Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)最新文献

Objective: To evaluate the effect of pharmacological modulation of HIF-1 on the expression of IL-33 and IL-17 in a murine model of allergic pulmonary inflam- mation (API) with different degrees of severity.

Methods: 5 mice/group received ovalbumin (OVA) 1(mild), 2(moderate) or 3(severe) challenges via i.t. prior to allergen sensitization, in addition to the HIF-1 induction or inhibition groups, received EDHB (OVA+EDHB) i.p. or 2ME (OVA+2ME) i.t. respectively. Control groups received saline solution (SS) in the same way. HE (inflammatory infiltrate), PAS (mucus production) and immunohistochemical staining for HIF-1a, IL-33, IL-17 were performed, quantitatively analyzing by digital pathology.

Results: We obtained different degrees of severity with a greater number of challenges, increasing the expression of HIF-1, correlating with the expression of IL-33/IL-17. Increasing or decreasing, respectively by pharmacological modulation.

Conclusions: The above suggests that the high expression of HIF-1 favors the production of IL-33 and IL-17 contributing to the damage in lung tissue and the severity of the disease and these can be regulated through the modulation of HIF- 1.

Objective: Describe the pattern of allergic sensitivity in elderly.

Methods: Elderly (>60 years old) with a diagnosis of allergic respiratory disease in whom sensitivity was identified by pricking with ALK-abello extracts (Port Washington, NY, United States) were included. The results were analyzed using descriptive statistics and compared with a series of young adults in a 3:1 ratio. Association analyzes were performed with c2 test using SPSSv.21 software (SPSS software, IBM, NY, USA).

Results: 17 elderlies, predominantly women were identified (70%) with an average age of 64 years, 52% suffered from asthma and 47% allergic rhinitis, 82% were predominantly intradomiciliary polysensitive (82%), the most frequent being Dermatophagoides pteronyssinus (50%), decreasing to < 18% (p<0.01) to various species (Ligustrum vulgare, Salsola kali, Periplaneta americana, Canis familiaris, Juniperus sp and Fraxinus sp). Interestingly, AM were more sensitive to mites compared to young adults (p<0.01/OR= 8.92). This may be because the reactivity of the skin may decrease with age.

Conclusions: The main allergic sensitivity that can be identified by conventional techniques in elderly is Dermatophagoides pteronyssinusm, up to 50%.

Abstract: In the face of SARS-CoV-2 infection, an uncontrolled and unregulated response of the innate immune system can cause local and multisystem organ damage, which is characteristic of patients admitted to hospitals and who die from this virus. See some of the factors involved in the severe pathological pictures of this infection, mainly in men, in articles published between 2010 and 2021 and specialized books. Research shows that age, gender, race, and blood group (specifically A), coupled with factors such as immunosenescence and comorbidities, are crucial in the severity of the disease. Finally, it is suggested that, although men and women have the same probability of becoming ill with COVID-19, men are more likely to die because they have more ACE2 receptors in plasma, greater esterase activity, produce more proinflammatory cytokines, and respond differently to hormones (testosterone favors the innate immune response more while estrogens favor the adaptive one) and to the effects of dopamine inhibitors, involved in the inflammatory response. In addition, androgen hormones regulate the TMPRSS receptor and induce metalloproteases involved in adhesion and fibrotic processes.

Objective: To determine the association between AR and the frequency of hyposmia.

Method: Cross-sectional, case-control, non-probabilistic census survey in subjects between 14 and 50 years of age. AR was identified by clinical symptoms and positive skin tests. Olfactory function was assessed with the Sniffin Sticks Screening Test. This research was approved by the Ethics and Research Committees of the ISSSTE Regional Hospital "Dr. Valentín Gómez Farías": ZAPOPAN ISSSTE/CEI/488/2020.

Result: A total of 147 patients were included, 62 with AR and 85 controls. The average age was 33 years (35 years in AR and 31 years in controls). As a measure of association, the prevalence ratio was calculated, estimating that those with AR have 2.2 times more risk of having hyposmia than controls. Likewise, between them there was a calculated discrepancy of 12.5509 (expected discrepancy 3.84), and a statistical significance of 0.00039 (p=0.00039).

Conclusion: AR represents a chronic systemic inflammatory process that leads to hyposmia. Its correlation has been reported from 23 to 48%.1 Likewise, it is important to consider the role that olfaction plays in recognizing and interacting with our environment, and consequently the impact on the quality of life of those who suffer from it. AR significantly increases the risk for suffering hyposmia.

Background: Fixed erythema pigmento (FPE) is an allergic drug reaction, the pathophysiology of which is not exactly known. It is more common in women with location on the face. Clinical presentation: round or oval red-purple macule, well defined, with swelling, pain, itching, and burning. Diagnosis is clinical, oral chal- lenge is contraindicated due to possible severe reaction. On withdrawal of the drug, residual violaceous hyperpigmentation remains.

Case report: 34-year-old female diagnosed with allergic rhinitis and asthma. She received treatment with ibuprofen and cephalexin 1 month ago due to dental infection. For the past 2 weeks, she has presented dermatological lesions characterized by hyperpigmentation under the lower eyelids, accompanied by pain, burning, and itching. On physical examination, well-defined red-purple pigmentation was observed in both periocular regions. The challenge test is not justified, the clinical history is the diagnostic pillar. The indication is to stop the medication immediately and continue monitoring.

Conclusions: EPF is a drug reaction related to drug use. It creates a challenge for diagnosis due to poor knowledge of the characteristics of the dermatosis and poor clinical and pharmacological questioning. The EPF approach requires knowing the clinical characteristics of this dermatosis, making a differential diagnosis with other lesions and indicating the suspension of the responsible medication.

