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Current Allergy & Clinical Immunology
Current Allergy and Clinical Immunology is the official journal of the Allergy Society of South Africa and is produced as a service to understanding and communication in the field of allergy.
| Publisher | Allergy Society of South Africa (ALLSA) |
|---|---|
| Frequency | Quarterly |
| Coverage | Vol 18 Number 2 Jun 2005 - current |
| Accreditation(s) |
Department of Higher Education and Training (DHET) |
| Language | English |
| Journal Status | Active |
| Collection(s) |
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ALLSA 2017 congress report
More LessThe 26th Annual Congress of the Allergy Society of South Africa (ALLSA) took place at the Boardwalk Hotel in Port Elizabeth in September 2017.
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Successful desensitisation of non-immune type symptoms secondary to salicylate hypersensitivity/intolerance
More LessIntroduction: Salicylate allergy/intolerance is a well-described entity that may present with typical hypersensitivity symptoms such as rhinitis, wheezing and urticaria or non-immune-type features such as headache, migraine, fatigue and abdominal cramps. Whereas aspirin desensitisation has been associated with success in patients presenting with Samter’s triad of recurrent nasal polyps, asthma and aspirin sensitivity, the procedure has not been described in patients presenting with atypical or non-hypersensitivity-type symptoms.
Case report: A 48-year-old female presented with a two-year history of chronic headaches, migraines, fatigue and occasional upper-body myoclonic jerk-like movements upon exposure to a host of sodium salicylatecontaining foods and beverages. The Flow-Cellular Antigen Stimulation Test (CAST) (Bühlmann Laboratories AG, Schönenbuch, Switzerland) for sodium salicylate was positive (stimulation index-3.9 [normal <2], percentage basophils-6.4% [normal <5%]). Aspirin desensitisation was successfully conducted in the ICU over a two-day period. At one month follow-up, she reported complete tolerance of salicylate-containing foods as well as a much better quality of life (QoL).
Discussion: Salicylate hypersensitivity/intolerance presenting with atypical or non-hypersensitivity-type symptoms may be successfully treated with aspirin desensitisation, resulting in a significant improvement in QoL.
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A primary immunodeficiency diseases odyssey – answer from the exome in a case with immunodeficiency and autoimmunity
More LessObjectives: To illustrate the use of whole exome sequencing (WES) in the diagnosis of an unidentified primary immunodeficiency disease (PID) with a complex clinical phenotype of severe infections and autoimmunity.
Methods: Stored DNA from a 14-year-old deceased female of mixed racial ethnicity, treated for five years for an unidentified PID, was referred for WES to establish a post-mortem diagnosis. Previous laboratory investigations failed to confirm a PID diagnostic category. DNA extracted from whole blood was subjected to WES for the identification of potential disease-causing mutations. Variants of interest were confirmed by Sanger sequencing to ensure that they were not sequencing artefacts.
Results: A total of six PID candidate variants in five different genes were identified using WES and an in-house bioinformatics software package. A compound heterozygous variant was identified in the gene encoding the Lipopolysaccharide-responsive beige-like protein (LRBA). This gene has been associated with combined immunodeficiency (CID) previously classified as combined variable immunodeficiency disorder (CVID).
Conclusions: Next-generation sequencing (NGS) technologies such as WES are essential complementary investigations in the diagnosis of PIDs that manifest with a wide spectrum of phenotypes. Plausible candidate variants associated with a specific phenotype may be rapidly and cost-effectively identified by WES, and correct diagnosis can assist with targeted treatment. Candidate variants of unknown pathogenicity will, however, require detailed functional validation in the investigation of more complex and rare PIDs.
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Complement deficiency
More LessThe paediatrician, Dr Goodheart, is called to an urgent consultation in the Casualty section of her hospital. She has to review a four-year-old boy, Pieter, for possible intensivecare unit (ICU) admission. He was brought in by ambulance, referred by his local clinic for suspected meningococcal infection. Pieter had presented to the clinic with a one-day history of fever and confusion. A petechial rash was noted on the trunk and legs on the day of the clinic visit.
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The mast cell and IgE
More LessDr Do-a-lot asks her students to write short notes on the role that mast cells and immunoglobulin E (IgE) play in allergic inflammation.
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© Publisher: Allergy Society of South Africa (ALLSA)
© Publisher: Allergy Society of South Africa (ALLSA)