Although Anisakis allergy is well known to cause acute urticaria (AU) after eating seafood, it still remains unclear what percentage of AU cases is caused by Anisakis allergy. Therefore, to elucidate the relationship between Anisakis allergy and AU after seafood intake (AUSI), we examined the serum level of specific immunoglobulin E against Anisakis simplex (IgE (AS)) in 40 patients with AUSI (26 males and 14 females) and 21 patients with chronic idiopathic urticaria with no history of seafood allergy (CIU) (8 males and 13 females) as controls at the city hospital close to the Kesennuma fishing port in Japan. The frequency of IgE (AS) positive patients was significantly higher in AUSI (50% (7/14)) than in CIU (8% (1/13)) only among female cases; in males, there was no significant difference between AUSI (65% (17/26)) and CIU (63% (5/8)). Similarly, the level of IgE (AS) was significantly higher in female patients with AUSI (16.2±21.3 (mean+SD)) than CIU (0.8±1.2) but no significant difference was found between AUSI (30.1±39.6) and CIU (6.6±7.5) in males. These data demonstrated that Anisakis allergy can be a major cause of AUSI in female cases who less frequently eat seafood contaminated with Anisakis simplex. In male cases, we cannot diagnose Anisakis allergy with IgE (AS) positivity.
Pallister-Killian syndrome is caused by mosaic tetrasomy 12p; the clinical features are hypomelanotic streaks along Blaschko's lines, temporal and frontal balding with woolly hair, overgrowth, and psychomotor retardation. Herein we report a case of Pallister-Killian syndrome and discuss the clinical definition of hypomelanosis of Ito, which is now considered to be general term for mosaicism showing streaks of hypopigmentation along Blaschko's line and psychomotor retardation.
A variety of visceral involvements develop throughout the course of drug-induced hypersensitivity syndrome (DIHS). Pneumonia during the course of DIHS has been retrospectively investigated in recent Japanese case reports. The pneumonia was classified into two groups: early onset pneumonia that appeared within 2 weeks after development of DIHS, and late onset pneumonia that appeared more than 5 weeks after the onset. In the early onset group, pneumonia developed before treatment for DIHS. No infectious agents were detected and favorable outcomes were achieved with corticosteroid. On the other hand, in the late onset group, the patients were older, and infectious agents such as cytomegalovirus and Pneumocystis jirovecii, were frequenthy detected. Pneumocystis jirovecii pneumonia (PCP) often resulted in poor outcomes. The results suggest that PCP could be one of the poor prognostic factors for DIHS. A further accumulation of case reports and laboratory analyses around the development of PCP in DIHS patients, is needed. In addition, based on the pathomechanism of DIHS, the prophylactic administration of antimicrobial agents and appropriate treatment for PCP is advised.