Revista alergia Mexico最新文献

Objective: To describe health relaed quality of life in a cohort of stable adult outpatients with hereditary an-gioedema (HAE) with validated tools.

Methods: An observational, cross-sectional, and descriptive study was performed, carried out in patients with hereditary angioedema, coming from the City of Buenos Aires and its provinces: Corrientes, Chubut, Entre Ríos and Santa Fe. The HAE-QoL and SF-12v2 health questionnaires were applied to assess the related quality of life. with health.

Results: 100 patients were included; median age: 41.5 years (range: 18-77); 65% were female, and 79% had type 1 HAE. Asymptomatic, mild, moderate and severe cases accounted for 6, 29, 38, and 27% of participants, respectively. Seventeen percent of patients were receiving long-term prophylaxis. Icatibant was the most fre-quent treatment for acute episodes. All health domains SF-12v2 scores were lower than expected in general population, excepting "vitality" and "physical functioning". Total and all specific domains HAE-QoL scores were reduced. Differences between women and men and in every age-defined group were demonstrated for sev-eral specific domains.

Conclusions: Health relaed to quality life was notably reduced in Argentinean patients with HAE, when imple-menting the HAE.QoL, and SF-12v2 questionnaries. The need for multidisciplinary strategies approaching this complex disease is highlighted.

Objective: To evaluate the differences and similarities in clinical picture, laboratory findings and outcomes between children's with Kawasaki Disease (KD) versus multisystem inflammatory syndrome (MIS-C).

Methods: We conducted a retrospective, comparative study from children with Kawasaki Disease (KD) hospi-talized in Sinaloa Pediatric Hospital from January 1, 2004, to March 31, 2020, and patients with multisystem inflammatory syndrome (MIS-C) according with World Health Organization (WHO) case definition criteria be-tween May 1, 2020 and May 31, 2021. Demographic characteristics, epidemiological data, clinical features, laboratory findings, type of treatment and clinical outcomes were compared among both groups.

Results: Eighty-one patients were included (62 patients with KD and 19 with MIS-C). several clinical and lab-oratory differences were found among these two entities. Median age was lower in KD vs. MIS-C (25 vs 79 months). Those finding more frequent in KD were male gender (64.5 vs. 47.4%), Mucocutaneous features (93.5 vs. 63.2%): Oral changes (83.9 vs. 63.2%) and extremity changes (77.4 vs. 57.9%); complete form of KD was (75.8 vs. 47.4%), Coronary artery aneurysm (16.1 vs. 11.8%). Secondly, findings that were more frequent in MIS-C than KD were Gastrointestinal involvement (89.4 vs. 9.6%), shock (57.9 vs. 3.2%), neurological symp-toms (63.1 vs. 11.2%), kidney involvement (52.6 vs. 16.1%), heart disease in general (52.9% vs 29%): Myocardial dysfunction (23.5 vs. 11.3%) and pericardial effusion (17.6 vs. 2.9%). Lymphocyte count (2.07 + 2.03 vs. 4.28 + 3.01/mm3), platelet count (197.89 + 187.51 vs. 420.37 + 200.08/mm3); serum albumin (2.29 + 0.65 vs. 3.33 + 0.06g/dL), and CPR (21.4 + 11.23 vs. 14.26 + 12.37 mg/dL). KD vs. MIS-C types of Treatment: IVIG (96.8 vs. 94.7%), systemic steroids (4.82 vs. 94.7%), IVIG resistance (19.4 vs. 15.8). Finally, mortality in KD was 0% and 5.3% in MIS-C.

Conclusions: Similarities were found in both groups such as fever, rash, and conjunctivitis. Nevertheless, signifi-cant differences such as severity of clinical presentation with multi-organ involvement and worst inflammato-ry response were found more frequently in MIS-C group than KD group, requiring more fluid replacement, use of inotropic agents and higher steroids dosages. Also, mortality rate was higher in patients with MIS-C thanpatients with KD. Similar results have been observed in other studies where both disorders were compared.

