Allergies/Hypersensitivity and Intolerance Clinical Reference Group

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Date

Thursday, August 8, 2019

Schedule
2nd Thursday of every month
Time: 20:00 UTC


GoToMeeting Details

https://snomed.zoom.us/j/934143312

Meeting ID: 934-143-312

International numbers available: https://snomed.zoom.us/zoomconference?m=EochJjO8ozm1ZiDr_x9p-bFJCbIBwgqV


Invitese:

Apologies



Objectives

  • See discussion items below:

Discussion items

ItemDescriptionOwnerNotesAction
1

Welcome and role call

Bruce Goldberg



2Allergy to animals

Bruce Goldberg, Natasha Krul

  • Allergy to furry animals (cats, dogs, etc.) represented in SNOMED CT as Allergy to animal x dander. Request from member of allergy CRG for more general allergy concept e.g. allergy to cat. An allergy is not caused by a living organism but rather a substance derived from that organism (usually a protein). Dander is one of several sources of allergenic proteins. In cats, exposure to the major cat allergen is in part due to a salivary allergen adhering to skin and hair during grooming. Some individuals may be allergic to proteins in cat urine.
  • MedDRA also has concepts, Allergic to cats, Allergic to dogs, Allergic to horses, etc. so having something comparable would be helpful.


Create general animal groupers with accompanying PT which reflects the accepted clinical idioms.

  •  Ensure that the 'allergy substance (protein)' exists and include the animal insulin derived allergy substances within this hierarchy.
  •  CRG group members to propose detailed content required (see below*)
  •  Submit via CRS and prioritise appropriately and/or as part of Bruce Goldberg's work in the allergy group.
  • Allergy to animals.pptx
  • *We (Natasha Krul )have a very active allergist in an academic hospital who has provided us with a list of relevant allergens. He has divided the list into categories like inhalation allergens, food allergens etc. and for each group of allergens he would like a 'header'  for instance 'pulse vegetables' as a header for peas, peanuts, beans etc so the allergist who is registering the information can choose what level he wants to register in. I understand there a plans to create a 'header' in Snomed for animal feathers, protein, dander, epithelium? Am I correct?
3Allergen and Allergy to substance refset for Belgium

Bruce Goldberg, Marie-Alexandra Lambot

4Cytostatic vs. cytotoxic drugs

Bruce Goldberg, Natasha Krul

  • There is a 372688009|Antineoplastic agent (substance)| in Snomed with a child 373526007|Cytotoxic (substance)|. We were wondering why Snomed doesn't have a separate concept for Cytostatic (substance)?
  • We have seen that Snomed sees antineoplastic agent synonomous to cytostatic agent for instance in 292196008|Antineoplastic adverse reaction| which is defined with antineoplastic agent as a causative agent.
  • An antineoplastic agent can be cytotoxic (killing the cells) or cytostatic (inhibiting growth but not killing them) Is there a reason or explanation why the Snomed hierarchy does not contain a cytostatic (substance)? 
  • Cytotoxic and cytostatic often used interchangeably in clinical literature although can be differentiated based on studies in scientific literature
  • Individual drugs may exhibit both properties possibly related to dose and other factors
  • List of drugs that would be classified as cytotoxic vs. cytostatic is missing
  • Requires use case
  •  Natasha Krul awaiting reply from her hospital pharmacologist to see if she knows of any medication that falls into one of the two categories. 
    • "The reason we came to this question was during our translation project. We saw synonyms in Snomed (cytotoxic and cytostatic) of which we werent sure if they were real synonyms and whether or not we should add them to our translations. I have asked several pharmacologists including a pharmacologist specialised in oncylytic medication and they all said that currently no distinction is made between cytotoxic and cytostatic. It depends on the dose whether a substance is toxic or static". 
5Allergy to substance remediation project

Bruce Goldberg, ALL

  • Begin group review


6Allergy to alpha-gal and alpha-gal syndromeBruce Goldberg
  • Task completed in SCA. Under review
7Adjourn

Bruce Goldberg, All

  • AOB



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