Objective: To know the prevalence of CMPA with the scale in patients of the pediatrics external consultation in the Municipal Institute of Pension of Chihuahua in period from march to may 2022, Series of cases.

Methods: A search was carried out on CMPA consultations in the period from March to May 2022, permission and informed consent was requested to access the clinical file and retrospectively, an analytical, observational, non- experimental, descriptive study was carried out., the COMISS scale was applied, and formulated a series of cases.

Results: The prevalence of CMPA is 0.3%. CMPA positive patients did not have statistically significant differences with the suspects in terms of age, gestational age, birth weight, maternal age, atopy or tobacco. Presenting a series of cases.

Conclusions: The prevalence of CMA with the use of COMISS was 0.3%, lower than the prevalence worldwide. The wider use of this scale is suggested to be considered in order to achieve a more accurate diagnosis.

Abstract: La planta Hevea brasiliensis se utiliza ampliamente en la industria como fuente de extracción de caucho, un elemento empleado en diversas áreas comerciales y médicas. Los estudios inmunológicos de esta especie indican que es una fuente alergénica importante, que puede provocar sensibilización y alergia. Se han identificado diferentes componentes alergénicos de esta planta, con diversas propiedades inmunitarias y bioquímicas, y estudiado más de diez tipos diferentes de alérgenos, cada uno con distinta capacidad de inducir síntomas alérgicos. En esta revisión informamos los avances actuales en el estudio de Hevea brasiliensis.

Background: Autoinflammatory diseases are a heterogeneous group of pathologies whose prevalence is undefined to date. Within these, the Periodic Fever Syndrome, Adenitis, Pharyngitis and Aphthosis (PFAPA) is determined as the most common and the most studied. Neurodevelopmental and behavioral disor- ders, including those of the Autism Spectrum, are especially prevalent in patients with allergic and autoimmune diseases, however, there is little documented regarding their relationship with autoinflammation.

Case report: The case of a patient with Asperger Syndrome with subsequent onset of this autoinflammatory disease is shown. Two weekly blood counts and complete serum immunoglobulins are obtained, which do not show a decrease in neutrophil counts or sublevels or supralevels in immunoglobulins.

Conclusion: When he returned to his follow-up appointment, he reported a feverish peak 2 days before, which ceased with the administration of the steroid, and if there was presence of oral ulcers on this occasion, fulfilling the modified Marshall criteria. Likewise, a great change is noted in their development and cooper- ation in exploration. The duality of this autoinflammatory syndrome in a patient with Asperger Syndrome is determined.

Background: Perioperative anaphylaxis can be life-threatening. The global incidence is estimated to be 1 in 10,000-20,000 procedures. The most common agents are neuromuscular blockers, latex, and antibiotics. There are very few reports of allergies to inhaled anesthetics such as sevoflurane, which is considered relatively safe in patients with drug allergies.

Case report: 12-year-old patient, admitted to oncology, diagnosed with acute lymphoblastic leukemia. History of two perioperative hypersensitivity reactions. In the first event, lidocaine and rupivacaine were administered, he presented urticaria, managed with an antihistamine. On the second occasion, he received only sevoflurane and presented anaphylaxis, treated with intramuscular adrenaline. Later during intrathecal therapy, he received sevoflurane, he presented rash and arterial hypotension, managed again with adrenaline, with total remission of symptoms. Retrospectively Brighton criteria level I of certainty, classified as serious by Brown. Hypersensitivity to sevoflurane was suspected, ruling out other anesthetics such as lidocaine and rupivacaine with negative intradermal skin tests. Molecular components for latex were requested with negative results for Hev b 1, Hev b 3, Hev b 6. Due to the above and associated with the characteristics of the drug, a basophil activation test for sevoflurane was performed with an activation percentage of 50% (positive). Perioperative anaphylaxis due to sevoflurane is confirmed.

Conclusion: All drugs involved in perioperative hypersensitivity reactions should be considered to establish adequate and safe treatment alternatives for this small group of patients.

Introduction: Rituximab is an Anti-CD20 chimeric monoclonal antibody, being the treatment of lymphoproliferative diseases and rheumatological disorders; hypersensitivity reactions (HRS) are associated with infusion, cytokine release, type I (IgE/non-IgE), mixed, type III and IV. Desensitization seeks to induce tem- porary tolerance, decreasing the probability of clinical manifestations through gradual administration of the total dose of the drug, being target cells of the procedure, basophils, and mast cells, preventing their activation.

Case report: The objective is to present a personalized desensitization protocol in a 36-year-old female patient with systemic lupus erythematosus (SLE) pre- viously treated with rituximab in 2019, 4 doses, presenting during the fourth administration, after 10 minutes, dyspnea, feeling foreign body in the pharynx, chest pain, angioedema, and neurological alteration. Requiring new administration of rituximab due to persistent proteinuria secondary to SLE. After performing skin tests (negative), a 13-step desensitization scheme was performed with 3 concentrations (solution: A [1:100], B [1:10] and C [1:1]). Since only 52% of RHS to rituximab are positive in skin tests and given the degree of reaction (serious), desensitization is decided, based on reactions presented by patient and clinical context. Achieving a cumulative dose of 897.87 mg in a period of 5 hours, without reactions during or after the procedure, concluding successfully.

Conclusion: By carrying out desensitization protocols, the administration of a drug is allowed, offering a safe therapeutic option, when this is the treatment of choice in previously sensitized patients, offering an alternative when the benefits outweigh the risks of its administration.