Spotlight on Annals
The April issue of the Annals of Allergy, Asthma and Immunology is full of great features for the practicing allergist-immunologist. This month we present two articles which should have particular interest for our readers.
The first addresses the question of whether there might be a relationship between a history of penicillin allergy and the presence of chronic urticaria. Silverman and colleagues performed a retrospective review of over 11,000 medical records to find that the prevalence of self-reported penicillin allergy in urticaria patients was three times that of the general population and the prevalence of urticaria was also three time higher in patients with self-reported penicillin allergy than patients who did not report a penicillin allergy. The authors suggest that an inquiry about penicillin allergy should accompany the workup for chronic urticaria.
The March issue of Annals of Allergy, Asthma and Immunology focuses on issues and findings associated with IgE. As you likely know, 2016 is the 50th anniversary of the discovery of IgE. Two articles help to focus the March issue on what IgE is and what it can do.
In an elegant perspective article, Tom Platts-Mills and colleagues provide a succinct review of the history of IgE – how it was discovered, who was involved and some of the interesting pitfalls and opportunities that shaped the discovery pathway. They then track the development of assay for total and specific IgE that we all use in our routine clinical practices and outline the events due to the expertise and good fortune of the researchers involved.
The February issue of the Annals of Allergy, Asthma and Immunology has an excellent lineup of information for the allergy and immunology specialist interested in updating their knowledge of patient care – both everyday problems and thought-provoking information for future clinical use.
As the world of organized medicine continues to evolve, we as practicing allergists-immunologists are affected by the need to be more efficient and accurate in our diagnostic and therapeutic acumen as well as remembering that disease management is a partnership between us/our staff and the patient/family. In the December issue of the Annals of Allergy, Asthma and Immunology, two articles in particular highlight these issues.
Given our recognition of increased diversity contained within the expanding number of asthma phenotypes, providing optimal care for these patients is becoming increasingly complex. This is particularly true in having modern tools to recognize levels of asthma severity and control as well as increased awareness of cofactors that can make management more challenging. In the November issue of the Annals of Allergy, Asthma and Immunology, there are two articles in particular that address various aspects of this conundrum.
Vitamin D insufficiency/deficiency has become a focal point for multiple studies aimed at showing associations between vitamin D levels and disease activity in rhinitis, asthma, food allergy, atopic dermatitis and others. Eosinophilic esophagitis (EoE) patients are increasingly seen by allergists, primarily for assessment of the potential allergic component to their disease. Noting this background, the authors were interested in determining whether their cohort of EoE patients might have disease associated with vitamin D insufficiency/deficiency. Even though it was a small cohort (n=69 with half children), there was still a significant majority of patients whose vitamin D levels fell into the insufficiency range (median 28.9 ng/dL). This was even truer if the EoE patient was older and larger. The actual allergic association was less robust with the possible exception of peanut sensitization.
The September issue of the Annals of Allergy, Asthma and Immunology, available online and in print September 2, will be an excellent resource for a variety of areas important to the practicing allergist-immunologist. Two articles are of particular note. The first, “Immediate hypersensitivity reactions to corticosteroids,” by Patel et al. is an excellent review of the evidence for that unusual patient who actually has adverse reactions to corticosteroid administration that has an immunological basis. This seeming paradox is described and defended by a surprisingly robust literature. Another article that you will be interested in is a systematic review of the literature on the use of tiotropium in the treatment of asthma.