Oscar Manuel Calderón-Llosa, Danny Muñoz-Campos, Margarita Olivares-Gómez
Objective: To report the registry of the HAE Peruvian patient's association.
Methods: We used the questionnaire of the Latin American HAE committee. Consent was requested from the patient's association to report the data.
Results: We report data of 63 patients, 51 Female, 12 Male, range age between 6 to 74 years. Nine under 18 years old, 5/9 between 6 to 13 years. Forty-five HAE C1-INH type I, 12 HAE-FXII, 5 HAE UNK, 1 AAE. Symptoms onset average age in 56/62 HAE patients was 16.8. In a group of 50/62 adult HAE patients, the average diagnostic delay approximately was 19.3 years. Laboratory tests: we can perform C4 complement C1-inhibitor antigenic and functional tests. Treatments: The patients have access to tranexamic acid (TA) and attenuated androgens. We do not have registered specific long-term prophylaxis treatments. We used moderate/high doses of TA, in most patients up to 6 gr i.v./in 24 hours, we start with the treatment immediately the HAE acute crisis is beginning, it helps to the HAE attacks are less symptomatic, resolves in a few days and decrease the frequency.
Conclusions: We present 63 members of the Association of Patients with Hereditary Angioedema of Perú. We have improved blood tests for HAE diagnosis. Moderate and high doses of Tranexamic Acid are used for prophylaxis and acute crisis respectively, with acceptable response. No deaths have been reported due to HAE crisis in the patient's association.
目的:报告秘鲁 HAE 患者协会的登记情况:报告秘鲁 HAE 患者协会的登记情况:我们使用了拉丁美洲 HAE 委员会的调查问卷。结果:我们报告了 63 名患者的数据,其中 51 名女性,12 名男性:我们报告了 63 名患者的数据,其中 51 名女性,12 名男性,年龄在 6 至 74 岁之间。其中 9 人未满 18 岁,5/9 人在 6-13 岁之间。45 名 HAE C1-INH I 型患者,12 名 HAE-FXII 型患者,5 名 HAE UNK 型患者,1 名 AAE 型患者。56/62 名 HAE 患者的平均发病年龄为 16.8 岁。在 50/62 名成年 HAE 患者中,平均诊断延迟时间约为 19.3 年。实验室检测:我们可以进行 C4 补体 C1 抑制剂抗原和功能检测。治疗:患者可使用氨甲环酸(TA)和减效雄激素。我们没有登记特定的长期预防治疗。我们使用中等/高剂量的氨甲环酸(TA),大多数患者可在24小时内静脉注射6克氨甲环酸,我们在HAE急性危象开始时立即开始治疗,这有助于减轻HAE发作的症状,在几天内缓解症状并降低发作频率:我们目前有 63 名秘鲁遗传性血管性水肿患者协会成员。我们改进了用于诊断遗传性血管性水肿的血液检测方法。中等剂量和高剂量的氨甲环酸分别用于预防和急性危象,反应良好。在患者协会中,没有因HAE危象而死亡的报告。
{"title":"[Registry of Members of the Association of Patients with Hereditary Angioedema of Perú].","authors":"Oscar Manuel Calderón-Llosa, Danny Muñoz-Campos, Margarita Olivares-Gómez","doi":"10.29262/ram.v71i1.1318","DOIUrl":"https://doi.org/10.29262/ram.v71i1.1318","url":null,"abstract":"<p><strong>Objective: </strong>To report the registry of the HAE Peruvian patient's association.</p><p><strong>Methods: </strong>We used the questionnaire of the Latin American HAE committee. Consent was requested from the patient's association to report the data.</p><p><strong>Results: </strong>We report data of 63 patients, 51 Female, 12 Male, range age between 6 to 74 years. Nine under 18 years old, 5/9 between 6 to 13 years. Forty-five HAE C1-INH type I, 12 HAE-FXII, 5 HAE UNK, 1 AAE. Symptoms onset average age in 56/62 HAE patients was 16.8. In a group of 50/62 adult HAE patients, the average diagnostic delay approximately was 19.3 years. <i>Laboratory tests</i>: we can perform C4 complement C1-inhibitor antigenic and functional tests. <i>Treatments</i>: The patients have access to tranexamic acid (TA) and attenuated androgens. We do not have registered specific long-term prophylaxis treatments. We used moderate/high doses of TA, in most patients up to 6 gr i.v./in 24 hours, we start with the treatment immediately the HAE acute crisis is beginning, it helps to the HAE attacks are less symptomatic, resolves in a few days and decrease the frequency.</p><p><strong>Conclusions: </strong>We present 63 members of the Association of Patients with Hereditary Angioedema of Perú. We have improved blood tests for HAE diagnosis. Moderate and high doses of Tranexamic Acid are used for prophylaxis and acute crisis respectively, with acceptable response. No deaths have been reported due to HAE crisis in the patient's association.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrés Sánchez, Yaquelin Padilla, Adriana Lorduy, Jorge Sánchez, Marlon Múnera, Claudia Baena, Carlos Bernal, Juan Urrego
Objective: Conduct an in-silico assessment of potential molecular mimicry between human aquaporins, A. fumigatus, and diverse allergenic sources.
