AMANDA ROCHA FIRMINO PEREIRA
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conferenceObject Case report of severe anaphylaxis induced by morphine and tramadol(2018) BRUGNOLLI, R. M.; PEREIRA, A. R. F.; KALIL, J.; MOTTA, A. A.; V, M. Aun; GIAVINA-BIANCHI, P.- Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction(2020) PEREIRA, Amanda Rocha Firmino; AUN, Marcelo Vivolo; KELMANN, Nathalia Coelho Portilho; MOTTA, Antonio Abilio; KALIL, Jorge; GIAVINA-BIANCHI, PedroThe fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. In such situations, desensitization is the only option. We describe the case of a patient who presented fixed eruption due to sulfamethoxazole-trimethoprim, who underwent successful desensitization, but required a repeat procedure twice due to relapse after inadvertent full-dose reintroduction. In non-immediate hypersensitivity reaction to drug, the indication is controversial and there is no technical standardization. Furthermore, the time at which such tolerance is lost after discontinuing the drug involved is unknown. In severe non-immediate reactions of types II and III, desensitization is contraindicated. The patient underwent desensitisation to sulfamethoxazole-trimethoprim three times - the first with recurrence of lesions and the second and third without manifestations, all concluded successfully and with no premedication.
- Chronic inducible urticaria: confirmation through challenge tests and response to treatment(2020) PEREIRA, Amanda Rocha Firmino; MOTTA, Antonio Abilio; KALIL, Jorge; AGONDI, Rosana CamaraObjective: To evaluate the positivity of challenge tests of patients suspected of chronic inducible urticaria and the response to treatment. Methods: A retrospective study of electronic medical records of patients suspected of chronic inducible urticaria. All patients were submitted to challenge tests with triggering stimuli, according to the clinical history and, subsequently, the response to drug treatment was evaluated. Results: A total of 191 patients with suspected chronic inducible urticaria were included. It was confirmed in 118 patients and 122 positive tests (4 patients with 2 different positive tests). Most had dermographic urticaria (70.3%), followed by cholinergic urticaria (17.8%). Regarding treatment, 28% responded to antihistamine in licensed doses, 34.7% with increased doses, 9.3% responded to the addition of another medication. The concomitance of chronic inducible urticaria and chronic spontaneous urticaria was found in 35.3% of patients, being more frequent in females, with longer time to control symptoms and higher frequency of cholinergic urticaria. Conclusion: The confirmation of chronic inducible urticaria in patients with this suspicion, after challenge tests, was high. There was a good response to antihistamine. In the concomitance of chronic spontaneous urticaria, longer time to control symptoms and higher frequency of cholinergic urticaria were observed.