skin test results (positive SPT and/or SSPT and/or specific IgE to HE proteins, with good tolerance to HE), these results should not be used to predict intolerance to HE.
doi:10.18176/jiaci.0081 pmid:27763862 fatcat:t7hwiwmnwjh2zi2j4cqhwc3nda