Hlavní téma – Alergologie

prof. MUDr. Petr Panzner, CSc.

Vnitr Lek 2025, 71(6):339  

Angioedema - differential diagnosis and new therapeutic options

Irena Krčmová

Vnitr Lek 2025, 71(6):343-352 | DOI: 10.36290/vnl.2025.066  

Angioedema is defined as transient, recurrent swelling of the subcutaneous and/or submucosal tissues. Angioedema may affect the face, lips, neck and extremities, oral cavity, larynx and/or intestinal mucosa. Local swelling results from regionally increased permeability in subcutaneous or submucosal capillaries and postcapillary venules. Plasma extravasation occurs in response to vasoactive mediators released by activation of mast cells and/or basophils or the contact (kinin-kallikrein), complement and fibrinolytic enzyme systems of plasma, although biologically the situation is not clearly black and white. From a pathophysiological perspective, angioedema...

Allergy to insect stings - clear rules, but also new questions

Martina Vachová

Vnitr Lek 2025, 71(6):353-358 | DOI: 10.36290/vnl.2025.067  

The most serious clinical manifestation of insect venom allergy is life-threatening anaphylaxis. European epidemiological data clearly confirm that insect stings are the most common trigger of this severe systemic allergic reaction in adults, surpassing even medications and foods in this regard. Another manifestation of insect venom allergy is large local reaction around the site of the insect sting. From a clinical point of view, these reactions are significantly less serious than systemic reactions, but even extensive local swelling can bother the patient for several days. The aim of this article is to present current diagnostic and treatment procedures...

Penicillin allergy delabeling - the path to effective antibiotic therapy

Lenka Sedláčková, Tereza Rudová

Vnitr Lek 2025, 71(6):359-363 | DOI: 10.36290/vnl.2025.068  

Betalactam allergy, especially the most common allergy to penicillin, is one of the most common drug allergies. Ten percent of patients claim to have it, although in 90% of them it is ruled out after a thorough allergy testing and they tolerate penicillin. The use of alternative antibiotics in these patients may be associated with lower efficacy, more side effects, higher risk of multidrug-resistant bacterial infections and longer hospital stays. Comprehensive allergy testing to rule out allergy may not always be available. However, strategies are emerging in antimicrobial stewardship programs to quickly and safely screen for penicillin tolerance without...

Current options for pharmacotherapy of obesity

Ľubica Cibičková

Vnitr Lek 2025, 71(6):365-371 | DOI: 10.36290/vnl.2025.069  

Antiobesity medication are one of the options to promote weight loss, especially when dietary measures and physical activity do not bring the expected results. However, their use should always be part of a comprehensive approach to obesity treatment that includes a healthy diet, exercise and psychological support. In recent years, we have seen an increase in the availability of pharmacotherapy for obesity, so that we can individualise treatment and try to 'tailor it to the patient'. The popular drug phentermine (Adipex), which acts on the central nervous system and helps to suppress appetite, has been withdrawn from the market relatively recently....

Viral hepatitis: News in diagnosis and therapy

Petr Husa, Petr Husa ml.

Vnitr Lek 2025, 71(6):372-376 | DOI: 10.36290/vnl.2025.070  

Viral hepatitis remains a serious health problem in the 21st century. In the Czech Republic, the biggest problems currently are repeated local epidemics of viral hepatitis A, an increasing number of cases of acute hepatitis E, and the treatment of viral hepatitis C in drug users. Since May 2025, new recommended procedures from the European Association for the Study of the Liver (EASL) have been available, which in some respects change the approach to the diagnosis and treatment of viral hepatitis B. Viral hepatitis D is still very rare in the Czech Republic, occurring mainly in foreigners. In the case of superinfection with hepatitis D virus (HDV)...

Advances in the diagnosis and treatment of systemic lupus erythematosus

Martina Skácelová

Vnitr Lek 2025, 71(6):377-383 | DOI: 10.36290/vnl.2025.071  

Advances in the research of targeted therapy have greatly expanded the treatment options for patients with systemic lupus erythematosus (SLE). Biological therapies have become an integral part of the new 2023 EULAR recommendations for the treatment of SLE and lupus nephritis. Biologic drugs (belimumab, anifrolumab) are indicated in the treatment of patients with severe forms of non-renal SLE without life-threatening organ involvement and severe neuropsychiatric manifestations, i.e. especially when extensive skin and joint involvement predominates; belimumab also has a role in the treatment of lupus nephritis. Rituximab is particularly indicated in...

Parainfectious exudative pericarditis in bilateral pneumonia as the primary manifestation of systemic lupus erythematosus

Jakub Tatarka

Vnitr Lek 2025, 71(6):385-388 | DOI: 10.36290/vnl.2025.072  

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a diverse clinical presentation that can affect almost all organ systems. Cardiopulmonary manifestations are no exception, with pericarditis being the most common cardiac involvement in patients with SLE. It is usually an aseptic serous pericarditis, while the parainfectious exudative form with complicated pleural effusion is rare and represents a diagnostic and therapeutic challenge. In this article, we present the case of a 53-year-old female patient hospitalized for parainfectious exudative pericarditis and bilateral pneumonia, in whom the diagnosis of SLE was established during...

The role of motivation in obesity treatment

Šárka Slabá

Vnitr Lek 2025, 71(6):394-397 | DOI: 10.36290/vnl.2025.074  

Patient motivation plays a key role in obesity treatment, not only at the initiation of lifestyle changes but particularly in their long-term maintenance. This article summarizes current knowledge about motivational processes in individuals with obesity, outlining common barriers and influencing factors through the lens of self-determination theory and behavioral science. It focuses on practical strategies for effective patient communication, enhancing intrinsic motivation, and managing relapse as a normal part of treatment. Emphasis is placed on interdisciplinary collaboration and the need for ongoing motivational support throughout the therapeutic...

Evinacumab: a therapeutic agent for homozygous familial hypercholesterolemia

Vladimír Blaha

Vnitr Lek 2025, 71(6):389-393 | DOI: 10.36290/vnl.2025.073  

Homozygous familial hypercholesterolemia (HoFH) is a severe genetic disorder characterized by extremely high levels of LDL cholesterol and early development of atherosclerosis. Despite combined lipid-lowering therapy, the vast majority of patients fail to achieve target LDL-C levels. Evinacumab, a fully human monoclonal antibody against angiopoietin-like protein 3 (ANGPTL3), represents a novel therapeutic option. This article summarizes the mechanism of action, clinical evidence, and practical aspects of evinacumab administration in patients with HoFH.