Discover and read the best of Twitter Threads about #allergy

Most recents (17)

Scott Morrison made an announcement about reducing PBS Medicines. Trouble is he INCREASED them on Jan 1st, 2022, during a Pandemic

affordablemedicines.com.au/home/ #auspol @Mark_Butler_MP Image
Anyone see the Irony here. On the same day Morrison announces cheaper medication and healthcare - He cuts Heart scans, ECG’s from #Medicare Rebates. #LNPCutsToHealth

themandarin.com.au/187973-electio… ImageImage
The moment Liberals Distracted Voters, while they Cut #MRI’s, sleep apnea, #spinal fusion, skin lesion treatments and #Allergy Testing in 2018.
#LNPHealthCuts @RACGP @gedkearney #Medicare #auspol2022 Image
Read 11 tweets
Hey @JacksonSqMall @BurgerKingCAN when a person places an order for a burger from a fast food restaurant and they specify NO PICKLES OR ONIONS DUE TO #ALLERGY it shouldn’t take 28 minute to get your order and the first time they give EXTRA pickles and onions. (Part 1)
(Part 2) So @BurgerKingCAN remakes it but only removes onions but you need them to remake it a Second time so it’s the third sandwich and now this time they forget the cheese on the damn sandwich. If BK had any sense they would close this location for absolute terrible service
(Part 3) Also due to the fact of allergies I need to raise my voice slightly to the point where the manager threatens to have me banned from the mall because you guys are trying have me test out the @HamHealthSci by sending me to the damn hospital

#DoBetter
Read 4 tweets
1/🧵 Let’s learn about Ace inh-induced angioedema
 
His lips & tongue swelled up hours after taking a blood pressure med he’d been on 10 years - lisinopril.

📍What’s the treatment?
📍Is it an allergy?
📍What’s a common thought error?

(Pic w Perm - trigger warning tweets 2 & 4)
2/ Angioedema is potentially life-threatening
 
It’s very scary to see the tongue & lips swelling up so much and the airway compromised.

The patients are watched in the ICU so that intubation and even tracheostomy can occur emergently if required.

What’s the Dz Mechanism?
3/ Is ACE-inh induced Angioedema an allergy?
 
NO! It’s not an IGE mediated allergic reaction.

💥 Pro Tip:
People can get angioedema from allergies, but they would be very itchy, and my patient was not itching at all.

That's because it's mediated by a buildup of bradykinin.
Read 11 tweets
It has recently been suggested that vaccine boosters might “desensitize” an immune system to SARS-CoV-2, á la allergy shots.

That’s not how allergy shots work — I know because I prescribe them a lot.

I will elaborate for anyone interested. Let’s begin:

1/19
Say a person is allergic to ragweed. This means when they breathe in ragweed pollen, their body develops an immune reaction ➡️ allergy symptoms.

2/19
The ragweed pollen is an otherwise BENIGN object, i.e. it hasn’t directly caused damage to the body. The person’s immune response has. A non-allergic person could inhale the same pollen and have ZERO symptoms.

(I’ll explain why the point about damage is important later)

3/19
Read 19 tweets
⭐️FIVE Little Allergy/Immunology Lessons from 5 Big Days on Consults ⭐️ @mghaifellows @MGHAllergy. #Urticaria #Angioedema #vaccine reactions eosinophilia and #drugallergy /1
ONE-To treat acute urticaria (hives), antihistamines should be nonsedating and scheduled (not diphenhydramine PRN). Allegra/fexofenadine and Zyrtec/cetirizine have large therapeutic windows and are used safely at 4+ times the daily allergic rhinitis dose/2
TWO-Angioedema in an adult without skin itching/hives/rash—check if they on an ACE inhibitor! Although ~10% get it w/in 30d, many happen after years of uneventfully being on it /3 ncbi.nlm.nih.gov/pmc/articles/P…
Read 8 tweets
Starting #UnsungHeroesImmuno. Did you know about Onesimus and his knowledge of variolation? 1/
#UnsungHeroesImmuno What about Dr. William Augustus Hinton and his work with syphilis? 2/
#UnsungHeroesImmuno We also have Drs. Louis Tompkins Wright and Jane Cook Wright, a father-daughter pair that changed the field of oncology. 3/
Read 14 tweets
In this opinion paper @RMedzhitov went back to drawing board to update his views on #allergy and how it could develop.