Methods: Amino acid sequences of human AQP3 and A. fumigatus aquaporin were compared through multiple alignments with 25 aquaporins from diverse allergenic sources. Phylogenetic analysis and homology-based modeling were executed, and the ElliPro server predicted conserved antigenic regions on 3D structures.
Results: Global identity among studied aquaporins was 32.6%, with a specific conserved local region at 71.4%. Five monophyletic clades (A-E) were formed, and Group B displayed the highest identity (95%), including 6 mammalian aquaporins, notably AQP3. A. fumigatus aquaporin exhibited the highest identity with Malassezia sympodialis (35%). Three linear and three discontinuous epitopes were identified in both human and A. fumigatus aquaporins. The Root Mean Square Deviation (RMSD) from overlapping aquaporin structures was 1.006.
Conclusion: Identification of potential linear and conformational epitopes on human AQP3 suggests likely molecular mimicry with A. fumigatus aquaporins. High identity in a specific antigenic region indicates potential autoreactivity and a probable antigenic site involved in cross-reactivity. Validation through in vitro and in vivo studies is essential for further understanding and confirmation.
{"title":"[In silico analysis of molecular mimicry between human aquaporin 3, Aspergillus fumigatus aquaporin and aquaporins from allergic sources].","authors":"Andrés Sánchez, Yaquelin Padilla, Adriana Lorduy, Jorge Sánchez, Marlon Múnera, Claudia Baena, Carlos Bernal, Juan Urrego","doi":"10.29262/ram.v71i1.1370","DOIUrl":"https://doi.org/10.29262/ram.v71i1.1370","url":null,"abstract":"<p><strong>Objective: </strong>Conduct an in-silico assessment of potential molecular mimicry between human aquaporins, <i>A. fumigatus</i>, and diverse allergenic sources.</p><p><strong>Methods: </strong>Amino acid sequences of human AQP3 and <i>A. fumigatus</i> aquaporin were compared through multiple alignments with 25 aquaporins from diverse allergenic sources. Phylogenetic analysis and homology-based modeling were executed, and the ElliPro server predicted conserved antigenic regions on 3D structures.</p><p><strong>Results: </strong>Global identity among studied aquaporins was 32.6%, with a specific conserved local region at 71.4%. Five monophyletic clades (A-E) were formed, and Group B displayed the highest identity (95%), including 6 mammalian aquaporins, notably AQP3. <i>A. fumigatus</i> aquaporin exhibited the highest identity with Malassezia sympodialis (35%). Three linear and three discontinuous epitopes were identified in both human and <i>A. fumigatus</i> aquaporins. The Root Mean Square Deviation (RMSD) from overlapping aquaporin structures was 1.006.</p><p><strong>Conclusion: </strong>Identification of potential linear and conformational epitopes on human AQP3 suggests likely molecular mimicry with <i>A. fumigatus</i> aquaporins. High identity in a specific antigenic region indicates potential autoreactivity and a probable antigenic site involved in cross-reactivity. Validation through in vitro and in vivo studies is essential for further understanding and confirmation.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Loxoscelism is a toxic clinical condition caused by the bite of spiders of the genus Loxosceles, with wide distribution throughout the world.1 Phospholipase D is responsible for dermonecrosis, inflammation, platelet aggregation, hemolysis, alteration of vascular permeability, cytotoxicity, nephrotoxicity, acute renal failure, among other symptoms involved with this protein.
Case report: 27-year-old male patient, who began with a sudden episode of intense pain in the right hand, in the metacarpus and metacarpophalangeal joints. On clinical examination, the upper extremity was noted to have increased volume, extensive edema, hyperemia, and increased local temperature; The lesion progressed to extensive necrosis. Fasciotomies were performed, from distal to proximal, and release of the second and third finger compartment through longitudinal radial and ulnar incisions. A skin autograft was placed, obtained from the anterior surface of the right thigh. Opioid analgesics, non-steroidal anti-inflammatory drugs, corticosteroids, and antibiotics were administered. The skin biopsy reported: inflammatory infiltrate with neutrophils, ulceration, and bacterial colonies. After 27 days he had a favorable evolution, so he was discharged to his home, with follow-up by staff from the Outpatient Service.
Conclusion: Cutaneous loxoscelism, as a cause of acute compartment syndrome of the hand, is rare, but should be considered in an area endemic for Loxosceles spp. Surgical decompression of the affected compartments represents a decisive factor in the treatment of patients.
