⭐️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…
THREE-In cases of drug-induced hypereosinophilia with concern for organ damage (AEC>3K), especially when not responsive to corticosteroid or when use of corticosteroid use is risky, consider use of anti-IL-5 biologics (e.g., mepolizumab, benralizumab)/4
FOUR-Giving sulfonamide non-antibiotics (e.g., Lasix) to patients with sulfonamide antibiotic allergy (e.g.Bactrim) is okay. The IgE and T cell sulfonamide antibiotic allergies are mediated through structures that don’t exist in the non-antibiotics. /5
FIVE-If there is a lifesaving - or quality of life saving - med that causes anaphylaxis, many can still have the drugs safely by desensitization. MGH performs >20 drug desensitizations a week that largely occur in infusion centers and hospital floors. /6 ncbi.nlm.nih.gov/pmc/articles/P…
Thanks to the amazing #allergy #immunology fellows @JenniferLiMD and @Third_Wheal for a great week, @rebeccasaff for running the fellowship program, #BenSlawski for running the desens service, and @AleenaBanerjiMD for her clinical leadership of @MGHAllergy. #AIMedEd/ 7
@rubin_allergy @AllergyKidsDoc @EricMacyMD @ericashenoy @ShreyaTrivediMD @BranchWestyn @IDDoc1978 @drjessigold @DrEstherFreeman @Jessicastern16 @PAallergy @KhouryMD @FIT_AAAAI_org @MishaRosenbach @PharmerMeg #IDtwitter #medtwitter #AIMedEd
• • •
Missing some Tweet in this thread? You can try to
force a refresh