#immunology

I read this paper and here is my take on it

1/
@RMedzhitov Why focus on allergy? b/c allergy is a paradox. The allergy we recognize is a completely maladaptive response and has no protective role whatsoever. It is not clear why do we even need IgE

2/
@RMedzhitov So, some 10 years ago or so, @RMedzhitov started to suggest that #allergy is an intrinsic property of a certain type of #antigens, many of them with enzymatic function (enzymes). 3/
Read 24 tweets
It has been a busy month learning about #allergy after #COVID19Vaccines but we so excited to receive this broad information from @CDCgov. Highlights below!/1
cdc.gov/mmwr/volumes/7…
*Potential #anaphylaxis 175 of 1,893,360 1st doses of @pfizer vaccines (0.009%; 90 per million)
*Confirmed #anaphylaxis, 21 of 1,893,360 1st doses of @pfizer vaccines (0.0011%; 11 per million)
-->Better than we thought (1 per 100,000)but greater than usual 1 per million)/2
*17 of 21 Anaphylaxis cases (81%) had allergy history; 7 of 21 (33%) had prior anaphylaxis
*Anaphylaxis occurred a median of 13 min (2–150 min) after vaccination; 71% occurred within 15 min (i.e., CDC recommended waiting/observation time)
*Follow-up for 20 patients & 100% OK /3
Read 5 tweets
2/#allergy and #anaphylaxis can happen to any #drug or #vaccine, but reactions to #COVID19vaccine are exceedingly rare (~6 in >300K vaccinations so far--> 0.002%). #vaccines have always been a rare cause of allergic reactions in healthcare.
3/Recently we looked at ~3K allergic reactions in healthcare settings @MassGenBrigham: contrasts caused allergy the most & just 6 vaccine reactions in 10-years. @NeelamPhadkeMD @MGH_ClinEpi @lizhou08 @JieHealthAI @PaigeWickner
pubmed.ncbi.nlm.nih.gov/32959347/
Read 4 tweets
1/ OK so 1 week after UK #COVID19Vaccine allergy was described, I need to reorient you to my world, the world where #drugallergy is the best field of #MedTwitter #AIMedEd #allergyimmunologyrocks. Let's get down to this confusion about the #covid19vaccine and #allergy
2/ There is no reason to think that anyone -- other than patients with a known allergy to an ingredient in this vaccine or an ingredient cross-reactive to an ingredient in this vaccine -- might have an #allergy the @pfizer #CovidVaccine.
3/ There is even very little that we think could cause an #allergy in this @pfizer vaccine. But 2 patients had #anaphylaxis after vaccination and we need to think about why. Something epidemiologically different in the UK population compared to clinical trial populations?
Read 12 tweets
1/OK so there *may* be new reports of allergy to #COVID19 vaccines but many other things (e.g., vasovagal syncope) can be misdiagnosed as allergy so we need more clinical details from the UK
cnn.com/2020/12/09/hea…
2/ BUT, it is not surprising that allergic reactions might be identified during massive vaccination but not clinical trials because #allergy to vaccines are exceedingly rare (1 per million). In the @US_FDA report, AEs within 30 min for vaccine vs placebo were similar: Image
3/Most vaccine allergies come from the excipients and allergists can do skin testing to the vaccine and its excipients (often facilitating safe and totally unremarkable vaccination). Excipients are often shared for many approved vaccines: cdc.gov/vaccines/pubs/…
Read 10 tweets
1/ #IDTwitter and #IDFellows, here is another #IDboardreview question: 20F p/w pharyngitis w/fever. There is no cough. Exam: Cervical adenopathy; tonsillar exudate. Rapid Strep antigen test pos. You start to prescribe her Amoxicillin but there is an allergy alert.
2/ She reports an allergic reaction to penicillin around age 8 or 9. She had a rash but no other symptoms. It resolved following discontinuation of med. She did not receive any treatment. Which of the following would you do next?
3/ Today we are going to talk about everyone’s favorite – #penicillin #allergy!
Read 14 tweets
Tomorrow's to-do list so far:

1) morning ablutions, etc
2) Stanford Neurodiversity Summit
3) diarise stuff
4) start putting meds into @NPSMedicineWise app
5) email dietitan to confirm appt time, check on what details to prepare ahead of appt.
6) reply to emails from endo & send her drug & PyoG info/pics
7) tidy up files, apps on phone, backup
8) start transferring over to new phone
9) physical phone stuff: case, screen protector, etc
10) figure out where to order from/order book for S's Dad's birthday.
11) email upper airway ENT prx re next Tues appt; they were supposed to have sent a confirmation, info on where to find them, permission to travel to appt, etc, but yet to receive.

12) work out new glucometer (Read the darn instructions first! Text @louiseallana if stuck).
Read 12 tweets
I had a pretty scary experience last night as a patient that I wanted to share. This story may hit home for #allergy #foodallergy #celiac friends and I hope will be enlightening for my #medtwitter #medstudenttwitter friends! 1/
So my family ordered takeout from a restaurant that I’ve eaten safely at dozens of times in the past. Unfortunately 2 bites into my food, I started to feel nauseous and my lips start tingling.

For anyone with food allergies, you know that’s the start of something bad. 2/
That uncomfortable feeling progressed into full blown anaphylaxis very quickly.

Ive made it 28 yrs, never had to use my EpiPen before & I made the huge mistake of not having it with me. I am INCREDIBLY thankful that my partner keeps one for me at all times just in case. 3/
Read 17 tweets
thread

Remarkable @bmj_latest @BMJCaseReports report documenting the extreme lengths a bedbound patient went through to get a diagnosis of #POTS, #MCAS, #SIBO and #tachycardia

read her story here

#MedEd #MedTwitter @MayoClinic
casereports.bmj.com/content/2018/b…
2. After suffering for 16 years, seeing 19 docs with repeated misdiagnosis:

Her cardiologist couldnt diagnose #POTS

Her gastroenterologist couldnt diagnose #SIBO

Her immunologist couldnt diagnose #MCAS

Her neurologist referred her to a #psychiatrist!

casereports.bmj.com/content/2018/b…
3. Patient: the "neurologist was out of ideas and suggested I get a psych evaluation, which I declined"

the patient <referred herself> to @MayoClinic

#SickNotWeak #chronicillness #chronicpain #MedEd #medtwitter

casereports.bmj.com/content/2018/b…
Read 10 tweets
1/I've said many times that I am poor because I am unemployed (except for my writing) and I am unemployed because I am disabled.

I am now officially rejecting that shit.

I am still disabled. I still am not employed.

#Disability #ChronicIllness #poverty
2/But the reason I am unemployed is because society has deemed me disposable. This isn't on me.

#disabled #DisabledPeopleMatter #PplWDisabilitiesMATTER
3/It's because society has decided the WANTS of the abled (specifically in my case, to use fragrance and decorate with balloons) are more important than my survival. This isn't on me.

#BanBalloonsInstead #fragrance #MCS #MCAS #allergy #asthma
Read 18 tweets
Dr L in the buzzfeed article says humans make alpha-gal sugar, But, here’s a podcast & transcript w/Dr Commins, Prof at UNC Allergy & Immunology who was part of the discovery team in 2009 & is an expert on AG. He says humans don’t make alpha-gal sugar./1 apple.news/A-Ybbhe0lQXuD_…
Dr Commins also clarified that the 2009 discovery involved the lone star tick but that it can be caused by other ticks. His research is ongoing. I disagree w/him on 2 things:
1) I Do think anyone w/a tick bite should be tested for the allergy apprx 6 weeks after the bite.
And/2
2) The reaction does not always cause itching. I’ve found the random palm itching to be more common than torso hives, but, even more common than that is no hives. And, I agree that the allergy response, unlike other food allergies, is delayed. Dr C say apprx 4 hrs after/3
Read 9 tweets

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