背景:1 磷脂酶 D 可导致皮肌坏死、炎症、血小板聚集、溶血、血管通透性改变、细胞毒性、肾毒性、急性肾衰竭等症状:27 岁男性患者,起初右手掌骨和掌指关节突然剧烈疼痛。临床检查发现,上肢体积增大、广泛水肿、充血和局部温度升高;病变发展为广泛坏死。医生从远端到近端进行了筋膜切开术,并通过桡侧和尺侧纵向切口松解了第二和第三指间室。从右侧大腿前侧取皮,进行了自体皮肤移植。治疗过程中使用了阿片类镇痛药、非甾体抗炎药、皮质类固醇激素和抗生素。皮肤活检报告显示:炎性浸润伴有中性粒细胞、溃疡和细菌菌落。27 天后,患者病情好转,出院回家,由门诊部工作人员进行随访:结论:作为手部急性隔室综合征病因的皮肤梭形虫病十分罕见,但在梭形虫病流行的地区应予以重视。
{"title":"[Loxoscelism with acute compartment síndrome: A case report with successful conclusion].","authors":"Itzel Yoselin Sánchez-Perez, Yareni Chávez-Ríos, Sergio Gerardo Moreno-Hernández, Andrea Velasco-Medina, Guillermo Velázquez-Sámano, Espiridión Ramos-Martínez","doi":"10.29262/ram.v71i1.1289","DOIUrl":"10.29262/ram.v71i1.1289","url":null,"abstract":"<p><strong>Background: </strong>Loxoscelism is a toxic clinical condition caused by the bite of spiders of the genus <i>Loxosceles</i>, with wide distribution throughout the world.1 Phospholipase D is responsible for dermonecrosis, inflammation, platelet aggregation, hemolysis, alteration of vascular permeability, cytotoxicity, nephrotoxicity, acute renal failure, among other symptoms involved with this protein.</p><p><strong>Case report: </strong>27-year-old male patient, who began with a sudden episode of intense pain in the right hand, in the metacarpus and metacarpophalangeal joints. On clinical examination, the upper extremity was noted to have increased volume, extensive edema, hyperemia, and increased local temperature; The lesion progressed to extensive necrosis. Fasciotomies were performed, from distal to proximal, and release of the second and third finger compartment through longitudinal radial and ulnar incisions. A skin autograft was placed, obtained from the anterior surface of the right thigh. Opioid analgesics, non-steroidal anti-inflammatory drugs, corticosteroids, and antibiotics were administered. The skin biopsy reported: inflammatory infiltrate with neutrophils, ulceration, and bacterial colonies. After 27 days he had a favorable evolution, so he was discharged to his home, with follow-up by staff from the Outpatient Service.</p><p><strong>Conclusion: </strong>Cutaneous loxoscelism, as a cause of acute compartment syndrome of the hand, is rare, but should be considered in an area endemic for <i>Loxosceles spp</i>. Surgical decompression of the affected compartments represents a decisive factor in the treatment of patients.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Lozano, Victoria Marrugo, Juan Carlos Alvarado, Karen Hernandez, Kevin Llinás Caballero, Nathalie Acevedo, Josefina Zakzuk, Luis Caraballo
Objective: To compare the relative frequencies of immune cell populations in the peripheral blood according to A. lumbricoides infection status.
Methods: Peripheral blood samples were collected from participants infected (n = 35) and uninfected with A. lumbricoides (n=27) residing in different rural municipalities of Bolívar. Infection was diagnosed using two coprological examinations and the Kato-Katz technique. Immunophenotyping was performed using two panels of markers and staining in fresh blood. The flow cytometry reading was performed on a spectral cytometer (Northern Lights, Cytek, USA). The populations identified in the first panel (Figure 1) were T lymphocytes (CD45+ CD3+), CD4+ or CD8+, B lymphocytes (CD45+ SSClow CD3- CD19+), neutrophils (CD45+ SSChi CD3- CD16+), and eosinophils (CD45+ SSChi CD3- CD16low). Monocytes were identified in another panel (Figure 2): classical (CD14++ CD16 -), intermediate (CD14++ CD16+), and non-classical (CD14+ CD16++). Dendritic cells, including CD123 + + CD303 + (plasmacytoid), HLA-DR + + CD1c + (myeloid CD1c +), and CD14-CD141 + + (myeloid CD141 +), were also identified. The study received approval from the Ethics Committee of the University of Cartagena, and participants provided informed consent. Funding was provided by the Colombian Sistema General de Regalías under BPIN2020000100405 - BPIN2020000100364.
Results: No significant differences were observed in age [mean cases: 35.69 (SD: 17.7) vs. controls: 37.04 (SD: 15.6) years] or sex (cases: 62.9% vs. controls: 74.1%) (Table 1). All infections were mild, with a median of 96 eggs (IQR, 48-216). A marginally significant difference was observed only in the percentage of neutrophils (45.37% in cases vs. 54.79% in controls, p=0.041) (Figure 3). Although the frequency of eosinophils was higher in the cases (8.1% vs. 6%), this difference was not significant (p=0.138) (Figure 3). No significant differences were observed in the populations of monocytes or dendritic cells between cases and controls (Figure 4).
Conclusion: Mild A. lumbricoides infection appears to affect the number of neutrophils in peripheral blood. The low infection intensity in the studied samples may explain the lack of a significant impact on other cellular populations.
