Leonor Carneiro-Leão - Academia.edu (original) (raw)

Papers by Leonor Carneiro-Leão

Research paper thumbnail of O papel da Imunoalergologia no apoio a doentes internados ao cuidado de outras especialidades

Revista portuguesa de imunoalergologia, Dec 15, 2022

Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes inter... more Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes internados ao cuidado de outras especialidades. Métodos: Revisão dos pedidos de colaboração realizados ao serviço de IA entre janeiro de 2018 a junho de 2019, através da consulta dos processos clínicos dos doentes, com colheita de dados demográficos, motivo de internamento e do pedido de colaboração, diagnóstico imunoalergológico e orientação. Resultados: Foram identificados 177 pedidos de colaboração correspondentes a 157 internamentos de doentes com idade entre os 7 meses e os 89 anos, 52% dos quais do sexo feminino. Os pedidos mais frequentes resultaram da suspeita de reação de hipersensibilidade a fármacos (83%), seguido de pedidos para apoio na decisão terapêutica e exacerbação de asma. Os 177 pedidos originaram 446 visitas médicas de IA a internamentos (média de 2,6 visitas/ /doente). A suspeita de hipersensibilidade a fármacos foi confirmada em 64% dos casos, com diagnóstico de reações cutâneas graves em 19% e anafilaxia em 6%. A taxa de mortalidade foi de 5,1%, e 46,2% foram posteriormente avalia

Research paper thumbnail of Idiopathic mast cell activation syndrome is more often suspected than diagnosed—A prospective real‐life study

Allergy

BackgroundIdiopathic mast cell activation syndrome (MCAS) is characterized by three diagnostic cr... more BackgroundIdiopathic mast cell activation syndrome (MCAS) is characterized by three diagnostic criteria: (1) episodic mast cell (MC)‐driven signs/symptoms of at least two organ systems in the absence of clonal MC expansion and definite triggers, (2) episodic increase in tryptase, and (3) response to MC‐targeted treatment. Many patients believe they have MCAS, but how often this is the case remains unknown.MethodsWe prospectively investigated patients with suspected MCAS (n = 100) for the diagnostic criteria including baseline tryptase, KIT D816V mutation, and patient‐reported outcome measures (PROMs) over the course of 12 weeks. Comorbid depression and anxiety were explored with the Hospital Anxiety and Depression Scale (HADS).ResultsIn 53% of our patients (80% females), suspicion of MCAS was based on self‐evaluation. In total, patients reported 87 different symptoms, mostly fatigue (n = 57), musculoskeletal pain/weakness (n = 49), and abdominal pain (n = 43), with overall high dise...

Research paper thumbnail of Angioedema: Abordagem Diagnóstica e Terapêutica em Contexto de Urgência

Acta Médica Portuguesa, Apr 1, 2022

Research paper thumbnail of Fish allergy

Annals of Allergy, Asthma & Immunology, 2022

Research paper thumbnail of Effects of Exercise on the Skin Epithelial Barrier of Young Elite Athletes-Swimming Comparatively to Non-Water Sports Training Session

International Journal of Environmental Research and Public Health, 2021

The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine... more The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine and other irritating chemicals that may induce contact dermatitis. To evaluate the effect of a swimming training session on transepidermal water loss (TWEL) in swimmers compared to football players, elite swimmers and football players were invited to participate (58 athletes) in the study, where TEWL was measured before, immediately after, and 30 min after a 2 h training session. The probe was held on the dorsum of the hand, volar forearm, and on the antecubital flexure for 1 min. The volar forearm, antecubital flexure, and hand dorsum showed a significant increase in TEWL in swimmers in both measurements after training compared to baseline (p < 0.001). In football players, an increase in TEWL was observed on the hands’ dorsum between baseline and after training measurements. The variations on TEWL levels before and immediately after the training session were higher among swimmers on...

