BACKGROUND: Baboon syndrome is a rare disease characterized by well-defined purpuric skin eruptions in the gluteal and intertriginous areas, like those seen in red-rumped baboons. A new acronym, SDRIFE (drug-related symm...BACKGROUND: Baboon syndrome is a rare disease characterized by well-defined purpuric skin eruptions in the gluteal and intertriginous areas, like those seen in red-rumped baboons. A new acronym, SDRIFE (drug-related symmetric intertriginous and flexural rash), has been proposed to better define the disease. CASE REPORT: A 68-year-old male patient, with no relevant medical history, presented to the Emergency Department with acute respiratory distress. He was administered parenteral hydrocortisone without incident. He was prescribed oral deflazacort for home use, and two hours after taking the first tablet, a skin eruption appeared in the bilateral inguinal region. Diprogenta (betamethasone/gentamicin cream) was applied topically, and one hour after application, the rash spread to the inner thighs and lower abdomen, accompanied by nausea and a fever of 40°C. The patient was evaluated at home and given saline solution and antipyretics, which reduced the fever. The skin symptoms gradually resolved, leaving a residual hyperpigmented lesion. Five years prior, the patient reported generalized urticarial symptoms one hour after administration of parenteral methylprednisolone. Patch tests with corticosteroids were positive for budesonide and hydrocortisone 17-butyrate. A controlled exposure test with deflazacort showed good tolerance. CONCLUSIONS: We emphasize the importance of studying these types of patients and seeking alternatives to corticosteroids for future prescription, given their widespread use in medicine.
BACKGROUND: Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent, bradykinin-mediated swelling episodes, with substantial impact on morbidity, quality of life, a...BACKGROUND: Hereditary angioedema (HAE) is a rare, potentially life-threatening genetic disorder characterized by recurrent, bradykinin-mediated swelling episodes, with substantial impact on morbidity, quality of life, and healthcare resource use. Targeted agents have reshaped long-term prophylaxis (LTP); however, effective implementation depends on clinical decision-making as well as health-system access and structural constraints. OBJECTIVE: To comprehensively describe HAE long-term prophylaxis management in Mexico, focusing on the diagnostic approach, LTP use, treatment access and availability, perceived disease control, and applicability of clinical recommendations, based on structured national expert opinion. METHODS: We conducted a descriptive and analytical evaluation of Mexico-specific data derived from a structured Delphi process involving clinicians experienced in HAE management. Assessed domains included diagnostic testing practices, selection and prescribing frequency of LTP therapies, use of non-recommended treatments, funding sources, medication availability issues, access barriers, and clinicians' perceptions regarding disease control and guideline applicability. RESULTS: Experts reported strong conceptual alignment with current clinical recommendations. LTP prescribing was predominantly concentrated on lanadelumab, with limited use of C1-INH concentrates and no reported use of berotralstat. Despite reported public coverage, frequent barriers related to availability and cost constrained effective access and treatment continuity. Clinical guidelines were perceived as highly applicable; however, a gap between recommended care and feasible real-world implementation was consistently acknowledged. CONCLUSIONS: HAE prophylaxis management in Mexico appears aligned with contemporary standards, yet sustained and individualized implementation remains limited by structural access and supply constraints. Key priorities include strengthening timely diagnosis, ensuring continuous access to targeted therapies, and standardizing follow-up in routine clinical care.