{"title":"[Characterization of peripheral blood cellular populations in relation to Ascaris Lumbricoides infection in rural areas of Bolívar].","authors":"Ana Lozano, Victoria Marrugo, Juan Carlos Alvarado, Karen Hernandez, Kevin Llinás Caballero, Nathalie Acevedo, Josefina Zakzuk, Luis Caraballo","doi":"10.29262/ram.v71i1.1372","DOIUrl":"https://doi.org/10.29262/ram.v71i1.1372","url":null,"abstract":"<p><strong>Objective: </strong>To compare the relative frequencies of immune cell populations in the peripheral blood according to <i>A. lumbricoides</i> infection status.</p><p><strong>Methods: </strong>Peripheral blood samples were collected from participants infected (n = 35) and uninfected with <i>A. lumbricoides</i> (n=27) residing in different rural municipalities of Bolívar. Infection was diagnosed using two coprological examinations and the Kato-Katz technique. Immunophenotyping was performed using two panels of markers and staining in fresh blood. The flow cytometry reading was performed on a spectral cytometer (Northern Lights, Cytek, USA). The populations identified in the first panel (Figure 1) were T lymphocytes (CD45+ CD3+), CD4+ or CD8+, B lymphocytes (CD45+ SSClow CD3- CD19+), neutrophils (CD45+ SSChi CD3- CD16+), and eosinophils (CD45+ SSChi CD3- CD16low). Monocytes were identified in another panel (Figure 2): classical (CD14++ CD16 -), intermediate (CD14++ CD16+), and non-classical (CD14+ CD16++). Dendritic cells, including CD123 + + CD303 + (plasmacytoid), HLA-DR + + CD1c + (myeloid CD1c +), and CD14-CD141 + + (myeloid CD141 +), were also identified. The study received approval from the Ethics Committee of the University of Cartagena, and participants provided informed consent. Funding was provided by the Colombian Sistema General de Regalías under BPIN2020000100405 - BPIN2020000100364.</p><p><strong>Results: </strong>No significant differences were observed in age [mean cases: 35.69 (SD: 17.7) vs. controls: 37.04 (SD: 15.6) years] or sex (cases: 62.9% vs. controls: 74.1%) (Table 1). All infections were mild, with a median of 96 eggs (IQR, 48-216). A marginally significant difference was observed only in the percentage of neutrophils (45.37% in cases vs. 54.79% in controls, p=0.041) (Figure 3). Although the frequency of eosinophils was higher in the cases (8.1% vs. 6%), this difference was not significant (p=0.138) (Figure 3). No significant differences were observed in the populations of monocytes or dendritic cells between cases and controls (Figure 4).</p><p><strong>Conclusion: </strong>Mild <i>A. lumbricoides</i> infection appears to affect the number of neutrophils in peripheral blood. The low infection intensity in the studied samples may explain the lack of a significant impact on other cellular populations.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sergio Iván Assia-Robles, María Del Rocío Hernández-Morales, Eleazar Mancilla-Hernández, Diana Paola López-Méndez, Samara Nazarala-Sanchez, Sandra Aidée González-Hidalgo
Objective: To determine the prevalence and risk factors of the post-COVID-19 condition of children and adolescents from a cohort.
Methods: Observational and analytical cohort study. Statistical analysis: percentages, frequencies; averages; Odds ratio, χ2 test, and multiple binary logistic regression. Statistical Package, for the Social Sciences 23.
Results: Prevalence of the post-COVID-19 condition was: 14.8% of 175 patients who fulfilled the inclusion criteria, 26 developed post-COVID-19 condition, mean age 5.9 years (SD: 5.05), sex: 27% men, 73% women, frequent symptoms: fatigue, runny nose, muscle pain, dyspnea. Symptoms associated with post-COVID-19 condition: muscle pain (OR: 27; p = 0.000; IC95%5.2-139), dysgeusia (OR: 19; p = 0.012; IC95%: 1.9-19), and fatigue (OR: 5; p = 0.001; IC95%: 1.9-13.5). Associated risk factors: female (OR: 3.58; p = 0.023; CI95%: 1.19-10.71), comorbidities (OR: 24.5; p = 0.000; CI95%: 7.52-79), allergic rhinitis (OR: 8.7; p = 0.000; CI95%: 2.66-28.87), atopic dermatitis (OR: 9. 58; p = 0.016 CI95%: 1.51-60.5).
Conclusions: Although the majority of children infected with SARS-CoV-2 recover completely, some of them will develop a post-COVID-19 condition, knowing the most frequent symptoms and associated factors, will allow a better evaluation, for its opportune detection and effective treatment.
