Revista alergia Mexico最新文献

The small airway, present since the origins of humanity and described barely a century ago, has recently been discovered as the anatomical site where inflammation begins in some obstructive lung diseases, such as asthma and Chronic Obstructive Pulmonary Disease (COPD), per se. Small airway dysfuction was identified in up to 91% of asthmatic patients and in a large proportion of COPD patients. In subjects without pathology, small airway represent 98.8% (approximately 4500 ml) of the total lung volume, contributing only between 10-25% of the total lung resistance; however, in subjects with obstruction, it can represent up to 90% of the total resistance. Despite this, its morphological and functional characteristics allow its dysfunction to remain undetected by conventional diagnostic methods, such as spirometry. Hence the importance of this review, which offers an overview of the tools available to assess small airway dysfunction and the possible therapies that act in this silent zone.

Objective: To determine the effect of pasteurization and freezing on the content of IgA1 and IgA2 in breast milk.

Methods: Observational, retrospective study, carried out in women who had been breastfeeding their newborn for more than 30 days, and could donate 50 mL of milk. The concentration of IgA1 and IgA2 was determined by turbidimetry, before and after being subjected to pasteurization and freezing, every 15 days for 2 months. Freezing was at -20°C. A total IgA content of 1598.5 mg/dL was found.

Results: 10 breast milk donors were selected. The initial concentration of IgA1 and IA2 was 651 and 945.7 mg/dL, respectively; At the end of the freezing times, the content of both immunoglobulins decreased: IgA1 of 74% and IgA2 of 86%. After the treatments, the immunoglobulin content decreased dramatically, with a significant difference of p < 0.05.

Conclusions: Pasteurization and freezing significantly affect the content of IgA1 and IgA in breast milk; therefore, breast-feeding remains the best way to offer full immunological protection to the infant.

Background: WHIM syndrome corresponds to an inborn error of innate and intrinsic immunity, characterized by: warts (Warts), Hypogammaglobulinemia, Infections and Myelocathexis, for its acronym in English.

Case report: 4-year-old male, with severe neutropenia and B-cell lymphopenia from birth, without severe infections or warts; the panel genetic sequencing study of primary immunodeficiencies with the CXCR4 c.1000C>T (p.Arg334*) variant, which is associated with WHIM syndrome.

Conclusions: The diagnosis of severe neutropenia from birth should include the search for inborn errors of immunity, through genetic sequencing studies, especially in asymptomatic or oligosymptomatic patients.

Background: Stevens-Johnson syndrome is a severe drug reaction. Sulfonamides have been associated with drug reactions, complications, sequelae, even death.

Case report: A 40-year-old female patient with a medical history of endometriosis and recently diagnosed chronic inflammatory ulcerative colitis. She was treated at the Allergology service of the San Juan de Dios Hospital of the Costa Rican Social Security Fund, and after 20 days of treatment with sulfasalazine she had a severe drug reaction on the skin, compatible with Stevens-Johnson syndrome. The lymphocyte transformation test was positive, confirming sulfasalazine as the causative agent.

Conclusion: The lymphocyte transformation test is a useful method that can confirm the causative agent and prevent important complications in the future.

Objective: To characterize demographically and clinically the patients with anaphylaxis treated in a third level health institution in Medellin, Colombia.

Methods: A cross-sectional descriptive observational study was carried out, which includedpatients were diagnosed with anaphylaxis between 2009 and 2019. Information was retrieved from medical records through a collection instrument. Subsequently, a descriptive statistical analysis of proportions and measures of central tendency of the variables of interest was performed.

Results: A total of 1820 records were reviewed and data from 253 patients were included. Among the reported comorbidities, drug allergy was the most prevalent (28%). The most frequent manifestations of anaphylaxis were cutaneous and respiratory. Most of the cases presented basal tryptase values ≤ 11.4 ng/mL (94.7%). Different etiological agents (food, drugs, insects and latex) were reported, and their frequency varied according to age. Adrenaline, steroids, and antihistamines were the treatments of choice in 39.9, 34.3, and 39.9% of cases, respectively.

Conclusions: The characteristics of anaphylaxis in a medical center in Colombia coincide with those reported in Latin American. The treatment of anaphylaxis is not standardized, which makes it necessary to educate the health personnel and develop national guidelines.

Background: The most common cause of hyperthyroidism is Graves' disease. Propylthiouracil (PTU) is one of the drugs used to treat this disease. Leukocytoclastic vasculitis is described among dermatologic adverse effects of PTU.

Case report: A 18-year-old woman, allergic to methimazole, developed a vasculitis associated to ANCAs with characteristics of leukocytoclastic vasculitis, associated to PTU treatment. She did not present systemic involvement. PTU treatment was suspended. Two months later, the skin lesions had almost completely resolved.

