Nickel sulphate, food additives and seronegative

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This study below shows that salicylates can certainly cause bronchoconstriction. Aspirin (and other salicylates) have long been known to be asthma triggers – this can be a cause of the feeling of her throat closing up or difficulty breathing. Cross-sensitivity with colorings (especially tartrazine) has been known for many years. You never know what may be hidden in restaurant food. MSG (often found hidden under other names in restaurant food even when they promise

MSG isn’t in there) can also cause that effect, or a feeling of tightness of the chest, or other symptoms.

Whole abstract: http://www.ncbi.nlm.nih.gov/pubmed/7561989?dopt=Abstract

Full text is available for purchase

"Aspirin, salicylate, sulfite and tartrazine induced bronchoconstriction. Safe doses and case definition in epidemiological studies. Corder EH, Buckley CE 3rd, J Clin Epidemiol 1995

Oct;48(10):1269-75

Allergic-like reactions to chemical components of foods and medicines may be common.

... A 15% decrease in the amount of air expired in one second was defined a positive response. ... Doses to which the most sensitive (5%) and practically all (95%) susceptible persons might respectively respond are: metabisulfite 4.6 mg, 255.8 mg; tartrazine 3.4 mg, 885.6 mg; aspirin 0.8 mg, 332.3 mg; and salicylate 2.6 mg, 89.9 mg. Doses within these ranges can be used in epidemiological studies."

Notice that the amounts he lists as reasonable have never actually been used in tests of these additives.

http://www.ncbi.nlm.nih.gov/pubmed/3740556?dopt=Abstract

Ann Allergy.

1986 Aug;57(2):133-4.

Sensitivity to non-acetylated salicylates in a patient with asthma, nasal polyps, and rheumatoid arthritis.

Chudwin DS , Strub M , Golden HE , Frey C , Richmond GW , Luskin AT .

A woman experienced exacerbations of bronchial asthma after taking aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis.

On oral challenges, she developed an urticarial reaction after tartrazine; urticarial and bronchospastic reactions after salicylsalicylic acid; and urticarial and bronchospastic reactions after choline magnesium trisalicylate. Non-acetylated salicylates have been recommended for use in aspirin- and/or tartrazine-sensitive patients. The results of sensitivity studies of our patient indicates that such patients may also be sensitive to non-acetylated salicylates.

Ann Allergy.

1986 Aug;57(2):133-4.

Sensitivity to non-acetylated salicylates in a patient with asthma, nasal polyps, and rheumatoid arthritis.

Chudwin DS , Strub M , Golden HE , Frey C , Richmond GW , Luskin AT .

A woman experienced exacerbations of bronchial asthma after taking aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis.

On oral challenges, she developed an urticarial reaction after tartrazine; urticarial and bronchospastic reactions after salicylsalicylic acid; and urticarial and bronchospastic reactions after choline magnesium trisalicylate. Non-acetylated salicylates have been recommended for use in aspirin- and/or tartrazine-sensitive patients. The results of sensitivity studies of our patient indicates that such patients may also be sensitive to non-acetylated salicylates.

J Korean Med Sci.

1991 Jun;6(2):113-7.

Free full text at http://jkms.org/fulltext/pdf/jkms-6-113.pdf

Sodium salicylate sensitivity in an asthmatic patient with aspirin sensitivity.

Park HS , Lim YS , Suh JE , Rhu NS , Cho DI , Kim JW .

Department of Chest Medicine, National Medical Center, Seoul, Korea.

Non-acetylated salicylates have been recommended for use as alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazinesensitive patients. We experienced a case of an aspirin-sensitive asthmatic patient who developed a broncho-obstructive reaction after taking 100 mg of sodium salicylate. The result of this study suggests that sodium salicylate may cross-react with aspirin in aspirin-and tartrazine-sensitive patients.

Chiropr Osteopat.

2007 Oct 9;15:16.

FULL TEXT of study at http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17922921

An unusual case of gout in the wrist: the importance of monitoring medication dosage and interaction. A case report.

Jacobs CL , Stern PJ .