Research paper thumbnail of Anafilaxia na comunidade - Materiais educacionais

Research paper thumbnail of Anaphylaxis in the community - Educational materials

To improve the knowledge and management of anaphylaxis in Portugal, the Portuguese Society of All... more To improve the knowledge and management of anaphylaxis in Portugal, the Portuguese Society of Allergy and Clinical Immunology (SPAIC) interest group on “Anaphylaxis and Fatal Immunoallergic Diseases” (GANDALF) has produced several educational materials. On this educational page GANDALF presents the poster “Anaphylaxis: Diagnosis and

Research paper thumbnail of Mycoplasma‐induced rash and mucositis with toxic epidermal necrolysis‐like progression

International Journal of Dermatology, 2020

Mycoplasma-induced rash and mucositis with toxic epidermal necrolysis-like progression Dear Edito... more Mycoplasma-induced rash and mucositis with toxic epidermal necrolysis-like progression Dear Editor, Mycoplasma pneumoniae (MP) infection can cause mucocutaneous eruptions in up to one-quarter of all cases. These eruptions are diverse but are typically characterized by moderate-to-severe involvement of at least two mucosal sites and sparse or even absent skin involvement. Recently, mycoplasma-induced rash and mucositis (MIRM) was proposed as a distinct clinical entity, separate from erythema multiforme (EM) and Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN). We present a case that illustrates the challenges in classifying these disorders. A 19-year-old girl, with no relevant medical history or recent drug intake, presented with a 3-day history of odynophagia and conjunctivitis, followed by dysuria, dysphagia, and a pruritic febrile rash. Physical examination revealed confluent typical and atypical raised target lesions with a central blister over the face,

Research paper thumbnail of Anaphylaxis in children and adolescents: The Portuguese Anaphylaxis Registry

Pediatric Allergy and Immunology, 2021

BackgroundAnaphylaxis is increasing at pediatric age; however, its characterization is hampered b... more BackgroundAnaphylaxis is increasing at pediatric age; however, its characterization is hampered by underdiagnosis and underreporting. The aim of this study was to identify the causes of anaphylaxis in children and adolescents in Portugal, thus contributing to a better knowledge of its etiology, clinical manifestations, and management.MethodsDuring a 10‐year period, a nationwide notification system for anaphylaxis was implemented, with voluntary reporting by allergists. Data on 533 patients under 18 years of age with anaphylaxis were included.ResultsMean age was 8.5 ± 4.9 years, 61% were male; 45% had asthma. Mean age at the first anaphylaxis episode was 5.3 ± 4.7 years (ranging from 1 month to 17 years of age), 63% at pre‐school age. Most reactions occurred at home (57%). Food‐induced anaphylaxis was the leading cause (77%). The main culprit foods were cow's milk (32%), tree nuts (16%), shellfish (13%), egg (12%), fresh fruits (11%), fish (8%), and peanut (8%). Other causes incl...

Research paper thumbnail of Real-life experience of an allergy and clinical immunology department in a Portuguese reference COVID-19 hospital

The Journal of Allergy and Clinical Immunology: In Practice, 2020

Research paper thumbnail of Desensitization to carboplatin in low-grade glioma. A revision of 100 treatments in children

Research paper thumbnail of Gestão e plano de contingência do Serviço de Imunoalergologia do Centro Hospitalar e Universitário de S. João no contexto da pandemia por COVID-19

Revista Portuguesa de Imunoalergologia, 2020

Research paper thumbnail of Hymenoptera Venom Allergy Re-Sting reactions

European Annals of Allergy and Clinical Immunology, 2020

Research paper thumbnail of Anafilaxia em Portugal: 10 anos de Registo Nacional da SPAIC 2007-2017

Revista Portuguesa de Imunoalergologia, Jan 3, 2020

" da SPAIC (37%), primeira causa nos adultos, e os venenos de himenópteros (7%). Os principais al... more " da SPAIC (37%), primeira causa nos adultos, e os venenos de himenópteros (7%). Os principais alimentos foram o marisco (crustáceos e/ou moluscos) 27%, frutas frescas 17%, leite 16%, frutos secos 15%, peixe 8%, ovo 7%, amendoim 7% e sementes 3%. Os principais fármacos foram os AINE, 43%, os antibióticos, 39%, e os agentes anestésicos, 6%. Outras causas identificadas foram a anafilaxia induzida pelo exercício, 3%, a anafilaxia induzida pelo látex, a anafilaxia induzida pelo frio e a anafilaxia idiopática, 2%, entre outras. Houve predomínio de manifestações mucocutâneas (96%), seguido de respiratórias (82%) e cardiovasculares (36%). A maioria dos doentes (80%) foi admitida em serviço de urgência, sendo que apenas 43% recebeu tratamento com adrenalina. Ocorreu recorrência da anafilaxia em 41% dos doentes (com ≥ 3 episódios de anafilaxia em 21%), tendo sido o dispositivo autoinjetor de adrenalina utilizado por 7% dos doentes. Conclusões: Os alimentos foram a causa mais frequente de anafilaxia em Portugal, sobretudo em idade pediátrica. Os fármacos foram os principais desencadeantes de anafilaxia na idade adulta. Destaca-se o subtratamento com adrenalina e a recorrência de anafilaxia, apontando para a necessidade de serem implementadas medidas estratégicas e educativas de forma a melhorar a abordagem diagnóstica e terapêutica da anafilaxia.