Villarreal González RV, Flores García NA, de la Fuente LA
… +21 more, Fraga Olvera A, Ávila Lara A, Montiel Sierra AJ, Robledo Martínez AI, Correa Serrano CA, García Rosas C, Alonso Bello CD, Rico Solís GA, Ochoa García IV, Jimenez Sandoval JO, Ramírez Heredia J, González Juárez K, Moreno González MM, Ortega Cisneros M, García Cruz MLH, Arias Martínez MI, Hernández Ojeda M, Servín Suárez N, Cortés Grimaldo RM, Ruiz López SP, Zecua Nájera Y
BACKGROUND: Hypersensitivity reactions to iodinated contrast media represent a relevant clinical issue due to their increasing use in radiodiagnostic procedures. These reactions are classified as immediate or non-immedia...BACKGROUND: Hypersensitivity reactions to iodinated contrast media represent a relevant clinical issue due to their increasing use in radiodiagnostic procedures. These reactions are classified as immediate or non-immediate, immunological and non-immunological, with variable prevalence and potentially serious consequences such as anaphylaxis or severe cutaneous adverse reactions. Identifying risk factors, classification, and immunological mechanisms of iodinated contrast media enables the development of effective prevention and management strategies. OBJECTIVE: To analyze the chemical characteristics of iodinated contrast media, the associated immunological mechanisms, and available diagnostic tools to establish effective strategies for the prevention, diagnosis, and management of hypersensitivity reactions in both general and vulnerable populations. METHODOLOGY: A literature review was conducted analyzing the different types of contrast media according to their chemical structure, osmolarity, osmolality, and viscosity, highlighting their association with the risk of hypersensitivity reactions. The immunological mechanisms involved are described, including IgE-mediated responses, T-cell-mediated reactions, and activation of the MRGPRX2 receptor. Diagnostic tools such as in vivo, in vitro tests, and controlled exposure tests were examined in terms of sensitivity, specificity, and clinical utility. Cross-reactivity between iodinated contrast media agents and the usefulness of grouping them based on chemical characteristics to guide the selection of safer alternatives were addressed. Finally, therapeutic and preventive strategies were reviewed, including premedication protocols, iodinated contrast media selection, and special considerations for vulnerable populations such as pediatric patients, pregnant women, and older adults. CONCLUSIONS: Hypersensitivity to iodinated contrast media requires a multidisciplinary diagnostic and therapeutic approach based on accurate characterization of the reaction, immunological assessment, and personalized selection of contrast agents. Current knowledge allows for a significant reduction in HSR recurrence through substitution of the culprit agent and/or appropriate premedication, thereby improving the safety of contrast-enhanced diagnostic procedures.
BACKGROUND: Asthma-COPD overlap syndrome (ACO) is characterized by features of both asthma and COPD and is associated with a higher risk of hospital admissions. While several studies have analyzed the scientific producti...BACKGROUND: Asthma-COPD overlap syndrome (ACO) is characterized by features of both asthma and COPD and is associated with a higher risk of hospital admissions. While several studies have analyzed the scientific production on asthma and COPD separately, little is known about the state of research on the overlap syndrome. OBJECTIVE: To analyze the scientific output on asthma-COPD overlap (ACO). METHODOLOGY: A bibliometric study was conducted using Scopus and Web of Science, including original articles published up to 2024. Indicators of productivity, collaboration, and impact were analyzed with the package in RStudio. RESULTS: A total of 436 articles on ACO were identified. The first publication appeared in 2005, and since 2013 the scientific output has grown markedly, with an annual growth rate of 8.38%. The most productive countries were South Korea (n = 330), the United States (n = 329), and China (n = 312). The thematic analysis of research on ACO showed that the main areas studied are diagnosis and vulnerable populations, as well as the epidemiology and pathophysiology of the disease, while the treatment area remains under development, particularly regarding the study of monoclonal antibodies. CONCLUSION: The analysis of scientific production on ACO reveals that, despite the sustained increase in research, significant gaps persist regarding therapeutic strategies. Furthermore, research remains limited in several countries with a high disease burden; mapping these areas and regions will be essential to foster the generation of local evidence to guide clinical and public health decision-making.
OBJECTIVE: To describe the prevalence and epidemiological and clinical characteristics of patients with chronic prurigo. METHODS: A descriptive, cross-sectional study was conducted on adult patients enrolled in the Medic...OBJECTIVE: To describe the prevalence and epidemiological and clinical characteristics of patients with chronic prurigo. METHODS: A descriptive, cross-sectional study was conducted on adult patients enrolled in the Medical Care Program of the Hospital Italiano de Buenos Aires, Argentina (PMHI), between January 1, 2018, and January 1, 2023. RESULTS: 132,535 patients were registered, of whom 144 had chronic prurigo; 105 (73%) were women with a median age of 67.5 years (IQR 51-79). The point prevalence of chronic prurigo was 0.11% (95% CI: 0.09-0.13%), significantly higher in women than in men (0.13% [95% CI: 0.11-0.16%] vs 0.07% [95% CI: 0.05-0.09%], p<0.0006). The most frequent manifestations were papules (90%) and excoriations (84.7%), followed by plaques (21.5%) and nodules (18.7%). The median time to diagnosis was 168 days (IQR 36-765). The most frequently prescribed treatments were emollients, topical corticosteroids, and antihistamines. CONCLUSIONS: The prevalence of chronic prurigo in our cohort differs from that reported in other countries. Unlike previous studies, no statistically significant associations with other skin diseases were found. The treatment the patients received was inconsistent with that proposed in international guidelines.
