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A 35-year-old female, professional diver, reported nausea, vomiting, and systemic hives 20 to 30 minutes after ingestion of antipasto made with jellyfish. Patient reported prior episodes of swelling after stings from several different creatures, including jelly fish. She also developed a systemic allergic reaction after sting from an unknown creature while diving. On the initial visit to our hospital, serum total IgE level was 545IU/ml. We extracted crude allergen from jellyfish and evaluated allergen specific IgE antibody levels using ELISA. Patient samples showed higher levels of jellyfish-derived allergen specific IgE than healthy control samples. Basophils were isolated from the peripheral blood of patient. Stimulation with jellyfish-derived allergen showed expression of surface antigens on basophils increased in a concentration-dependent manner. Methods using sodium dodecyl sulfate poly acrylamide gel electrophoresis and immunoblotting showed acid-soluble collagen fraction from jellyfish contained above 250kDa weighed protein that may have caused this current event. A provocation test using jellyfish samples was not performed due to risk of anaphylactic shock. The patient was diagnosed with a jellyfish allergy due to IgE mediated anaphylaxis after ingestion. She was asked to refrain from consuming any food containing jellyfish. IgE-mediated food allergy caused by jellyfish is rare worldwide. Collagen was speculated to be an allergen in this study. Additional study to detect specific allergens related to jellyfish allergy would be particularly useful to specify disease phenotypes and individual care in future.

Basophils represent less than 1% of peripheral blood leukocytes. Under physiological conditions, basophils principally circulate in peripheral blood, while mast cells reside in peripheral tissues. Like mast cells, they express the high-affinity IgE receptor on their cell surface and release chemical mediators. Because of morphological and functional similarities, basophils have long been considered to be redundant "circulating mast cells" and minor (probably negligible) players in inflammation. Mouse and human basophils cannot be stained in routinely processed histological specimens, and thus, our understanding of tissue basophils in allergic inflammation had been limited. However, recent studies in mice have revealed that basopihls play non-redundant roles from mast cells. Basophils function as a source of IL-4, IL-13, and CCL22, thereby contributing Th2 immunity. They are also capable of presenting antigens. Basophils are essential for the development of IgE-mediated chronic allergic skin inflammation in mice. Recent immunohistochemical studies with an basophil-specific antibody revealed that, in humans, varying numbers of basophils infiltrate skin lesions of inflammatory diseases, such as atopic dermatitis, urticaria, prurigo, and eosinophilic pustular folliculitis. Basophils may play important roles in a variety of inflammatory skin diseases than previously thought.

Background: We experienced three cases of patients who suffered from systemic urticaria and systemic symptoms such as general fatigue and dyspnea which occurred just after the sting of centipede. The result of prick test by centipede venom revealed positive reaction in all three patients, so we diagnosed the symptoms of them as immediate type allergic reaction against centipede venom. And more there have been some reports documented the relationship between centipede allergy and bee allergy, so we added the examination about bee allergy on these three patients., Methods: The measurement of bee venom specific IgE was practiced on all three patients and intradermal skin test about bee venom was done only on one patient. Moreover we also practiced prick test of centipede venom against another three patients who were diagnosed as having bee allergy., Results: All patients of centipede allergy showed positive reaction for the specific IgE antibody of Wasp and/or Honeybee and one patient who was practiced skin test also reacted positively against Wasp and Yellow Jacket venom. But none of three patients of bee allergy showed positive reaction against centipede venom., Conclusion: According to these results we suspected that there lies some relationship between centipede allergy and bee allergy. But it is supposed that only little involvement of centipede allergy was concerned among the patients of bee allergy. Until now there have been only a few reports as to the centipede allergy. But actually we guess it may be the phenomenon that could occur frequently.