{"title":"[Post-COVID-19 condition in children and adolescents from a cohort: prevalence and risk factors].","authors":"Sergio Iván Assia-Robles, María Del Rocío Hernández-Morales, Eleazar Mancilla-Hernández, Diana Paola López-Méndez, Samara Nazarala-Sanchez, Sandra Aidée González-Hidalgo","doi":"10.29262/ram.v71i1.1285","DOIUrl":"10.29262/ram.v71i1.1285","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and risk factors of the post-COVID-19 condition of children and adolescents from a cohort.</p><p><strong>Methods: </strong>Observational and analytical cohort study. Statistical analysis: percentages, frequencies; averages; Odds ratio, χ<sup>2</sup> test, and multiple binary logistic regression. Statistical Package, for the Social Sciences 23.</p><p><strong>Results: </strong>Prevalence of the post-COVID-19 condition was: 14.8% of 175 patients who fulfilled the inclusion criteria, 26 developed post-COVID-19 condition, mean age 5.9 years (SD: 5.05), sex: 27% men, 73% women, frequent symptoms: fatigue, runny nose, muscle pain, dyspnea. Symptoms associated with post-COVID-19 condition: muscle pain (OR: 27; p = 0.000; IC95%5.2-139), dysgeusia (OR: 19; p = 0.012; IC95%: 1.9-19), and fatigue (OR: 5; p = 0.001; IC95%: 1.9-13.5). Associated risk factors: female (OR: 3.58; p = 0.023; CI95%: 1.19-10.71), comorbidities (OR: 24.5; p = 0.000; CI95%: 7.52-79), allergic rhinitis (OR: 8.7; p = 0.000; CI95%: 2.66-28.87), atopic dermatitis (OR: 9. 58; p = 0.016 CI95%: 1.51-60.5).</p><p><strong>Conclusions: </strong>Although the majority of children infected with SARS-CoV-2 recover completely, some of them will develop a post-COVID-19 condition, knowing the most frequent symptoms and associated factors, will allow a better evaluation, for its opportune detection and effective treatment.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Legumes belonging to the family Fabaceae of the order Fabales are a widely consumed source of protein. IgE-mediated hypersensitivity reactions to legumes have been described, the most studied allergens being peanuts and soybeans. In the Mediterranean region and India, lentils, chickpeas and peas have been considered important allergens and legumes have been reported to represent the fifth most common cause of food allergy in children under 5 years of age in Spain. In Latin America, there are few reports of allergy to legumes other than peanuts, and these are especially in the paediatric population.
Objective: To describe a case of IgE-mediated legume allergy in an adult female patient.
Case report: We describe the case of a 65-year-old female patient who reports a 20-year history of generalized urticaria, accompanied by angioedema and dyspnea occurring immediately after consumption of lentils, beans, chickpeas, soya beans and cold meats, requiring admission to the emergency department for this cause. Tolerates peanuts. She does not report anaphylaxis in any context other than those described. He has presented generalized pruritus with exposure to fumes from cooking beans. Pathological history: Hypertension, type II diabetes mellitus, hypothyroidism. Allergic: Anaphylaxis due to penicillin at the age of 30. Other history: extensive local reaction to hymenoptera sting. Prick test trophoallergens: soya 3 mm. Prick to prick protein based on commercial soybean 7mm, chickpea 5mm, lentil 6mm and bean 7mm. He was negative for wheat and peanut (Image 1) (Attached in separate file). It has a normal tryptase report. Indication was given for adequate adrenaline and strict avoidance of legumes, except peanuts.
Conclusions: Legume allergy is little known in our environment and mainly affects children. Clinical manifestations include mild reactions and anaphylaxis. A high degree of cross-reactivity among legumes has been reported. Lentils have cross-reactivity with chickpeas and beans. Peanut allergy may also be associated with allergy to lentils, chickpeas, and peas, but is less frequently reported.
{"title":"[Anaphylaxis due to legumes: case report].","authors":"Leidy Johana Alzate-Pérez, Natalia Aguirre-Morales, Libia Susana Diez-Zuluaga","doi":"10.29262/ram.v71i1.1358","DOIUrl":"10.29262/ram.v71i1.1358","url":null,"abstract":"<p><strong>Background: </strong>Legumes belonging to the family <i>Fabaceae</i> of the order <i>Fabales</i> are a widely consumed source of protein. IgE-mediated hypersensitivity reactions to legumes have been described, the most studied allergens being peanuts and soybeans. In the Mediterranean region and India, lentils, chickpeas and peas have been considered important allergens and legumes have been reported to represent the fifth most common cause of food allergy in children under 5 years of age in Spain. In Latin America, there are few reports of allergy to legumes other than peanuts, and these are especially in the paediatric population.</p><p><strong>Objective: </strong>To describe a case of IgE-mediated legume allergy in an adult female patient.</p><p><strong>Case report: </strong>We describe the case of a 65-year-old female patient who reports a 20-year history of generalized urticaria, accompanied by angioedema and dyspnea occurring immediately after consumption of lentils, beans, chickpeas, soya beans and cold meats, requiring admission to the emergency department for this cause. Tolerates peanuts. She does not report anaphylaxis in any context other than those described. He has presented generalized pruritus with exposure to fumes from cooking beans. <i>Pathological history</i>: Hypertension, type II diabetes mellitus, hypothyroidism. <i>Allergic</i>: Anaphylaxis due to penicillin at the age of 30. <i>Other history</i>: extensive local reaction to hymenoptera sting. Prick test trophoallergens: soya 3 mm. Prick to prick protein based on commercial soybean 7mm, chickpea 5mm, lentil 6mm and bean 7mm. He was negative for wheat and peanut (Image 1) (Attached in separate file). It has a normal tryptase report. Indication was given for adequate adrenaline and strict avoidance of legumes, except peanuts.</p><p><strong>Conclusions: </strong>Legume allergy is little known in our environment and mainly affects children. Clinical manifestations include mild reactions and anaphylaxis. A high degree of cross-reactivity among legumes has been reported. Lentils have cross-reactivity with chickpeas and beans. Peanut allergy may also be associated with allergy to lentils, chickpeas, and peas, but is less frequently reported.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hereditary Angioedema (HAE) is a rare disease characterized by episodes of swelling, HAE crisis could cause death by suffocation, and also affect the quality of life in these patients. There exists an important disparity of HAE specific treatments between countries, inclusive in the same region, currently in Perú we use moderate and high doses of Tranexamic Acid (TA) in prophylaxis therapy and in acute HAE crisis respectively.