Research paper thumbnail of Carta ao Editor: Anafilaxia, Diagnóstico e Tratamento

Acta Médica Portuguesa, 2018

Após a anafilaxia, salienta-se a pertinência de uma adequada orientação do doente, 1,2,4 através ... more Após a anafilaxia, salienta-se a pertinência de uma adequada orientação do doente, 1,2,4 através da referenciação urgente para consulta de Imunoalergologia, prescrição de tratamento de emergência e notificação do episódio no Catálogo Português de Alergias e Reações Adversas. 4

Research paper thumbnail of Omalizumab in the Treatment of Hyper-IgE Syndrome: 2 Case Reports

Journal of Investigational Allergology and Clinical Immunology, 2019

Supplementary material Figure 1 (A-D): Dorsum of patient 1, previous to omalizumab-1A-and after 6... more Supplementary material Figure 1 (A-D): Dorsum of patient 1, previous to omalizumab-1A-and after 6 months' follow-up-1B; Dorsum of patient 2, previous to omalizumab-1C-and after 11 months' follow-up-1D.

Research paper thumbnail of The effect of inspiratory muscle training on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers: a randomized controlled trial

Porto Biomedical Journal, 2019

Background: According to studies performed on terrestrial sports athletes, inspiratory muscle tra... more Background: According to studies performed on terrestrial sports athletes, inspiratory muscle training (IMT) may improve athletes’ performance. However, evidence of its effects in elite swimmers is lacking. Therefore, we aimed to assess the effect of 12-week IMT on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers. Methods: Elite swimmers from the main FC Porto swimming team (in competitive training for a minimum period of 3 years) were invited to participate and were randomly allocated into intervention or control groups. The intervention group performed 30 inspiratory efforts, twice a day, 5 times a week, against a pressure threshold load equivalent to 50% of maximal inspiratory pressure, whereas the control group performed inspiratory efforts at the same frequency but against a 15% load. Swimming performance was assessed through time trials, converted into points according to International Swimming Federation Points T...

Research paper thumbnail of How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers

The Journal of Allergy and Clinical Immunology: In Practice, 2019

Omalizumab is an effective treatment for patients with chronic spontaneous urticaria (CSU). In ro... more Omalizumab is an effective treatment for patients with chronic spontaneous urticaria (CSU). In routine clinical practice, physicians often face complex cases of CSU and need to decide whether patients are suitable for omalizumab treatment and how to manage this therapy. Here, we provide evidence and experience-based answers to the most common and important questions on omalizumab treatment of CSU. At 4 large urticaria centers, questions on the use of omalizumab in the treatment of patients with CSU were collected and then ranked by frequency and importance and grouped into top 5 domains using an interactive consensus approach. We suggest that omalizumab can be used to treat patients with CSU with any of the 3 CSU phenotypes (wheals only, angioedema only, wheals and angioedema), with comorbid chronic inducible urticaria, with cancer, who receive other biologics or cyclosporine, or who are pregnant or want to become pregnant, or are breast-feeding. Omalizumab treatment should be started with 300 mg every 4 weeks, monitored with validated patient-reported outcome measures, and maintained, in responders, until remission of CSU. Finally, partial responders or non responders can benefit from omalizumab updosing or adding or switching to cyclosporine. We believe our suggestions on the use of omalizumab in CSU will help to inform clinical decision making. Follow-up efforts should increase, systematically review, and profile the data available and provide evidence-based recommendations on how to best use omalizumab in CSU.

Research paper thumbnail of Identifying SJS/TEN using ICD-9-CM coding – Real or just fantasy?

