Revista alergia Mexico最新文献

Introduction: In many cases of drug allergy, it is necessary to do in vitro test, for several reasons. BAT (basophil activation test) is a very useful weapon in these cases. In many iv. or im. depot preparations, the culprit of the allergic reaction is an excipient, and not the main component.

Case report: A 37-year-old male, suffering from a Klinefelter syndrome needed treatment with a preparation of undecanoate of testosterone (Reandron). With the last administered dose, he suffered an anaphylactic shock with Kounis syndrome. The patient declined any in vivo studies, so we thought of BAT as a possibility for the diagnosis. The results were remarkable, showing a very high positivity to castor oil.

Conclusions: This is the second case in the world of anaphylaxis to a preparation of Testosterone, and the first one with the castor oil (also called Cremophor or Kolliphor) as responsible. El BAT was essential for the diagnosis and ulterior treatment of this patient. This is the first time, that this study with BAT, has been done with a Testosterone preparation.

Objectives: To describe the most frequent dermatological conditions observed in COVID-19 patients and to determine whether their presence could be used to establish an early diagnosis or to predict the progression of the infection.

Methods: There was a review in PubMed/MEDLINE and EMBASE of all the articles that had been published between January 1st and November 1st, 2020, with the search terms focused on "SARS-CoV-2", "COVID-19" and "Skin diseases".

Results: Eighty three studies met the inclusion criteria. Skin lesions have been reported in 0.2 % of the patients. The most frequently reported dermatoses were: maculopapular/ morbilliform rashes, urticaria and angioedema, chilblain-like acral pattern, and vesicular lesions. Among researchers, there are differences of opinion about a possible diagnostic or prognostic value of the skin diseases that are associated to the infection.

Conclusions: It is advisable to consider the diagnosis of SARS-CoV-2 infection in patients who call the doctor for skin lesions, urticaria, or angioedema, with or without other symptoms of the infection, especially if there is a previous history of recent exposure to other infected subjects.

Objective: To determine the prevalence of allergic rhinitis and its associated factors in students from several Mexican states.

Methods: A cross-sectional study was conducted in order to identify the factors that are associated with the prevalence of allergic rhinitis. The "Allergic Rhinitis Diagnostic Questionnaire for Epidemiological Studies" was used, together with another questionnaire, to identify risk factors in allergic rhinitis.

Results: 11381 students of 12-24 years of age were included; the prevalence of allergic rhinitis was of 18 % (CI 95 % = 11.4-24.6), with predominance in females (60%). The factors associated with allergic rhinitis were: heredity, (OR = 2-4, p < 0.0001), respiratory infections, (OR = 2-4.6, p < 0.0001); areas with humidity at home (OR= 1.5 - 1.9, p < 0.0001), and being female (OR = 1.7 - 2.4, p < 0.002). The use of tobacco, the educational level and vehicular traffic, as well as carpeting and the use of scented disinfectants, showed no association.

Conclusions: The factors associated with allergic rhinitis in students were; heredity, respiratory infections, humidity in house walls, and being female.

Introduction: Chronic mucocutaneous candidiasis associated with autoimmunity and ectodermal dysplasia is an inborn error of immunity, characterized by a classic triad (chronic mucocutaneous candidiasis, hyperparathyroidism, and adrenal insufficiency) due to the presence of autoantibodies against different endocrine and non-endocrine organs; and it is predominant in Jews and Finns.

Case report: A 7-year-old girl of European descent and positive consanguinity, with a personal history of recurrent respiratory infections, chronic candidiasis, pseudomembranous colitis, and pancytopenia. The clinical findings raised suspicions of an inborn error of immunity, and the accurate diagnosis of APECED (autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy) was made by detecting a pathogenic variant in the AIRE gene through new- generation sequencing technologies.

Conclusion: Nowadays, there is access to new genetic tools to establish an early diagnosis of the different inborn errors of immunity; thus, offering timely treatment and a better prognosis.

Introduction: Sugammadex is a cyclodextrin that reverses neuromuscular blockade, especially of rocuronium. The occurrence of anaphylaxis produced by its use is of 1:1000 and 1:20000; it is observed mainly in subjects of Asian origin.

Case report: A 9-year-old boy of Asian origin who, after the administration of sugammadex, immediately manifested an episode of anaphylaxis, which was reverted by using adrenaline and antihistamines. The serum tryptase at two hours was 27.7 μg/L; at 6 weeks, it was 3 μ/L. The sugammadex 100 mg/mL skin test was positive. The basophil activation test was positive with sugammadex 20 mg/mL.

Conclusion: The temporal relationship between the administration of the drug, the clinical manifestations, the elevation of tryptase, and the diagnostic tests performed, disclosed the episode of anaphylaxis associated with hypersensitivity to sugammadex.

