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

Background: Adverse drug reactions are defined as unexpected reactions, either derived from the pharmacokinetics of the treatment (Type A) or as a host immune response (Type B), resulting in harmful or undesirable manifestations in the patient following the administration of pharmacological therapy. Type B reactions are less defined and are considered a result of hypersensitivity to pharmacological treatment, categorized as immediate (within 1 to 6 hours after exposure) and delayed or non-immediate (occurring 6 hours after exposure).

Objective: A review to describe the immunological mechanisms of delayed hypersensitivity reactions to drugs.

Methods: A search of major medical databases on delayed hypersensitivity reactions to drugs was conducted. The review was limited to articles published in the period between 2013 and 2023, taking into consideration articles written in English and Spanish.

Results: The terms defining delayed hypersensitivity reactions to drugs, their classification, clinical manifestations, diagnosis, treatment algorithms, and prognosis.

Conclusions: Adverse drug reactions represent a challenge for the specialist physician, with a complex pathophysiology. A prompt diagnosis and treatment focused on the drug phenotype and its immunological expression are required to provide a multidisciplinary approach.

Objetives: To describe the events supposedly attributable to immunization with the Pfizer-BioNTech® COVID-19 vaccine in children aged 5 to 17 years in the state of Puebla, Mexico.

Methods: Observational, cross-sectional and descriptive study carried out based on the analysis of reports of events supposedly attributable to immunization in children aged 5 to 17 years, who received the vaccine with the BNT162b2 mRNA platform for COVID-19, since January. to December 2022. Percentages, frequencies, averages, standard deviations and medians were used for statistical analysis. The Statistical Package for the Social Sciences 23 program was implemented.

Results: 1,993,373 doses of the BNT162b2 vaccine were administered. 52 events presumed to be attributable to vaccination or immunization were reported. An annual rate of 2.6 per 100,000 doses applied was estimated. The age distribution recorded a median of 10.50 years (SD: 3.53). There were 56% women and 44% men; The most frequent symptoms were: dizziness, nausea, vomiting and pain at the vaccine application site. 2 cases of seizures and 1 of flaccid paralysis were reported.

Conclusions: The safety of vaccines against SARS-CoV-2 requires an improvement in strategies for epidemiological surveillance (passive and active), with a more robust approach to guarantee safe vaccination.

Background: Urticaria is characterized by the transient appearance of hives, angioedema, or both. Acute urticaria lasts less than 6 weeks. The origin is idiopathic in more than 50% of cases, and the most frequent triggers are infectious processes, drugs and foods.

Objective: Describe the origin, pathophysiology and treatment of patients with acute urticaria.

Methods: A bibliographic search of articles was carried out in PubMed, where the Mesh terms: "Urticaria", "Angioedema" and "Antihistamines" were included and those with information related to acute urticaria were chosen, among those published from 2014 to 2023. In addition, the inclusion of some publications from previous years was considered, due to their relevance for this review.

Results: The initial search returned 135 articles, but only 104 were used for the final manuscript.

Conclusions: Acute urticaria is one of the most frequent reasons for consultation in the Allergology and Dermatology emergency services. Although there are multiple etiological factors, most cases are idiopathic, so it should not be overdiagnosed as an allergic reaction.

Background: Allergic sensitization to topical antimicrobial treatments is a well-known problem. Furacin® is one of the most widely used in our environment. It contains 0.2% nitrofurazone and polyethylene glycol (PEG) as a vehicle.

Case report: 57-year-old male with no history of interest. He presented skin rash, blisters, and serous exudate 2-3 days after starting treatment with Furacin® (applied to an infected skin wound). Epicutaneous tests were performed with a true test battery, nitrofurantoin 1% in petrolatum, PEG15000 and 4000 1% in petrolatum, pure PEG 400, PEG monomethyl ether 350 1% in water. Positive result at 96 hours for nitrofurantoin.

Conclusion: Nitrofurazone is widely used as a topical antibiotic because of its bactericidal spectrum. It (including its excipients) should be considered in case of adverse reactions after application.

Objective: Estimate the prevalence of dermatological manifestations in Mexican patients with common variable immunodeficiency.