Anisakis-specific IgE (AsIgE) was examined in 84 cases of acute urticaria (AU) and 100 cases of atopic dermatitis (AD). Gender, age, disease category (AU or AD) and serum IgE value of the patients were compared with AsIgE. Univariate analysis showed that there was significant correlation between age and AsIgE, and between serum IgE and AsIgE. Serum IgE was significantly higher in AD than in AU. Age was significantly higher in AU than in AD. AsIgE was positive value in 26 cases (31%) of AU and 25 cases (25%) of AD. There were no significant differences between them. In these cases, however, AsIgE was significantly higher in AU than in AD. Percentage of patients with high AsIgE value (> class 2) was significantly higher in AU (20 cases, 24%) than in AD (3 cases, 3%). Multivariate analysis using discriminant analysis and logistic regression analysis showed that the most influential factor on AsIgE was disease category (relative risk = 16.87), and the second was age (relative risk = 1.05). Serum IgE and gender were considered not to influence on AsIgE. It is possible that Anisakis or related antigens have something to do with urticaria in AU patients with high AsIgE value.

Objects: Many studies show that sulfites cause multiple atopic manifestations by oral challenge in USA and Europe, however, there are few reports of sulfites sensitivity in Japan. The aim of this study establishes the presence of sulfites hypersensitivities in asthmatic subjects in Japan., Subjects and Method: Twenty adult asthmatic patients, who were non-steroid-dependent and without a suggestive history of sulfite sensitivity, underwent challenge with oral solution of metabisulfite., Result: Of 12 patients reacted to metabisulfite. They demonstrated airway obstruction 5 (41.7%), urticaria 4 (36.7%), skin manifestation 2 (16.7%) and nasal congestion 1 (8.3%). All patients who demonstrated airway obstruction, were sensitive to aspirin., Conclusion: Oral sulfite challenge should be made in patients with urticaria, that are not able to find out causative antigen, even though no suggestive history of sulfite sensitivity.

We report a case of hypocomplementemic urticarial vasculitis syndrome (HUVS) with membranous glomerulopathy in a 62-year-old man who had a 2-month history of secondary iritis. He was transferred to our hospital because of uncontrollable edema and respiratory dysfunction. Physical examination revealed anasarca, pulmonary edema, hypertension and urticaria-like eruption on his arms. Urinalysis, blood chemistry and serological studies showed massive proteinuria (10.5g/day) with numerous granular casts, hypoalbuminemia (1.5g/dl), renal dysfunction (creatinine; 1.6mg/dl, BUN; 86mg/dl), hypercholesterolemia (total cholesterol; 455mg/dl), positive results for antinuclear factor, microsome test, thyroid test, lupus anticoaglant, antithyroglobulin test and rheumatoid factor, but LE cell or double-strand anti DNA antibody was negative. Serum complement levels were persistently low as CH50 of 13 U/ml and Clq of 6.0 micrograms/dl. The patient serum precipitated with normal human Clq by immunodiffusion analysis, indicating the presence of anti-Clq antibody. Renal biopsy revealed membranous glomerulopathy with prominent fine granular deposition of Clq along the glomerular basement membrane by immunofluorescent study and subepithelial dense deposit by electron microscopy. Corticosteroid treatment was ineffective for hypocomplementemia and nephrotic syndrome. Acute subendocardial infarction occurred on the 25th hospital day and he died of acute respiratory distress syndrome on the 45th hospital day. Autopsy revealed leucocytoclastic vasculitis in the alveolar wall. HUVS was confirmed by clinical symptoms, such as iritis and urticaria-like eruption, serum anti-Clq antibody, the absence of any specific autoantibody for systemic lupus erythematosus (SLE) and leucocytoclastic vasculitis in the alveolar wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Anisakis larvae which parasitize sea fishes sometimes cause not only anisakiasis but also such allergic reactions as mackerel-induced urticaria. We prepared AlaSTAT by using excretory/secretory antigens from Anisakis larvae to detect specific IgE in various patients groups. The AlaSTAT positive rate was 87.5% in gastric anisakiasis patients who were endoscopically diagnosed, while it was 66.7% in patients who had acute abdominal pain but no larva detected. Ascariasis in the common bile duct was 0%. The positive rate in mackerel-induced urticaria patients was 75.0%, while it was 8.3% and 10.0% in patients with urticaria of unknown origin and normal controls, respectively. Based on these data, the detection of specific IgE using AlaSTAT is useful in elucidating the cause of urticaria or acute abdominal pain, such as Anisakis.