Objective: To determine prevalence, causes and risk factors of ADE in hospitalized patients of a General Hospital.

Methods: Observational and analytical case-control study, carried out in patients hospitalized for adverse drug events, treated at the Hospital General Dr. Eduardo Vázquez N, in Puebla, Mexico, between, June 2019 to June 2021. For the statistical analysis, percentages, frequencies, means, odds ratio, χ2, and multiple binary logistic regression were used. Data were analyzed using the Statistical Package for the Social Sciences 23 program.

Results: A total of 132 patients (66 cases and 66 controls) were registered. Of the group of cases, 26 patients treated for medication error and 40 with adverse drug reaction were reported. The prevalence of adverse drug events was 3.6%. The drugs and factors associated with the most reported adverse events were: antibiotics, anti-inflammatories; average age of 35 years (SD: 17.41); gender: 39.3% men, 60.7% women; services re-ported with the greatest attention: Emergencies and Surgery; frequent route of administration: intravenous (32.3%); main symptoms: skin; symptoms associated with adverse drug reactions: type A pruritus [OR: 8.5, p = 0.001(CI95%: 0.035-0.393)], type B pruritus [OR: 11, p = 0.001 (CI95%: 0.021-0.368)]; urticaria [OR: 19, p = 0.005(CI95%: 0.007-0.412)]. Risk factors associated with adverse events were: female gender [OR: 2.6, p = 0.05 (CI95%: 1.33-5.43)], history of allergy [OR: 3.4, p = 0.033 (CI95%: 1.04-8.40)] and prolonged hospital stay [OR: 5.4, p = 0.023 (CI95%: 3.82-6.74)].

Conclusions: The majority of ADEs were EM or ADR type A, both preventable reactions, so patient safety should be a priority when prescribing.

Background: Quinine is an alkaloid with antipyretic and anti-infective properties, and also an ingredient in tonic waters. Adverse reactions have been reported with this product, such as photosensitivity, vasculitis, and contact dermatitis.

Case report: A 31-year-old male patient who, after 3-4 hours of consuming "Schweppes®" gin with tonic water, manifested ulcers on the lips and oral cavity, and a fixed erythematous lesion on the second phalanx of the hand, 24 hours later. Skin tests with aeroallergens and food were negative, and 48-hour patch tests were positive (quinine [++] and "Schweppes®" [++]). Based on the test findings, the diagnosis of an adverse reaction to quinine, contained in the tonic water, will be established.

Conclusions: Quinine can be found in other types of foods or medications, so it is important to establish an accurate diagnosis and offer adequate recommendations to the patient with the consumption of this product.

Objetive: To describe the phenotype of DRESS syndrome induced by antituberculosis drugs.

Methods: Descriptive study, withdrawn from the review of the records of patients with DRESS syndrome, identified in the interconsultation of the Department of Research in Immunogenetics and Allergy, of the Insti-tuto Nacional de Enfermedades Respiratorias (INER) Ismael Cosío Villegas, among 2014 and 2020. Frequency analysis was performed. The associations between biomarkers and latency are calculated with the χ2 test and log-rank, and the evaluation of the change in the biomarkers with the Wilcoxon test. The value of p < 0.05 is considered statistically significant. For data analysis, the SPSS v.21 program was obtained.

Results: 15 patients were identified; represented by 0.02% of total cases treated in the Department for so-meimmuno-allergic condition (15/7052); the main symptomatology were: rash (100%), eosinophilia (93%), fe-ver (80%), adenomegaly (60%), kidney damage (40%), liver damage (33%), and latency of 21 days. Liver damage was associated with prolonged latency (p = 0.02). After treatment, the total levels of eosinophils (p < 0.001) and liver and kidney biomarkers (p < 0.04) decreased. DRESS syndrome induced by antituberculosis drugs is not associated with the number of drugs prescribed or with the pattern of resistance of Mycobacterium tuberculosis.