Methods: Cross-sectional and retrospective study, based on the analysis of records of patients with a diagnosis of common variable immunodeficiency, treated at the Siglo XXI National Medical Center (Mexican Social Security Institute), according to the criteria of the European Society of Immunodeficiencies (ESID). and of which only 3 had a genetic diagnosis with the following mutations: IRF2, CTLA4 and PIK-3, belonging to the Immunodeficiency Clinic of the National Medical Center Siglo XXI (IMSS), to evaluate dermatological manifestations, review of laboratory tests: IgA, IgM, IgG and type of replacement therapy with Immunoglobulin. The statistical analysis was carried out with the SPSS program; Descriptive statistics were used to analyze the data, according to the type of variable to be analyzed.

Results: 36 patients were included, of which 55.5% were women; with median age 34 years (18-94). The prevalence of dermatological manifestations was 70% (n = 25). 30.5% had a history of infectious dermatosis and 39.5% had a history of non-infectious dermatosis. The most common dermatosis was irritant contact dermatitis in 13.8% of patients. All received replacement therapy with human immunoglobulin, 33.3% intravenously and the rest subcutaneously.

Conclusions: Common variable immunodeficiency is an inborn error of immunity, with different clinical manifestations in various organs and systems (the skin is one of these). Dermatological manifestations are not usually described in patients with common variable immunodeficiency; However, it is important to identify them due to their relationship with certain complications (increased risk of superinfection), due to skin disruption and biological therapies.

Objetives: To evaluate the impact of cholecalciferol (D₃) supplementation using clinical and paraclinical variables in patients with RA and vitamin D insufficiency and deficiency.

Methods: A randomized, double-blind, placebo-controlled study included patients from 5 to 40 years with a diagnosis of RA and vitamin D insufficiency and deficiency. They were supplemented for 8 weeks with 4000 or 5000 IU, depending on age. Total nasal symptoms score (TNSS) was measured monthly and 25(OH)D₃ levels at baseline and at the end of the study.

Results: A total of 31 patients were included, with a mean age of 18.19 years. In the active group, there was a significant improvement in symptomatology with respect to the TNSS score and an increase in serum vitamin D levels (p < 0.01). There were no adverse reactions with cholecalciferol or placebo.

Conclusions: Supplementing patients with vitamin D₃, at the evaluated dose, together with conventional treatent for allergic rhinitis results in symptoms and quality of life improvement in patients with this disease.

Objective: Determine the level of knowledge of mothers of children under 5 years of age about vaccination schedule.

Methods: Cross-sectional, observational, descriptive, and analytical study, carried out in the Family Medicine Unit 1 of Orizaba, Veracruz, in which two questionnaires were applied to mothers of children under 5 years of age, one prepared by PAHO that qualifies attitudes. of parents about vaccines, and another that evaluates knowledge of immunizations. Absolute frequencies and percentages were estimated; and the association with Pearson's X² was determined.

Results: A total of 138 women were registered, with age limits of 18 to 48 years. The level of knowledge was high (70.3%) and was related to the age, education (p = 0.00) and occupation (p = 0.03) of the mothers. The highest frequencies were for housewives (47.1%), professionals (3.5%), married (60.2%) and of the Catholic religion (81.2%).

Conclusions: This study confirms the null hypothesis, which indicates that 70.3% have high knowledge about vaccination, and it is associated with the age, education, and occupation of the mothers.

Objective: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México.

Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019.

Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%).

Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

Background: Acute liver failure in pediatric age is a serious multisystem disease, characterized by a failure of the synthesis and detoxification function of the liver. Among the etiologies, viral infection should be investigated. Treatment is supportive and some cases require liver transplantation.

Case report: A 2-year-old girl was admitted for acute liver failure. The PCR viral panel was positive for Adenovirus 41 and IgG antibodies to SARS-CoV-2 were also found. Supportive treatment was started without improvement, so intravenous immunoglobulin was administered, with resolution of the liver failure.

Conclusions: Immunoglobulin has immunomodulatory mechanisms in children with severe acute hepatitis of infectious etiology, so in some cases, its administration can be considered as adjuvant therapy.