Allergology International, 2019

Table 1 Demographic and clinical characteristics of the all patients included and patients reclas... more Table 1 Demographic and clinical characteristics of the all patients included and patients reclassified as unlikely and possible SJS/TEN. Characteristic Overall n ¼ 71 Unlikely SJS/TEN y n ¼ 21 Possible SJS/TEN z n ¼ 23

Research paper thumbnail of Bullous Fixed Drug Eruption Caused by Etoricoxib Confirmed by Patch Testing

The Journal of Allergy and Clinical Immunology: In Practice, 2019

Research paper thumbnail of O papel da Imunoalergologia no apoio a doentes internados ao cuidado de outras especialidades

Revista portuguesa de imunoalergologia, Dec 15, 2022

Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes inter... more Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes internados ao cuidado de outras especialidades. Métodos: Revisão dos pedidos de colaboração realizados ao serviço de IA entre janeiro de 2018 a junho de 2019, através da consulta dos processos clínicos dos doentes, com colheita de dados demográficos, motivo de internamento e do pedido de colaboração, diagnóstico imunoalergológico e orientação. Resultados: Foram identificados 177 pedidos de colaboração correspondentes a 157 internamentos de doentes com idade entre os 7 meses e os 89 anos, 52% dos quais do sexo feminino. Os pedidos mais frequentes resultaram da suspeita de reação de hipersensibilidade a fármacos (83%), seguido de pedidos para apoio na decisão terapêutica e exacerbação de asma. Os 177 pedidos originaram 446 visitas médicas de IA a internamentos (média de 2,6 visitas/ /doente). A suspeita de hipersensibilidade a fármacos foi confirmada em 64% dos casos, com diagnóstico de reações cutâneas graves em 19% e anafilaxia em 6%. A taxa de mortalidade foi de 5,1%, e 46,2% foram posteriormente avalia

Research paper thumbnail of Idiopathic mast cell activation syndrome is more often suspected than diagnosed—A prospective real‐life study

Allergy

BackgroundIdiopathic mast cell activation syndrome (MCAS) is characterized by three diagnostic cr... more BackgroundIdiopathic mast cell activation syndrome (MCAS) is characterized by three diagnostic criteria: (1) episodic mast cell (MC)‐driven signs/symptoms of at least two organ systems in the absence of clonal MC expansion and definite triggers, (2) episodic increase in tryptase, and (3) response to MC‐targeted treatment. Many patients believe they have MCAS, but how often this is the case remains unknown.MethodsWe prospectively investigated patients with suspected MCAS (n = 100) for the diagnostic criteria including baseline tryptase, KIT D816V mutation, and patient‐reported outcome measures (PROMs) over the course of 12 weeks. Comorbid depression and anxiety were explored with the Hospital Anxiety and Depression Scale (HADS).ResultsIn 53% of our patients (80% females), suspicion of MCAS was based on self‐evaluation. In total, patients reported 87 different symptoms, mostly fatigue (n = 57), musculoskeletal pain/weakness (n = 49), and abdominal pain (n = 43), with overall high dise...

Research paper thumbnail of Angioedema: Abordagem Diagnóstica e Terapêutica em Contexto de Urgência

Acta Médica Portuguesa, Apr 1, 2022

Research paper thumbnail of Fish allergy

Annals of Allergy, Asthma & Immunology, 2022

Research paper thumbnail of Effects of Exercise on the Skin Epithelial Barrier of Young Elite Athletes-Swimming Comparatively to Non-Water Sports Training Session

International Journal of Environmental Research and Public Health, 2021

The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine... more The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine and other irritating chemicals that may induce contact dermatitis. To evaluate the effect of a swimming training session on transepidermal water loss (TWEL) in swimmers compared to football players, elite swimmers and football players were invited to participate (58 athletes) in the study, where TEWL was measured before, immediately after, and 30 min after a 2 h training session. The probe was held on the dorsum of the hand, volar forearm, and on the antecubital flexure for 1 min. The volar forearm, antecubital flexure, and hand dorsum showed a significant increase in TEWL in swimmers in both measurements after training compared to baseline (p < 0.001). In football players, an increase in TEWL was observed on the hands’ dorsum between baseline and after training measurements. The variations on TEWL levels before and immediately after the training session were higher among swimmers on...