OBJECTIVE: To describe the clinical and epidemiological characteristics of patients undergoing open oral food challenge test for suspected food allergy at a referral center in Bogotá, Colombia. METHODS: This was an obser...OBJECTIVE: To describe the clinical and epidemiological characteristics of patients undergoing open oral food challenge test for suspected food allergy at a referral center in Bogotá, Colombia. METHODS: This was an observational, descriptive, and retrospective study based on a review of the medical records of pediatric and adult patients who underwent open oral food challenge testing for suspected food allergy at a referral center in Bogotá between January 2022 and June 2025. Demographic variables, allergy history, foods involved, clinical manifestations, and diagnostic methods used were described. RESULTS: 253 oral food challenge tests were performed in 179 patients; 83% were children. The overall positivity rate was 15.4%, with the most frequent reactions to cow's milk (6.3%), egg (3.1%), legumes (1.5%), and fish (1.4%). Most reactions were mild, with a predominance of cutaneous and gastrointestinal symptoms. Only two cases of anaphylaxis were recorded (0.8%). CONCLUSION: This study provides clinical evidence of food allergy in Colombia, demonstrating an allergenicity profile distinct from that of other regions. The findings reinforce the need to standardize diagnostic criteria in Colombia and promote multicenter studies that define predictive thresholds adapted to local contexts.
OBJECTIVE: To establish, at the first time in Paraguay, for the first time in Paraguay, the laboratory diagnosis of HAE and to characterize affected patients. METHODS: An observational, descriptive, and cross-sectional s...OBJECTIVE: To establish, at the first time in Paraguay, for the first time in Paraguay, the laboratory diagnosis of HAE and to characterize affected patients. METHODS: An observational, descriptive, and cross-sectional study was conducted from 2023 to 2024 in patients older than one year with clinical symptoms of hereditary angioedema and asymptomatic relatives registered with the AEH-Paraguay Association, and 20 healthy donors. Quantitative C1-INH was determined by radial immunodiffusion and functional C1-INH by ELISA. Clinical and sociodemographic characteristics were evaluated. RESULTS: Forty patients were included: 26 with clinical symptoms of hereditary angioedema and 14 asymptomatic relatives. Fifty-three percent (21/40) were female, and 15/40 were minors (1-16 years). Decreased quantitative and functional C1-INH levels (HAE-1) were observed in 21/40 patients, and decreased functional C1-INH levels (HAE-2) were observed in 4/40. In this group (n = 25), 20 had edema and 5 were asymptomatic relatives; in addition, 6 patients in this group had a previous laboratory diagnosis, and 19 were newly detected cases. The most frequent edemas appeared in the extremities, face, abdomen, and larynx (n = 9). Fifty-six percent (14/25) reported having a deceased relative with a history of edema. Stress and puberty were the main triggering factors, and the median age of onset was 13 years. Six patients reported prophylactic treatment; the median duration of edema-related crises at one year was 6, with a median of 14 days of disability. CONCLUSION: We studied C1-INH in patients with recurrent edema and asymptomatic relatives, detecting 19 new cases and characterizing 25 patients with hereditary angioedema. This is the first diagnostic approach in Paraguay, and we report these initial data, which may be useful for the public health system in developing policies that address the diagnosis and treatment of patients with hereditary angioedema.
OBJETIVE: To estimate the prevalence of asthma and allergic rhinitis and to identify factors related to treatment among medical students at the University of Panama. METHODS: This was an observational, cross-sectional, a...OBJETIVE: To estimate the prevalence of asthma and allergic rhinitis and to identify factors related to treatment among medical students at the University of Panama. METHODS: This was an observational, cross-sectional, and analytical study with a follow-up phase to assess asthma and allergic rhinitis control between August and December 2024. Validated diagnostic questionnaires for asthma and rhinitis were administered digitally. Participants with a prior medical diagnosis and/or positive questionnaires completed the ACT and RCAT scales to evaluate clinical control. Descriptive statistics, chisquare tests, and McDonald's omega coefficient were used for internal reliability. RESULTS: 292 valid surveys were analyzed (62.7% women; mean age 21.2 years). The prevalence of asthma was 9.6% and of rhinitis 41.8%. Of the patients with asthma, 85.7% had concomitant rhinitis (p < 0.001). Eighty percent of asthma cases were well controlled clinically, compared to 36.6% of those with rhinitis. Less than 25% of rhinitis cases received medical follow-up, and 85.2% self-medicated. CONCLUSION: The coexistence of asthma and rhinitis was frequent among medical students, with good asthma control predominating over poor rhinitis control.
