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

Background: The treatment of eosinophilic esophagitis (EoE) is based on diets or drugs, with either being the first choice. Proton pump inhibitor (PPI) or swallowed topical corticosteroids (STC) are classically used, and more recently the use of dupilumab has been described as a therapeutic option.

Case report: A pediatric patient with difficult-to-manage eosinophilic esophagitis, diagnosed before the age of 2 years, in which the simultaneous use of triple pharmacological therapy (Dupilumab, PPI and STC) has been necessary for the histological control of the disease.

Conclusion: It is a case of interest since in current guidelines the use of combined pharmacological therapies is not recommended or fully described. In addition, it is a case in which a good response to treatment with dupilumab is observed despite not meeting the indication criteria of the pharmacological label, in terms of age and weight.

Background: This article analyzes the effects of a histamine- and pseudoallergen-restricted diet as an additional strategy in the treatment of chronic spontaneous urticaria (CSU). A comprehensive review of the literature was conducted using PubMed and Google Scholar, employing both MeSH and non-MeSH terms related to urticaria, histamine, and diet. The review included 78 selected articles published between 2014 and 2024. CSU is a persistent disease in which a considerable number of patients do not respond optimally to standard treatments. Up to one-third of these patients may benefit from reducing the intake of pseudoallergens and histamine-rich foods. Bioactive amines present in various foods tend to exacerbate CSU symptoms by promoting the release of histamine and other inflammatory mediators. The restriction of dietary histamine and the enhancement of diamine oxidase (DAO) enzyme function appear to alleviate symptoms, although variability in reported histamine levels across studies complicates the development of standardized guidelines. It is concluded that a low-histamine and pseudoallergen diet is a promising option for reducing symptoms in patients with chronic spontaneous urticaria (CSU), particularly those who do not achieve adequate control with antihistamines. Evaluating the effectiveness of this diet over a period of three to four weeks is recommended to observe potential benefits. Nevertheless, additional studies and further standardization are necessary to define safe histamine levels in foods and improve therapeutic recommendations.

Background: Adverse drug reactions are harmful and unintentional events related to medication use. Stevens-Johnson Syndrome is a serious adverse drug reaction that can progress to toxic epidermal necrolysis and is related to certain medications. It can even be triggered by infections and genetic factors.

Case report: A 62-year-old female patient with high blood pressure developed severe skin lesions after self-medicating with paracetamol and ibuprofen. She recovered favorably after several treatments and admissions to the Intensive Care Unit.

Conclusion: It is important to promptly identify the triggering factors of adverse drug reactions in order to intervene appropriately. The administration of corticosteroids and IV immunoglobulin is still under discussion. Immediate attention is required to improve clinical outcomes and comprehensive treatment, thus optimizing the outcome.

Background: Contact dermatitis to cosmetic products is a common condition. It is likely the most frequent reason for performing patch tests because many substances used in cosmetics are potent allergens. Cosmetic contact dermatitis most frequently affects the face. Patch test series need to be continuously revised to identify outdated and emerging allergens. The aim of this study is to propose a reformulation of the patch test series for cosmetics. The list of European Surveillance System on Contact Allergies was initially used to select the allergens. Publications in PubMed from the last 10 years were sought, showing the frequency of positive reactions to cosmetic allergens that were tested as part of a baseline series or cosmetics series. Subsequently, large international databases evaluating retail products were consulted to verify if these substances were present in cosmetics, because the relevance would be their presence in commercially sold cosmetics. It was adopted a threshold of 0.3% positive patch test reactions for including a substance in cosmetics series. It was deleted those present in the baseline series (Associação Brasileira de Alergia e Imunologia), fragrances, and allergens limited to hair products. It is believed that choosing too few allergens may result in the non-identification of relevant allergens and treatable cases. On the other hand, testing a series with many allergens is time-consuming and more costly. Therefore, it seems appropriate to create cosmetics series with 20 elements.

Objective: To evaluate, through in silico analysis, the cross-reactivity between Sco m 5 and arthropod proteins and to identify potential IgE-binding epitopes.