Research paper thumbnail of Anafilaxia na comunidade - Materiais educacionais

Research paper thumbnail of Anaphylaxis in the community - Educational materials

To improve the knowledge and management of anaphylaxis in Portugal, the Portuguese Society of All... more To improve the knowledge and management of anaphylaxis in Portugal, the Portuguese Society of Allergy and Clinical Immunology (SPAIC) interest group on “Anaphylaxis and Fatal Immunoallergic Diseases” (GANDALF) has produced several educational materials. On this educational page GANDALF presents the poster “Anaphylaxis: Diagnosis and

Research paper thumbnail of Mycoplasma‐induced rash and mucositis with toxic epidermal necrolysis‐like progression

International Journal of Dermatology, 2020

Mycoplasma-induced rash and mucositis with toxic epidermal necrolysis-like progression Dear Edito... more Mycoplasma-induced rash and mucositis with toxic epidermal necrolysis-like progression Dear Editor, Mycoplasma pneumoniae (MP) infection can cause mucocutaneous eruptions in up to one-quarter of all cases. These eruptions are diverse but are typically characterized by moderate-to-severe involvement of at least two mucosal sites and sparse or even absent skin involvement. Recently, mycoplasma-induced rash and mucositis (MIRM) was proposed as a distinct clinical entity, separate from erythema multiforme (EM) and Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN). We present a case that illustrates the challenges in classifying these disorders. A 19-year-old girl, with no relevant medical history or recent drug intake, presented with a 3-day history of odynophagia and conjunctivitis, followed by dysuria, dysphagia, and a pruritic febrile rash. Physical examination revealed confluent typical and atypical raised target lesions with a central blister over the face,

Research paper thumbnail of Anaphylaxis in children and adolescents: The Portuguese Anaphylaxis Registry

Pediatric Allergy and Immunology, 2021

BackgroundAnaphylaxis is increasing at pediatric age; however, its characterization is hampered b... more BackgroundAnaphylaxis is increasing at pediatric age; however, its characterization is hampered by underdiagnosis and underreporting. The aim of this study was to identify the causes of anaphylaxis in children and adolescents in Portugal, thus contributing to a better knowledge of its etiology, clinical manifestations, and management.MethodsDuring a 10‐year period, a nationwide notification system for anaphylaxis was implemented, with voluntary reporting by allergists. Data on 533 patients under 18 years of age with anaphylaxis were included.ResultsMean age was 8.5 ± 4.9 years, 61% were male; 45% had asthma. Mean age at the first anaphylaxis episode was 5.3 ± 4.7 years (ranging from 1 month to 17 years of age), 63% at pre‐school age. Most reactions occurred at home (57%). Food‐induced anaphylaxis was the leading cause (77%). The main culprit foods were cow's milk (32%), tree nuts (16%), shellfish (13%), egg (12%), fresh fruits (11%), fish (8%), and peanut (8%). Other causes incl...

Research paper thumbnail of Real-life experience of an allergy and clinical immunology department in a Portuguese reference COVID-19 hospital

The Journal of Allergy and Clinical Immunology: In Practice, 2020

Research paper thumbnail of Desensitization to carboplatin in low-grade glioma. A revision of 100 treatments in children

Research paper thumbnail of Gestão e plano de contingência do Serviço de Imunoalergologia do Centro Hospitalar e Universitário de S. João no contexto da pandemia por COVID-19

Revista Portuguesa de Imunoalergologia, 2020

Research paper thumbnail of Hymenoptera Venom Allergy Re-Sting reactions

European Annals of Allergy and Clinical Immunology, 2020

Research paper thumbnail of Anafilaxia em Portugal: 10 anos de Registo Nacional da SPAIC 2007-2017

Revista Portuguesa de Imunoalergologia, Jan 3, 2020

" da SPAIC (37%), primeira causa nos adultos, e os venenos de himenópteros (7%). Os principais al... more " da SPAIC (37%), primeira causa nos adultos, e os venenos de himenópteros (7%). Os principais alimentos foram o marisco (crustáceos e/ou moluscos) 27%, frutas frescas 17%, leite 16%, frutos secos 15%, peixe 8%, ovo 7%, amendoim 7% e sementes 3%. Os principais fármacos foram os AINE, 43%, os antibióticos, 39%, e os agentes anestésicos, 6%. Outras causas identificadas foram a anafilaxia induzida pelo exercício, 3%, a anafilaxia induzida pelo látex, a anafilaxia induzida pelo frio e a anafilaxia idiopática, 2%, entre outras. Houve predomínio de manifestações mucocutâneas (96%), seguido de respiratórias (82%) e cardiovasculares (36%). A maioria dos doentes (80%) foi admitida em serviço de urgência, sendo que apenas 43% recebeu tratamento com adrenalina. Ocorreu recorrência da anafilaxia em 41% dos doentes (com ≥ 3 episódios de anafilaxia em 21%), tendo sido o dispositivo autoinjetor de adrenalina utilizado por 7% dos doentes. Conclusões: Os alimentos foram a causa mais frequente de anafilaxia em Portugal, sobretudo em idade pediátrica. Os fármacos foram os principais desencadeantes de anafilaxia na idade adulta. Destaca-se o subtratamento com adrenalina e a recorrência de anafilaxia, apontando para a necessidade de serem implementadas medidas estratégicas e educativas de forma a melhorar a abordagem diagnóstica e terapêutica da anafilaxia.