Objective: To report our experience with TA in three types of HAE patients and be a guide to other countries with this therapy, where HAE specific treatments are not registered.
Case report: Patient 1: Woman. 49 years old. HAE-1. Symptoms began at the age of 12. Her final diagnosis was at age 45. Usually presents an acute crisis every two months approximately, she receives 2 g IV of TA when lips, tongue, facial episodes is beginning, eventually she needed other 1 - 2 g IV (after 4 hours). She receives Long-Term Prophylaxis (LTP) with TA (500 - 750 mg)/12 h. Patient 2: Woman 47 years old, HAE nC1INH-FXII. Symptoms began at the age of 19, during her first pregnancy, her definitive diagnosis was at the age of 41 years. She maintains a prophylaxis treatment of TA (750 mg-1,5 g)/daily; upper airway attacks are treated immediately with TA doses (1 - 2 g) when the crisis is beginning. Patient 3: Woman 43 years old, HAE-nC1INH-U. Genetic study did not recognize SERPING1, PLG1, ANGPT1, KNG1, FXII, mutations. Symptoms began at age 4, and her final diagnosis was at age 36. When the attack is beginning, she immediately receives TA (500 - 750 mg) orally / 12 hours during 2 to 3 days with acceptable tolerance and control of the HAE episodes. While the patients receive TA prophylaxis treatment doses (500 - 750 mg) every 8 or 12 hours respectively, the HAE episodes are less symptomatic and resolve in a few days.
Conclusions: We found this systematic review, used TA orally, on-demand and prophylaxis therapy, maximum cumulative dose 3 g/24 h1. In our HAE patients, we used TA up to 4 g (2 g - 2 g) intravenous for control of acute crisis in a interval of 4 hours, when decreases the reaction, the orally maintenance dose should be prescribed, 1 g/8 h with a progressive decrease of the dose in the next days. Tranexamic Acid treatment was useful in our different types of HAE patients. Most of our patients use high doses of TA to slow down and stop slowly the HAE crisis. TA is probably an option in countries where specific treatments are not registered, it could be administered orally and/or intravenous. High doses of TA were well tolerated and with acceptable response in HAE attacks.
{"title":"[Case series of hereditary angioedema patients and use of tranexamic acid treatments in prophylaxis and acute crisis, experience in Perú].","authors":"Oscar Calderón, Danny Muñoz, Margarita Olivares","doi":"10.29262/ram.v71i1.1319","DOIUrl":"10.29262/ram.v71i1.1319","url":null,"abstract":"<p><strong>Background: </strong>Hereditary Angioedema (HAE) is a rare disease characterized by episodes of swelling, HAE crisis could cause death by suffocation, and also affect the quality of life in these patients. There exists an important disparity of HAE specific treatments between countries, inclusive in the same region, currently in Perú we use moderate and high doses of Tranexamic Acid (TA) in prophylaxis therapy and in acute HAE crisis respectively.</p><p><strong>Objective: </strong>To report our experience with TA in three types of HAE patients and be a guide to other countries with this therapy, where HAE specific treatments are not registered.</p><p><strong>Case report: </strong><i><b>Patient 1:</b></i> Woman. 49 years old. HAE-1. Symptoms began at the age of 12. Her final diagnosis was at age 45. Usually presents an acute crisis every two months approximately, she receives 2 g IV of TA when lips, tongue, facial episodes is beginning, eventually she needed other 1 - 2 g IV (after 4 hours). She receives Long-Term Prophylaxis (LTP) with TA (500 - 750 mg)/12 h. <i><b>Patient 2:</b></i> Woman 47 years old, HAE nC1INH-FXII. Symptoms began at the age of 19, during her first pregnancy, her definitive diagnosis was at the age of 41 years. She maintains a prophylaxis treatment of TA (750 mg-1,5 g)/daily; upper airway attacks are treated immediately with TA doses (1 - 2 g) when the crisis is beginning. <i><b>Patient 3:</b></i> Woman 43 years old, HAE-nC1INH-U. Genetic study did not recognize SERPING1, PLG1, ANGPT1, KNG1, FXII, mutations. Symptoms began at age 4, and her final diagnosis was at age 36. When the attack is beginning, she immediately receives TA (500 - 750 mg) orally / 12 hours during 2 to 3 days with acceptable tolerance and control of the HAE episodes. While the patients receive TA prophylaxis treatment doses (500 - 750 mg) every 8 or 12 hours respectively, the HAE episodes are less symptomatic and resolve in a few days.</p><p><strong>Conclusions: </strong>We found this systematic review, used TA orally, on-demand and prophylaxis therapy, maximum cumulative dose 3 g/24 h<sup>1</sup>. In our HAE patients, we used TA up to 4 g (2 g - 2 g) intravenous for control of acute crisis in a interval of 4 hours, when decreases the reaction, the orally maintenance dose should be prescribed, 1 g/8 h with a progressive decrease of the dose in the next days. Tranexamic Acid treatment was useful in our different types of HAE patients. Most of our patients use high doses of TA to slow down and stop slowly the HAE crisis. TA is probably an option in countries where specific treatments are not registered, it could be administered orally and/or intravenous. High doses of TA were well tolerated and with acceptable response in HAE attacks.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iván Tinoco-Moran, Oscar Calderón-Liosa, Margarita Olivares-Gómez, Victor Farinango-Salazar, Iván Chérrez-Ojeda
Background: Anaphylaxis is a severe systemic allergic reaction that can be life-threatening, timely diagnosis and treatment is required in these patients, one of the most frequent triggers is pharmacological.