Methods: The homology between Sco m 5 and 15 arthropod allergens (Vespula, Polistes, Polybia, Solenopsis, Brachyponera, Phoneutria, and Dermatophagoides) was assessed using the ALLERMATCH server for pairwise alignments and PRALINE for multiple alignments. Phylogenetic trees were constructed using Molecular Evo-lutionary Genetics Analysis (MEGA). Epitope prediction was performed with the Ellipro server. Protein visualization was carried out through PyMOL.

Results: The multiple alignment showed 50% identity, and the pairwise alignments between Sco m 5 and arthropod proteins revealed diverse homology. Two linear epitopes and one conformational epitope were identified in Sco m 5, which were highly conserved in the studied arthropod proteins, such as bees, wasps, and ants.

Conclusion: The high homology between Sco m 5 and allergens from other arthropods supports the potential for cross-reactivity. The identification of potential epitopes in conserved regions reinforces this idea and could serve as important targets for therapeutic interventions in allergies triggered by arthropod venoms, especially Scolopendra spp. Further in vitro and in vivo studies are needed to confirm these findings.

Objetives: To determine the clinical and epidemiological characteristics and factors associated with immuno-suppression in children living with HIV.

Methods: Observational, analytical, cross-sectional study of patients treated at the Outpatient Center for the Prevention and Care of AIDS and Sexually Transmitted Infections in the State of Puebla. Statistical analysis: percentages, frequencies, means, standard deviation and medians; Inferential analysis: X² and univariate logistic regression. Statistical Package, for the Social Sciences 24.

Results: A total of 83 patients aged 0 to 17 years (mean 7 years; SD ± 6.3) were selected, with an average age at diagnosis of 2.6 years. Vertical transmission was found in 90% of cases; women 47% and men 53%. The most frequent diseases were recurrent infections, lymphadenopathy, diarrhea; four cases of tuberculosis were reported, malnutrition 35%. Clinical category: N 25%, A 66%. Immunological category: 1-72%, 2-13%. Factors associated with immunosuppression were vertical transmission (p < 0.008) and CD4 level (p < 0.007).

Conclusions: Knowing the characteristics that describe pediatric HIV/AIDS, its clinical presentation, and its limitations, may guide to install improvements in care and follow-up, improving the prognosis of children.

Objective: Determine the prevalence of allergic rhinitis in school children.

Methods: Cross-sectional, descriptive study in children from 6 to 10 years old. Those who underwent skin testing (mites, pollens, fungi, cockroach, dog and cat hair) were included. The diagnosis of allergic rhinitis was made based on the test recommended by the European Academy of Allergy and Clinical Immunology (EAACI) and the American College of Allergy, Asthma and Immunology (ACAAI) for the diagnosis of allergy mediated by allergen-specific IgE. The statistical analysis included confidence interval for averages and percentages.

Results: In the 992 patients, the prevalence of allergic rhinitis was 15.7% (95% CI; 13.4-18.0), the predominant symptom was hyaline rhinorrhea in 94.7% (95% CI; 91.4-94.6), the main allergen was dust mites 60.4% (95% CI; 52.7-68.1) and pollen 59.3% (95% CI; 51.6-67.0).

Conclusion: The prevalence of allergic rhinitis in school children with positive skin tests is 15.7%, with a predominance of males with 63.1%.

Background: Tree tomato (Solanum betaceum or Cyphomandra betaceae) or tamarillo belongs to the Solanaceae family and is widely consumed in Latin American countries.

Case report: We report the case of a 43-year-old male from Ecuador who suffered two systemic anaphylaxis after drinking tamarillo juice, with previous tolerance to tamarillo on several occasions. Allergology study showed positivity in prick-prick to tamarillo peel and pulp and negativity to other types. SDS-PAGE immunoblotting with peel-pulp and Western Blot showed multiple bands between 14-75 kDa in tamarillo peel and 11-75 kDa in pulp. ELISA inhibition showed that tamarillo only inhibited itself.

Conclusions: Given the results and tolerance to other types of tomato, we believe that the causative protein could be selective, so we report the first case of primary sensitivity to Solanum betaceum (tamarillo).