Research paper thumbnail of Carta ao Editor: Anafilaxia, Diagnóstico e Tratamento

Acta Médica Portuguesa, 2018

Após a anafilaxia, salienta-se a pertinência de uma adequada orientação do doente, 1,2,4 através ... more Após a anafilaxia, salienta-se a pertinência de uma adequada orientação do doente, 1,2,4 através da referenciação urgente para consulta de Imunoalergologia, prescrição de tratamento de emergência e notificação do episódio no Catálogo Português de Alergias e Reações Adversas. 4

Research paper thumbnail of Omalizumab in the Treatment of Hyper-IgE Syndrome: 2 Case Reports

Journal of Investigational Allergology and Clinical Immunology, 2019

Supplementary material Figure 1 (A-D): Dorsum of patient 1, previous to omalizumab-1A-and after 6... more Supplementary material Figure 1 (A-D): Dorsum of patient 1, previous to omalizumab-1A-and after 6 months' follow-up-1B; Dorsum of patient 2, previous to omalizumab-1C-and after 11 months' follow-up-1D.

Research paper thumbnail of The effect of inspiratory muscle training on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers: a randomized controlled trial

Porto Biomedical Journal, 2019

Background: According to studies performed on terrestrial sports athletes, inspiratory muscle tra... more Background: According to studies performed on terrestrial sports athletes, inspiratory muscle training (IMT) may improve athletes’ performance. However, evidence of its effects in elite swimmers is lacking. Therefore, we aimed to assess the effect of 12-week IMT on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers. Methods: Elite swimmers from the main FC Porto swimming team (in competitive training for a minimum period of 3 years) were invited to participate and were randomly allocated into intervention or control groups. The intervention group performed 30 inspiratory efforts, twice a day, 5 times a week, against a pressure threshold load equivalent to 50% of maximal inspiratory pressure, whereas the control group performed inspiratory efforts at the same frequency but against a 15% load. Swimming performance was assessed through time trials, converted into points according to International Swimming Federation Points T...

Research paper thumbnail of How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers

The Journal of Allergy and Clinical Immunology: In Practice, 2019

Omalizumab is an effective treatment for patients with chronic spontaneous urticaria (CSU). In ro... more Omalizumab is an effective treatment for patients with chronic spontaneous urticaria (CSU). In routine clinical practice, physicians often face complex cases of CSU and need to decide whether patients are suitable for omalizumab treatment and how to manage this therapy. Here, we provide evidence and experience-based answers to the most common and important questions on omalizumab treatment of CSU. At 4 large urticaria centers, questions on the use of omalizumab in the treatment of patients with CSU were collected and then ranked by frequency and importance and grouped into top 5 domains using an interactive consensus approach. We suggest that omalizumab can be used to treat patients with CSU with any of the 3 CSU phenotypes (wheals only, angioedema only, wheals and angioedema), with comorbid chronic inducible urticaria, with cancer, who receive other biologics or cyclosporine, or who are pregnant or want to become pregnant, or are breast-feeding. Omalizumab treatment should be started with 300 mg every 4 weeks, monitored with validated patient-reported outcome measures, and maintained, in responders, until remission of CSU. Finally, partial responders or non responders can benefit from omalizumab updosing or adding or switching to cyclosporine. We believe our suggestions on the use of omalizumab in CSU will help to inform clinical decision making. Follow-up efforts should increase, systematically review, and profile the data available and provide evidence-based recommendations on how to best use omalizumab in CSU.

Research paper thumbnail of Identifying SJS/TEN using ICD-9-CM coding – Real or just fantasy?

Allergology International, 2019

Table 1 Demographic and clinical characteristics of the all patients included and patients reclas... more Table 1 Demographic and clinical characteristics of the all patients included and patients reclassified as unlikely and possible SJS/TEN. Characteristic Overall n ¼ 71 Unlikely SJS/TEN y n ¼ 21 Possible SJS/TEN z n ¼ 23

Research paper thumbnail of Bullous Fixed Drug Eruption Caused by Etoricoxib Confirmed by Patch Testing

The Journal of Allergy and Clinical Immunology: In Practice, 2019