• Toxicological Research
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• v.17
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• pp.211-216
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• 2001

Drugs can have various adverse effects on the immune system including unintended immun-osuppression, induction of both drug-specific immune responses (including drug allergies) and non-specific immunostimulation (including autoimmune reactions), and direct activation of effector mechanisms (such as histamine release). As a practical matter, the Center for Drug Evaluation (CDER) relies on standard non-clinical toxicology studies to detect unintended immunosuppression. Specific assays using guinea pigs and mice are available to identify drugs that can induce immune-mediated dermal hypersensitivity reactions. Respiratory and systemic hypersensitivity and autoimmune reactions are more difficult to model in non-clinical studies. Unintended nonspecific immunstimulation can be detected in animal studies. CDER is currently developing specific guidance for evaluating potential drug immunotoxicity.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.423-426
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• 2005

Imatinib-mesylate (Gleevec, Glivec) is a protein-tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase created by the Philadelphia chromosome abnormality in CML. Imatinib is also used to treat patients with c-kit (CD 117)-positive unresectable tumors, or metastatic malignant gastrointestinal stromal tumors, or both. Imatinib is a welltolerated drug with few side effects. However, it has been associated with gastrointestinal irritation, fluid retention and edema, skin rashes, depigmentation, hepatotoxicity, hemorrhage, and hematological toxicity (anemia, neutropenia, and thrombocytopenia). In addition, imatinib has been associated with dyspnea and cough, which are mainly secondary to the pleural effusion and pulmonary edema, which represent local or general fluid retention. These events appear to be dose related and are more common encountered in the elderly. However, there has been no report of hypersensitivity pneumonitis associated with imatinib-mesylate in Korea. We report a case of 51-year old woman who developed hypersensitivity pneumonitis that might have been induced by imatinib-mesylate during the treatment of a gastrointestinal stromal tumor.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.327-330
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• 2015

The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

• Tuberculosis and Respiratory Diseases
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• v.68 no.4
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• pp.236-239
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• 2010

Hot tub lung is a lung disorder associated with exposure to hot tub water contaminated with Mycobacterium avium complex (MAC). Although its pathogenesis remains unclear, it may be considered hypersensitivity pneumonitis (HP) rather than an infectious disease. We report a case which fulfilled the current diagnostic criteria of hot tub lung. A patient had worked as a cleaner in the public bath for approximately one year and presented with dyspnea for over one month. The computed tomographic finding of bilateral ground glass attenuation and pathologic finding of granulomatous inflammation were consistent with HP. MAC was isolated from bronchoalveolar lavage fluid and hot tub water. After corticosteroid treatment without antimycobacterial medication, the patient improved and there has been no recurrence. The patient has since discontinued working in the public bath.

• Safety and Health at Work
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• v.11 no.2
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• pp.173-177
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• 2020

Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1290-1297
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• 1998

Bronchocentric granulomatosis(BCG), first defined in 1973, consists of granulomatous replacement of bronchial mucous membrane, often with heavy eosinophilic reaction within and about the involved bronchi. Etiologic factors are from hypersensitivity reaction for aspergillus, most often from idiopathic form, and in others from being associated with mycobacterium, ecchinococcus, rheumatoid disease, ankylosing spodylitis, and glomerulonephritis. Diagnosis is responsible only for pathologic findings and, in many cases, is confirmed in postoperative findings with misleading for tumor, tuberculosis, infectious or Wegener's granulomatosis. We report a case of bronchocentric granulomatosis associated with aspergillus.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.17 no.1
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• pp.1-12
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• 2007

We have reviewed all cases and epidemiological studies that have reported the association between worker's exposure to metalworking fluids(MWF) and non-malignant respiratory diseases. The followings are main conclusions we critically reviewed. Exposure to MWF was believed to be significantly related to the risk of cough and phlegm. Relative risk caused by straight MWF was found to be higher in exposure to straight MWF than water-soluble MWF. We also found that exposure to water-soluble MWF significantly caused hypersensitivity pneumonitis (HP) and occupational asthma. The main culprits that cause the development of HP and asthma are believed to be microbes contaminated in MWF, ethanolamine and biocides. HP and asthma could be developed at even exposure to lower than $0.5mg/m^3$, exposure level recommended by NIOSH. Most epidemiological studies have reported that relationship between chronic bronchitis and exposure to MWF was significant. Although there were several studies that suggested the significant association between exposure to MWF and the development of rhinitis and sinusitis, we could not conclude the causal relationship because of lack of evidences.

• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.302-307
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• 2004

Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.

• Allergy, Asthma & Respiratory Disease
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• v.12 no.4
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• pp.177-183
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• 2024

Dihydrocodeine is an effective antitussive agent that inhibits the cough reflex by interacting with opioid receptors in the brain. It is easily available in pharmacies without a prescription, which may contribute to a lack of awareness about potential drug hypersensitivity reactions. In the first reported case in Korea, a 29-year-old man developed acute generalized exanthematous pustulosis (AGEP) after consuming an over-the-counter cold medicine containing dihydrocodeine. He was admitted to the Emergency Department with high fever and full-body skin rashes that appeared 3 hours after taking the medicine. His EuroSCAR AGEP score was 9, with symptoms improving upon discontinuation of dihydrocodeine and the application of topical steroids. AGEP caused by dihydrocodeine, including codeine, is very rare, with 3 cases reported worldwide. By analyzing AGEP cases due to dihydrocodeine or codeine, we identified that risk factors for the development of AGEP from dihydrocodeine include a history of psoriasis and the presence of an IL36RN mutation, which result in the activation of Th17 in the blood or the skin. In cases of AGEP caused by dihydrocodeine, it is also recommended to discontinue codeine due to cross-reactivity with dihydrocodeine. Additionally, patients with AGEP due to dihydrocodeine may be able to use other opioid classes, such as morphine or tramadol, due to low cross-reactivity.

• Allergy, Asthma & Respiratory Disease
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• v.12 no.1
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• pp.9-16
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• 2024

Wheat allergy is one of the common causes of food allergies in children. The prevalence varies by age and country, and is known to be 0.04%-0.97% globally and 0.2%-1.3% in Korea. Wheat allergy usually appears with skin symptoms within 2 hours after ingestion, and in severe cases, it causes systemic symptoms and anaphylaxis. Wheat-dependent exercise-induced anaphylaxis, a serious wheat allergy, may occur after wheat consumption along with cofactors, such as exercise, alcohol, aspirin and/or nonsteroidal anti-inflammatory drugs. Wheat allergy is confirmed by oral food challenge. However, the challenging test is difficult to perform, although it is a confirmative diagnostic method. With the development of component resolved diagnostics, ω-5 gliadin specific immunoglobulin E (sIgE) along with wheat sIgE are useful for diagnosis of it. Wheat allergy should be differentiated from oral mite anaphylaxis or cross-reactivity to grass pollen allergy. It is recommended to avoid foods containing wheat, however, recently, efforts are being made to improve quality of life with oral immunotherapy.