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Granulomatous Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Albert Alhatem, Robert A. Schwartz, Muriel W. Lambert, W. Clark Lambert
Management: Patients should be referred to an endocrinologist for diagnosis and treatment. Overall, the main recommended management is symptomatic with avoidance of any triggers of mast cell degranulation. H1 antihistamines or antileukotriene agent products can help with pruritis (itching) or flushing. H2 antihistamines can help with gastrointestinal symptoms, such as abdominal pain, heartburn, cramping, and/or diarrhea. As long as tumor masses are present, the possibility exists that one or more may become activated, inducing a potentially disastrous vascular response.
Mastocytosis
Published in Dimitris Rigopoulos, Alexander C. Katoulis, Hyperpigmentation, 2017
Antileukotriene agents (e.g., leukotriene receptor antagonists as montelucast and 5-lipooxygenase inhibitors as zileuton) may be added for control of symptoms, such as flushing, itching, abdominal cramping, and recurrent anaphylaxis, that are suboptimally controlled by H1 and H2 antihistamines and cromoglycates. Accordingly, aspirin may be administered in adults only to control flushing, provided the patient is known to tolerate NSAIDs.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Cough may be the only, or predominant, symptom of asthma: cough-variant asthma.  12 In those with asthma or airway hyperresponsiveness, cough will respond transiently to bronchodilator therapy with β2 agonists  13* and in the long term has been shown to respond to sodium necrodomil,  14 ** antileukotriene agents,  15* and corticosteroids.  16* In addition, the bronchodilator ipratropium bromide has been found to be useful as an antitussive in patients with chronic obstructive pulmonary disease by decreasing both sputum production and cough.  17*⋆
Understanding decision-making and educational need in the management of pediatric patients with moderate-to-severe asthma: analysis of a US-based clinician survey
Published in Journal of Asthma, 2023
Gregory D. Salinas, Shereta Wiley, Sylvie Stacy, Rebecca Gall, Lakiea Wright-Bello, Anthia Mandarakas, Karyn Ruiz-Cordell, Joseph Gilbride
When asked what treatment they would recommend for this patient, clinicians’ responses were mixed; two-thirds of specialist clinicians would attempt to increase the patient’s dose of ICS/LABA from medium to high while just over half would add an antileukotriene agent. The opposite was the case with the pediatric clinicians: two-thirds preferred an antileukotriene and half chose a high-dose ICS/LABA. 31% of allergy clinicians but fewer pediatric (5%) or pediatric pulmonology clinicians (17%) would recommend a biologic therapy. Pediatric and pediatric pulmonology clinicians as a group were less likely than allergy clinicians to recommend a biologic (P < 0.01). The clinicians who chose to shift the patient to a high-dose ICS/LABA were asked what their treatment choice would be if this does not lead to patient improvement. Although there was little consensus in response, the specialist clinicians leading medication choice was biologic therapy (55% of allergy and 41% of pediatric pulmonology clinicians). Most pediatric clinicians would refer at this point.
Effectiveness of omalizumab in adolescent and adult patients with chronic idiopathic/spontaneous urticaria: a systematic review of ‘real-world’ evidence
Published in Expert Opinion on Biological Therapy, 2018
Jonathan A. Bernstein, Abhishek Kavati, Michael D. Tharp, Benjamin Ortiz, Karen MacDonald, Kris Denhaerynck, Ivo Abraham
The findings on discontinuation of other medications following initiation of omalizumab therapy should be interpreted with some caution as there was significant variation in methods across studies. Nonetheless, the data are encouraging with over 70% of patients having treatment with corticosteroids, antileukotriene agents, or immunomodulatory agents discontinued; and 60% of patients being discontinued from routine antihistamine therapy. Medication use patterns should be evaluated more systematically in future studies.