Informing in the studies about the effect size of an intervention or the impact of the factor(s) about an outcome, allows better decision-making for the application of the results in clinical practice. This article presents different methods to analyze the effect size, which can be through direct or indirect statistical methods. Within the direct methods, there's the difference in means between groups and the difference of absolute or relative frequencies. Among the indirect methods, Cohen's "d" family (which are based on standard deviation values), the "r and R2" family, measures of association (e.g. OR, RR, HR), and impact measures (e.g. NNT) are shown. The decision to use any of these methods depends on the objectives of the study and the measuring scale that is used to assess the results, as well as the data distribution. In order to enhance the understanding of the methods described in this article, examples are included, and the need to include level of precision (e.g. confidence intervals) is highlighted, along with the clinical decision thresholds for a better interpretation.

Objective: The objective of this research was to measure the correlation of the expression of IL-4 with allergen sensitization in patients with allergic rhinitis.

Methods: Descriptive analytics was used as a method in this research, with a cross-sectional approach. The subjects were 37 persons with allergic rhinitis who met the inclusion and exclusion criteria. This research was conducted in patients with clinical manifestations of symptoms of allergic rhinitis, and skin prick tests were carried out with ten types of allergens, which are: house dust, cotton, chicken feathers, shrimp, tuna, chicken egg-yolk, chicken egg-white, peanuts, tea, and chocolate. Venous blood sampling was performed for the Interleukin-4 (IL-4) test by using an ELISA device.

Results: The respondents were 37 patients with allergic rhinitis, of which 26 (70.3 %) were women and 11 (29.7 %) were men. The highest sensitivity to inhaled allergens in patients with rhinitis was to house dust in 31 samples (83.8 %). The correlation of the expression of IL-4 with sensitization to allergens in patients with allergic rhinitis based on the Spearman test resulted in p > 0.05, not significant with some allergens in a negative correlation.

Conclusion: There was no significant correlation between the expression of IL-4 and the sensitization to allergens in patients with allergic rhinitis.

Chronic granulomatous disease (CGD) is an inborn error of immunity that affects the functionality of phagocytosis; specifically, there's lack of production of oxygen-free radicals by NADPH oxidase. CGD manifests as severe and recurring bacterial and fungal infections, as well as local and systemic hyperinflammation. In countries where tuberculosis is endemic and the BCG vaccine is mandatory at birth, patients with CGD may present local or systemic reactions to this vaccine as first manifestation; besides, recurrent infections by M. tuberculosis may be present throughout their life. The susceptibility of these patients to mycobacteria is due to the excessive production of pro-inflammatory cytokines and the formation of granulomas that are inefficient in containing mycobacteria. In developed countries, patients with CGD do not present this type of infectious manifestations, except for migrants who come from developing countries. In this review, we present the characteristics of infections by BCG, M. tuberculosis, and other types of mycobacteria. Interestingly, there are no guidelines regarding anti-tuberculosis treatments in patients with CGD, so we propose the realization of a consensus by experts in order to establish guidelines for the treatment of mycobacterial disease in CGD.

Background: Hypersensitivity pneumonitis entails several inflammatory lung diseases that preferentially affect the alveolar and perialveolar tissue. It is a very rare disease in children, with a complicated diagnosis due to the fact that antigen exposure usually goes unnoticed.

Case report: A 12-year-old girl with dry cough, dyspnea, wheezing, and tachypnea, with partial improvement after treatment with inhaled bronchodilators and corticoids. The spirometry showed a restrictive pattern and reduced lung diffusion capacity; in the CT scan, centrilobular ground-glass opacities were observed, and a lymphocyte count of CD4/CD8 of 2.46 (lymphocytosis) was obtained from the bronchoalveolar lavage. IgG positivity to bird feathers was obtained.

Conclusions: The treatment of hypersensitivity pneumonitis is based on avoiding exposure to the causative agent, which is determined by the prognosis; for which taking an extensive medical history is of paramount importance. Corticosteroids can be prescribed based on the clinical response, the pulmonary function, and the radiological improvement.

Background: TempTest® is a new method based on the Peltier effect, which is validated for the diagnosis of patients with cold urticaria or heat urticaria, and it is able to measure the temperature variations and activity of these pathologies.

Objective: To analyze the results of provocation tests by using this new method in patients with UFr and UCal, who were followed in a center of reference and excellence for urticaria (GA2LEN UCARE) in Rio de Janeiro.

Methods: The medical records of 12 patients who had a history of UFr or UCal and were tested with TempTest® during December 2017 and February 2020 were analyzed. For temperature provocation tests, the patients were requested to place their forearm on the TempTest® thermal element for five minutes. A positive response was defined by the appearance of a 2-mm-papular lesion 10 minutes after the provocation test was started, as recommended.

Results: 10 of the patients were women and 2 of them were men, from 13 to 77 years of age (mean = 50.2 years). Among the twelve patients, three of them had heat urticaria and nine of them had cold urticaria. The patients who were diagnosed with heat urticaria tested positive for The patients with cold urticarial tested positive for temperatures of 27 °C or lower.

Conclusions: TempTest® is a reliable instrument to accurately diagnose and monitor diseases related to temperature variations, which is a factor that should be determined whenever possible since it can help patients prevent situations of exposure and danger.