Graduate Education and Research Programs, Canadian Memorial Chiropractic College,

6100 Leslie St,, Toronto, ON M2H 3J1, Canada. cjacobs@cmcc.ca.

ABSTRACT: BACKGROUND: Gouty arthritis of the wrist is uncommon although gout itself is the most common inflammatory arthritis in older patients. Some known risk factors for the development of gout include trauma, alcohol use, obesity, hyperuricaemia, hypertension and diabetes mellitus. As well, certain medications have been shown to promote the development of gout. These include thiazide diuretics, low dose salicylates and cyclosporine. We present a case of gouty wrist pain possibly precipitated by a medication dosage increase as well as medication interactions. CASE PRESENTATION:

A 77 year old male presented with right wrist pain. Redness and swelling was present at the dorsal aspect of his wrist and range of motion was full with pain at end range upon examination. One week prior, his anti-hypertensive medication dosage had been increased. The patient's situation continued to worsen. Radiographic examination revealed changes consistent with gouty arthritis. CONCLUSION: It is important for clinicians treating joint conditions to be aware of patients' comorbidities, medication usage and changes in dosages. Education of patients with gout is of prime importance.

Clinicians should educate patients that gout may occur at any joint in the body not only the lower limb. Patients should be aware of the signs and symptoms of an acute gouty attack and be made aware that changes in certain medication dosages may precipitate an attack. Awareness of radiographic changes associated with gout is still of importance although these changes are not seen as frequently as they have been in the past due to better control of the disease.

This one is not really related unless Cheryl also has tinnitus, but I thought it was interesting:

Reumatismo.

2006 Jan-Mar;58(1):66-75.

[The Italian contributions to the history of salicylates]

[Article in Italian]

Marson P , Pasero G .

Unità di Emaferesi, Servizio Immunotrasfusionale, Azienda Ospedaliera di Padova. piemarson@katamail.com

It is well-known that the modern history of salicylates began in 1899 when the compound acetylsalicylic acid was registered and introduced commercially as "aspirin" by the Bayer

Company of Germany. As a matter of fact, however, remedies made from willow bark had been used to treat fever and rheumatic complaints at least since 1763, when Edward

Stone described their efficacy against malarian fever. A number of Italian scientists made significant contributions during the long period of research leading up to the synthesis of acetylsalicylic acid and its widespread use in rheumatic diseases. In this paper we will review the contributions of some of these researchers, beginning with Bartolomeo

Rigatelli, who in 1824 used a willow bark extract as a therapeutic agent, denominating it

"salino amarissimo antifebbrile" (very bitter antipyretic salt). In the same year, Francesco

Fontana described this natural compound, giving it the name "salicina" (salicin). Two other Italian chemists added considerably to current knowledge of the salicylates:

Raffaele Piria in 1838, while working as a research fellow in Paris, extracted the chemical compound salicylic acid, and Cesare Bertagnini in 1855 published a detailed description of the classic adverse event associated with salicylate overdoses--tinnitus-which he studied by deliberately ingesting excessive doses himself. Bertagnini and above all Piria also played conspicuous roles in the history of Italy during the period of the

Italian Risorgimento, participating as volunteers in the crucial battle of Curtatone and

Montanara during the first Italian War of Independence.

Allergy.

2003 Sep;58(9):958-9.

Nickel sulphate, food additives and seronegative arthritis: is there any relationship?

Pacor ML , Di Lorenzo G , Lunardi C , Martinelli N , Biasi D , Corrocher R .

Department of Clinical and Experimental Medicine, Section of Internal Medicine,

University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134

Verona, Italy. marialuisa.pacor@univr.it

There is no abstract, but the full text was inside the whole issue which is free. I extracted it (next page)

Allergy.

2003 Sep;58(9):958-9

Nickel sulphate, food additives and seronegative arthritis: is there any relationship?

M. L. Pacor*, G. Di Lorenzo, C. Lunardi, N. Martinelli,

D. Biasi, R. Corrocher

Seronegative spondilo-arthropathies are characterized by particular clinical features such as sacroileitis, spondylitis and asymmetric peripheral arthritis mainly involving the lower limbs and negative rheumatoid factor. In most cases, they are associated with the HLA class I antigen B 27 (1). We have recently reported that in few selected cases of seronegative arthritis, articular symptoms may be triggered by food antigens (2). Therefore, as a complement to the above study (2), we discuss here the association between food additives, other substances like nickel sulphate and seronegative spondilo-arthropathies. In this study, we have enrolled 88 subjects, 54 females and 18 males, with ages ranging from 12 to 60 years, affected by seronegative arthritis and with suspected food additive intolerance on the basis of an improvement of symptoms after a food additives-free diet.