Objective: To report the case of a patient who presented anaphylaxis due to eye drops.
Case report: A 7-year-old male with a history of rhinitis and asthma with good control. It started with itchy eyes, ophthalmic drops were administered, composition: Polyethylene glycol 400, 0.4%, Propylene glycol 3 mg, polyquad 0.001%, presenting at 15 minutes an episode of anaphylaxis initially characterized by pruritus and intense conjunctival erythema, later nausea, vomiting, sweating, weakness, urticaria/facial angioedema and dyspnea were added, this episode was controlled opportunely with Levocetirizine 5 mg sublingual and Betametasona 4 mg intramuscular, progressively improving over the next 2 hours. The patient was evaluated by the Allergist, written recommendations were given to the mother in case this reaction occurred again, the use of the drops was prohibited, and the performance of skin test and a probable conjunctival provocation protocolized with the ophthalmic drops were pending. Accidentally 2 months later the patient was re-exposed with the same eye drops, presenting a similar reaction 15 minutes after the administration of the medication, they went to the emergency room where he received antihistamine and corticosteroid intravenous treatment, after this re-exposure is confirmed to the ophthalmic drops mentioned above as a trigger of anaphylaxis in this patient.
Conclusions: We present a case of conjunctival anaphylaxis after application of eye drops, confirmed by re-exposure to the drug. It is essential to give diagnoses, recommendations with treatments and avoidance of the probable triggering agent of the reaction. The administration of immediate medication when the allergic episode begins in these patients can be vital, even more so when they live far from a health center, as was the case in this patient.
{"title":"[Clinical case of anaphylaxis due to eye drops].","authors":"Iván Tinoco-Moran, Oscar Calderón-Liosa, Margarita Olivares-Gómez, Victor Farinango-Salazar, Iván Chérrez-Ojeda","doi":"10.29262/ram.v71i1.1324","DOIUrl":"10.29262/ram.v71i1.1324","url":null,"abstract":"<p><strong>Background: </strong>Anaphylaxis is a severe systemic allergic reaction that can be life-threatening, timely diagnosis and treatment is required in these patients, one of the most frequent triggers is pharmacological.</p><p><strong>Objective: </strong>To report the case of a patient who presented anaphylaxis due to eye drops.</p><p><strong>Case report: </strong>A 7-year-old male with a history of rhinitis and asthma with good control. It started with itchy eyes, ophthalmic drops were administered, composition: Polyethylene glycol 400, 0.4%, Propylene glycol 3 mg, polyquad 0.001%, presenting at 15 minutes an episode of anaphylaxis initially characterized by pruritus and intense conjunctival erythema, later nausea, vomiting, sweating, weakness, urticaria/facial angioedema and dyspnea were added, this episode was controlled opportunely with Levocetirizine 5 mg sublingual and Betametasona 4 mg intramuscular, progressively improving over the next 2 hours. The patient was evaluated by the Allergist, written recommendations were given to the mother in case this reaction occurred again, the use of the drops was prohibited, and the performance of skin test and a probable conjunctival provocation protocolized with the ophthalmic drops were pending. Accidentally 2 months later the patient was re-exposed with the same eye drops, presenting a similar reaction 15 minutes after the administration of the medication, they went to the emergency room where he received antihistamine and corticosteroid intravenous treatment, after this re-exposure is confirmed to the ophthalmic drops mentioned above as a trigger of anaphylaxis in this patient.</p><p><strong>Conclusions: </strong>We present a case of conjunctival anaphylaxis after application of eye drops, confirmed by re-exposure to the drug. It is essential to give diagnoses, recommendations with treatments and avoidance of the probable triggering agent of the reaction. The administration of immediate medication when the allergic episode begins in these patients can be vital, even more so when they live far from a health center, as was the case in this patient.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentina Prada-Moreno, Juan David Wilches-Gutiérrez, Diana Roció Arias-Osorio
Objective: Describe the design and implementation of a transdisciplinary care model for patients with hereditary angioedema in Colombia.