Conclusions: DRESS syndrome induced by antituberculosis drugs is an atypical clinical reaction, similar to other types of DRESS syndrome that respond favorably to systemic corticosteroids.

Acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) and COVID-19 have as a common characteristic the inflammatory lesion of the lung epithelium. The therapeutic options are associated with opportunistic infections, a hyperglycemic state, and adrenal involvement. Therefore, the search for new treatment strategies that reduce inflammation, and promote re-epithelialization of damaged tissue is very important. This work describes the relevant pathophysiological characteristics of these diseases and evaluates recent findings on the immunomodulatory, anti-inflammatory and regenerative effect of mesenchymal stem cells (MSC) and their therapeutic use. In Pubmed we selected the most relevant studies on the subject, published between 2003 and 2022 following the PRISMA guide. We conclude that MSCs are an important therapeutic option for regenerative treatment in COPD, ARDS, and COVID-19, because of their ability to differentiate into type II pneumocytes and maintain the size and function of lung tissue by replacing dead or damaged cells.

We report the case of a woman who started with a lichenoid eruption, unfavorable evolution, for which a drug reaction was suspected. The final diagnosis was paraneoplastic pemphigus. Multidisciplinary care and evaluation by an Allergist is important in patients with severe skin reactions, suspected of drug reactions, due to the difficulty in establishing the diagnosis.

Background: Among the autoimmune diseases causing erosive lesions and blisters on skin and mucous membranes is pemphigus. Within this is a rare subtype known as seborrheic pemphigus or Senear-usher syndrome which is characterized by broken blisters and crusts involving the seborrheic areas.

Case report: A 40-year-old female patient, initially treated in a first level unit for a condition of 45 days of evolution, characterized by thick scabby lesions with an erythematous base, pruritic and painful, located in the center of the face, with posterior extension towards the abdomen, thorax, and extremities. Treatment consisted of prednisolone, with favorable evolution. The biopsy of the lesions with the diagnosis of seborrheic pemphigus.

Conclusions: Senear-usher syndrome is a rare disease of multifactorial origin. Early diagnosis and adequate treatment are decisive factors to avoid the evolution and advanced forms of the disease.

Background: The severe pharmacodermias (SF) are associated with high morbidity and mortality. Chronic kidney failure (CKD) related with dialysis is one of the main factors associated with higher mortality. ABCD-10 is a predictive mortality scale that includes the history of dialysis.

Case report: Male 2 years old with a history of CKD on peritoneal dialysis and Lennox-Gastaut syndrome, admitted to the hospital due to acute peritonitis and developed SJS-NET secondary to phenytoin administration. He was treated with immunoglobulin and systemic steroid without improvement. Septic shock was added, presenting a fatal outcome.

Conclusions: In the case presented, the ABCD-10 scale was applied, reporting a greater prediction of mortality compared to SCORTEN due to a history of dialysis. In children with SF there are no validated predictive mortality. Future initiatives should search for risk factors for mortality in children who develop SF for the creation of a predictive mortality scale.

Background: The association between asthma and COVID-19 remains controversial. Objective. To establish the prevalence of asthma in a sample of patients with COVID-19-associated pneumonia; furthermore, to describe the clinical characteristics of patients with asthma compared to patients without asthma.

Methods: Clinical data corresponding to 120 patients hospitalized for pneumonia associated with SARS-CoV-2 infection were analyzed. Patients with and without asthma were compared based on COVID-19 severity.

Results: The prevalence of asthma in patients with COVID-19 pneumonia was 3.5% (95% CI: 2.0% to 5.1%). When comparing the severity of COVID-19 among asthma patients with non-asthma patients, it did not differ based on symptoms, comorbidity, duration of symptoms, need for assisted mechanical ventilation, biomarkers of inflammation, and the occurrence of death. Patients with asthma and COVID-19 showed a high T2 phenotype, poor respiratory function, and no regular treatment for asthma control.

Conclusions: No significant differences in the frequency of assisted mechanical ventilation or death were observed between patients hospitalized for COVID-19-associated pneumonia with and without a history of asthma.