Conclusions: Leukocytoclastic vasculitis should be considered in the spectrum of complications caused by the consumption of propylthiouracil. The lesions can manifest over time, from a few weeks to years after taking the drug. When there is no systemic involvement, propylthiouracil suspension is sufficient to cure the disease.

Objective: To characterize the scientific production of the Revista Alergia Mexico.

Methods: A descriptive study was carried out that took into consideration the bibliometric information of the Revista Alergia México hosted in PubMed (MEDLINE) and Scopus.

Results: The total number of articles published during 1991 to 2021 according to Pubmed was 1,115 (annual mean: 37.2 ± 12.3). Scopus registered 1,541 articles during 1972 to 2021 (annual mean: 30.8 ± 14.9); in both sources, original articles (49 and 78%, respectively) and review articles (21 and 12%, respectively) were the most published document modalities; the most relevant topics included asthma (32%), allergic rhinitis (16%) and drug allergy (9%). Public institutions in Mexico were the institutions with the highest number of published articles. The country with the highest number of published papers was Mexico (54%), followed by Colombia (5%) and Spain (4%). The 2020 citation index according to Scopus was 0.9; an H-index of 15; and an impact factor of 0.150. During the period 2016 - 2020, the annual rejection rate ranged from 7% to 30%.

Conclusions: Promoting the internationalization of the journal, publishing articles in the English language and achieving the impact factor are among some of the main needs of the Revista Alergia Mexico.

Objective: The purpose of this study was to analyze the geographic variation in the prevalence of asthma in children, according to their place of residence in Mexico.

Methods: A cross-sectional analysis of the epidemiological surveillance system dataset for respiratory diseases in Mexico carried on. From 27 February to 5 November 2020, a total of 1,048,576 subjects were screened for SARS-CoV2 infection, of which 35,899 were children under 18 years of age. The strength of the association was estimated by odds ratio (OR).

Results: Of 1,048,576 patients who attended for SARS-CoV2 infection detection, 35,899 corresponded to pediatric patients who met the study criteria. The estimated national prevalence of asthma was 3.9% (95% CI: 3.7-4.1%). The nationwide prevalence of asthma was 3.9% (95% CI: 3.7% - 4.1%); the minimum was 2.8% (Southeast region) and the maximum 6.8% (Southeast region). Compared to the South-West Region that presented the minimum prevalence at the national level, the Northwest (OR = 2.41) and Southeast (OR = 1.33) regions showed the highest risk of asthma in pediatric population.

Conclusions: The prevalence of asthma in children differed markedly among the different regions of Mexico; two regions, Northwest and Southeast, stood out. This study puts into context the role of the environment on the prevalence of asthma in children.

Background: Any substance used as a treatment for any disease can produce harmful or unpleasant events called adverse drug reactions (ADRs). They are due to inherent biological effects of the drug and are caused by immunological and non-immunological mechanisms.

Objectives: To describe the immunological mechanisms of hypersensitivity reactions (HSR) to drugs, their epidemiology, risk factors, classification, clinical manifestations, diagnosis, treatment, and prognosis.

Methods: A review of the most current literature in English and Spanish was carried out, in the main databases, related to the HSR of various drug groups.

Results: This study describes the terms used to define ADRs and HSRs, their classification and clinical manifestations, current diagnostic tools, treatment algorithms and prognosis of the most frequently used medications and with the highest prevalence of reported adverse events.

Conclusion: ADRs are a challenging entity, with a complex pathophysiology that has not been fully understood. Its approach requires a careful consideration since not all drugs have validated tests for their diagnosis nor a specific treatment. When indicating the use of any drug, the severity of the disease, the availability of other treatments and the potential risks of developing future adverse events should always be taken into consideration.

Objective: To describe the prevalence of persistent hypogammaglobulinemia in patients receiving Rituximab as a treatment for autoimmune rheumatological diseases.

Methods: A transversal, retrospective and unicentric study, carried out in patients with autoimmune rheumatic diseases who were admitted to the Rheumatology service of the Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Mexico City, to receive treatment with rituximab between January 2013 and January 2018. Descriptive and inferential statistics of serum levels of immunoglobulins, clinical-demographic characteristics, diagnosis, and treatment received were performed.

Results: from 262 patients with autoimmune rheumatological disease who received treatment with Rituximab; We identified 8 patients with persistent hypogammaglobulinemia (6 women and 2 men), this is a prevalence of 3.1%. No associated factors with the development of hypogammaglobulinemia were identified.

Conclusions: Until now, no associated prognostic or predictive factors have been identified with persistent hypogammaglobulinemia. Additional prospective studies are required to understand more precisely the implications of persistent hypogammaglobulinemia in patients with autoimmune diseases.