Fifty-two out of 88 patients presented a concomitant recurrent urticaria. After an additive-and nickel-free diet for 4 weeks, the patients were made to perform double blind, placebo-controlled challenges (DBPC) with food additives and nickel sulphate. The following substances were tested: tartrazine (E102), erythrosine (E127), sodium benzoate (E211), p-hydroxybenzoate (E218), sodium metabisulfite (E223), monosodium glutamate (E621) and nickel sulphate. The placebo and the substances could not be distinguished. Only one DBPC was performed per day. Each substance under investigation was challenged with at least 1-week interval. Only the appearance of arthritis (arthralgia and swelling of joints) and the possible appearance of urticaria (itch and hive) were considered as a positive response. The DBPC challenge test resulted positive in 13 patients, four males and nine females; the median number of joints involved was three

(range 1 –10). Ten patients (66.7%) presented a concomitant urticaria. With regard to the relapse of arthritis, seven patients were positive to only one substance and six patients to two substances. More precisely, six patients were positive to nickel and one patient to erythrosine.

With reference to the patients with positive DBPC to two substances three of six were positive to nickel and to monosodium glutamate, two of six were positive to nickel and to tartrazine, and one out of six was positive to monosodium glutamate and to sodium metabisulfite. No patient presented arthralgia or joint swelling after the placebo challenge. All patients with DBPC positive to nickel sulphate presented a positive patch test.

Seronegative arthritis constitutes a broad spectrum of diseases of unknown origin. Food antigens have been suggested to be involved in few selected cases of seronegative arthritis (2). Data from our study suggested that nickel sulphate, an ubiquitous metal, can induce an exacerbation of arthralgias in patients with previous sensitization to nickel itself. Contact with nickel may occur not only through the skin but also through gastrointestinal mucosa, by the ingestion of certain food items (3). The oral DBPC and the results of the free diet, suggested that in some patients the nickel and food additives, introduced with the daily diet, may be the cause of the perpetuation of the articular symptoms. We think that nickel sulphates and food additives are triggers or aggravating factors, instead of simply being etiologic factors of such symptoms.

*Department of Clinical and Experimental Medicine

Section of Internal Medicine

University of Verona

Policlinico G.B. Rossi

P. zzale L.A. Scuro, 10

37134 Verona

Italy

Tel: 0039 045 8074648

Fax: 0039 045 580111

E-mail: marialuisa.pacor@univr.it

Accepted for publication 29 November 2002

Allergy 2003: 58:958 –959

Copyright _ Blackwell Munksgaard 2003

ISSN 0105-4538

References

1. Kahn MA. Spondyloarthropathies. Curr Opin Rheumatol 1997;4:281

–314.

2. Pacor ML, Lunardi C, Di Lorenzo G, Biasi D, Corrocher R. Food allergy and seronegative arthritis: report of two cases. Clin Rheumatol 2001;

20:279 –281.

3. Di Gioacchino M, Boscolo P, Cavallucci E, Verna N, Di Stefano F, Di

Sciascio M, Masci S, Andreassi M, Sabbioni E, Angelucci D, Conti P.

Lymphocyte subset changes in blood and gastrointestinal mucosa after oral nickel challenge in nickel-sensitized women. Contact Dermatitis

2000;43:206

–211.

The full text is linked free at http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=9417771

Environ Health Perspect.

1998 Jan;106(1):27-32.

Common commercial cosmetic products induce arthritis in the DA rat.

Sverdrup B , Klareskog L , Kleinau S .

Department of Medicine, Rheumatology Unit, Karolinska Institute, Stockholm,

Sweden.

Many different agents, including mineral oil and silicone, have the capacity to act as immunological adjuvants, i.e., they can contribute to the activation of the immune system. Some adjuvants, including mineral oil, are known to induce arthritis in certain strains of rats after intradermal injection or percutaneous application. The aim of this study was to determine if common commercial cosmetic products containing mineral oil could induce arthritis in the highly susceptible DA (Dark Agouti) rat. Intradermal injection of five out of eight assayed cosmetic products without further additives resulted in arthritis with synovitis. One of the products induced a very aggressive arthritis, which had declined after 5-9 weeks. When this product was also assayed for arthritogenicity upon percutaneous administration, it induced a mild and transient arthritis in 5 out of 10 DA rats, whereas control animals showed no clinical signs of joint involvement. No arthritic reaction was seen in rats after peroral feeding with the most arthritogenic product or by intravaginal application of Freund's adjuvants.

Silicone gel implants in DA rats did not cause arthritis. We conclude that mineral oils included in common commercially available products retain their adjuvant properties and are arthritogenic in the presently investigated arthritis-prone rat strain. There is yet no evidence that mineral oils present in cosmetics may contribute to arthritis in humans, but we suggest that this question should be subject to further investigation.

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