Methods: Descriptive longitudinal observational study. 140 patients with hereditary angioedema were included in a transdisciplinary care model for one year. Seizure rates, hospitalizations, emergency room visits, quality of life, and pharmacological adherence were measured.
Results: The model was associated with reductions of 76% in seizures, 66% in hospitalizations, and 87% in emergency room visits. Pharmacological adherence increased 19% and was complete after four months. The quality of life increased significantly.
Conclusions: Hereditary angioedema is an orphan disease that requires a comprehensive approach for effective care.
{"title":"[Design and implementation of a transdisciplinary care model for patients with hereditary angioedema, in a Colombian health institution].","authors":"Valentina Prada-Moreno, Juan David Wilches-Gutiérrez, Diana Roció Arias-Osorio","doi":"10.29262/ram.v71i1.1378","DOIUrl":"10.29262/ram.v71i1.1378","url":null,"abstract":"<p><strong>Objective: </strong>Describe the design and implementation of a transdisciplinary care model for patients with hereditary angioedema in Colombia.</p><p><strong>Methods: </strong>Descriptive longitudinal observational study. 140 patients with hereditary angioedema were included in a transdisciplinary care model for one year. Seizure rates, hospitalizations, emergency room visits, quality of life, and pharmacological adherence were measured.</p><p><strong>Results: </strong>The model was associated with reductions of 76% in seizures, 66% in hospitalizations, and 87% in emergency room visits. Pharmacological adherence increased 19% and was complete after four months. The quality of life increased significantly.</p><p><strong>Conclusions: </strong>Hereditary angioedema is an orphan disease that requires a comprehensive approach for effective care.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Identify molecular mimicry between TPO, eosinophil peroxidase (EPX), thyroglobulin and IL24 and microorganism antigens.
Methods: Through in silico analysis, we performed local alignments between human and microorganism antigens with PSI-BLAST. Proteins that did not present a 3D structure were modeled by homology through the Swiss Modeller server and epitope prediction was performed through Ellipro. Epitopes were located in the 3D models using PYMOL software.
Results: A total of 38 microorganism antigens (parasites, bacteria) had identities between 30% and 45%, being the highest with Anisakis simplex. The alignment between 2 candidate proteins from A. simplex and EPX presented significant values, with identities of 43 and 44%. In bacteria, Campylobacter jejuni presented the highest identity with thyroglobulin (35%). 220 linear and conformational epitopes of microorganism antigens were predicted. Peroxidasin-like proteins from Toxocara canis and Trichinella pseudospiralis presented 10 epitopes similar to TPO and EPX, as possible molecules triggering cross-reactivity. No virus presented identity with the human proteins studied.
Conclusion: TPO and EPX antigens shared potential cross-reactive epitopes with bacterial and nematode proteins, suggesting that molecular mimicry could be a mechanism that explains the relationship between infections and urticaria/hypothyroidism. In vitro work is needed to demonstrate the results obtained in the in silico analysis.
{"title":"[Molecular mimicry between human thyroid peroxidase, thyroglobulin, cosinophil peroxidase, IL-24 and microorganisms antigens].","authors":"Andrés Sánchez, Valentina García, Yuliana Marcela Emiliani-Navarro, Jorge Sánchez, Juan Camilo Ramos-Gomez, Sonia Karina González-Rangel, Marlon Munera-Gomez","doi":"10.29262/ram.v71i1.1376","DOIUrl":"10.29262/ram.v71i1.1376","url":null,"abstract":"<p><strong>Objective: </strong>Identify molecular mimicry between TPO, eosinophil peroxidase (EPX), thyroglobulin and IL24 and microorganism antigens.</p><p><strong>Methods: </strong>Through in silico analysis, we performed local alignments between human and microorganism antigens with PSI-BLAST. Proteins that did not present a 3D structure were modeled by homology through the Swiss Modeller server and epitope prediction was performed through Ellipro. Epitopes were located in the 3D models using PYMOL software.</p><p><strong>Results: </strong>A total of 38 microorganism antigens (parasites, bacteria) had identities between 30% and 45%, being the highest with Anisakis simplex. The alignment between 2 candidate proteins from A. simplex and EPX presented significant values, with identities of 43 and 44%. In bacteria, Campylobacter jejuni presented the highest identity with thyroglobulin (35%). 220 linear and conformational epitopes of microorganism antigens were predicted. Peroxidasin-like proteins from Toxocara canis and Trichinella pseudospiralis presented 10 epitopes similar to TPO and EPX, as possible molecules triggering cross-reactivity. No virus presented identity with the human proteins studied.</p><p><strong>Conclusion: </strong>TPO and EPX antigens shared potential cross-reactive epitopes with bacterial and nematode proteins, suggesting that molecular mimicry could be a mechanism that explains the relationship between infections and urticaria/hypothyroidism. In vitro work is needed to demonstrate the results obtained in the in silico analysis.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}