OBJECTIVE: To determine the prevalence of sensitization to food allergens in pediatric and adult patients with allergic diseases. METHODOLOGY: A prospective, descriptive, observational, and cross-sectional study was cond...OBJECTIVE: To determine the prevalence of sensitization to food allergens in pediatric and adult patients with allergic diseases. METHODOLOGY: A prospective, descriptive, observational, and cross-sectional study was conducted on pediatric and adult patients treated at the General Hospital of Mexico Dr. Eduardo Liceaga, between August 2024 and May 2025. Associated sociodemographic and clinical factors were identified, and prick skin tests were performed on patients with allergic diseases and suspected food allergies. RESULTS: A total of 90 patients were registered. The 26.6% presented sensitization to food allergens, and 22.2% met allergy criteria. Allergic rhinitis was the most common comorbidity. A statistically significant association was found between older age and the presence of food allergen sensitization (p = 0.021), but not with food allergy (p = 0.28). The main allergens involved were walnut, casein, peanut, and shrimp. CONCLUSION: Food allergy is common in patients with a history of allergies. The findings are consistent with previous studies and underscore the need for further research into this condition in the Mexican population.
OBJECTIVE: To evaluate the type and intensity of response to benralizumab and identify responders and super-responders amongst patients with severe uncontrolled eosinophilic asthma managed in Mexico. METHODS: A multicent...OBJECTIVE: To evaluate the type and intensity of response to benralizumab and identify responders and super-responders amongst patients with severe uncontrolled eosinophilic asthma managed in Mexico. METHODS: A multicenter study in 3 hospitals in Mexico evaluating the Asthma Control Test and Asthma Control Questionnaire (ACT) scores; mini Asthma Quality of Life Questionnaire; peripheral blood eosinophils; exhaled fraction of nitric oxide; forced expiratory volume in 1 second before and after benralizumab treatment and the number of exacerbations at 12 months. RESULTS: The record of 28 patients with severe uncontrolled eosinophilic asthma were included. At 12-months, 82.1% were considered in asthma control, where 82% were responders and 64% classified as super-responders. 75% of patients had no exacerbations, with ACT scores improvement in 89% and 79% of patients discontinued maintenance corticosteroids. A total of 82% presented forced expiratory volume in 1 second values over 500 ml. ACT scores showed an average decrease of 1.35 points and a statistically significant decrease in serum eosinophils was observed. CONCLUSION: This is the first study in Mexico to evaluate the subgroup of super-responders to benralizumab who had clinical, laboratory and quality of life improvements. Besides the vast majority were responders and 64% super-responders at 12-months of treatment.
OBJECTIVE: To evaluate the single-blind, placebo-controlled penicillin challenge in HIV/AIDS patients without prior skin testing. METHODS: A prospective study was conducted in patients attending the Outpatient Center for...OBJECTIVE: To evaluate the single-blind, placebo-controlled penicillin challenge in HIV/AIDS patients without prior skin testing. METHODS: A prospective study was conducted in patients attending the Outpatient Center for the Prevention and Care of AIDS and Sexually Transmitted Infections in Puebla, Mexico. Statistical analysis included percentages, frequencies, means, standard deviations, and medians; χ (Fisher's exact test), one-way Kruskal-Wallis test, Cramer's V test; and binomial distribution. The Statistical Package for the Social Sciences 26 (SPSS) was used for data analysis. RESULTS: A total of 104 patients aged 18 years or older (mean age 34.6 ± 10.5 years) were registered: women (n = 3; 2.9%), men (n = 101; 97.1%). Regarding the study variables, the following results were found: 7 (6.7%) positive penicillin challenges, 2 (1.9%) positive placebo challenges, and 95 (91.3%) no reaction; effect size V = 0.038, p = 0.701 (placebo-penicillin), V = 1, p = 0.000 (no reaction-penicillin reaction), with a binomial distribution and B(7; 0.1533). Regarding comorbidities, a difference was observed between the groups (p<0.05) in symptoms during the challenge: pruritus in the penicillin reaction group (p = 0.03) and anxiety in the placebo group (p = 0.005). CONCLUSIONS: In HIV/AIDS patients categorized as low risk, the single-blind, placebo-controlled penicillin challenge allowed for the elimination of potential allergy, because the benefit of the antibiotic is crucial for a successful disease outcome.
BACKGROUND: RA is defined as a chronic Ig E-mediated inflammation of nasal mucosa. This study would favor a better understanding of humidity and temperature factors influence in the development of AR in preschool childre...BACKGROUND: RA is defined as a chronic Ig E-mediated inflammation of nasal mucosa. This study would favor a better understanding of humidity and temperature factors influence in the development of AR in preschool children of public initial education centers of Cuenca city. OBJECTIVE: To describe the association between microclimate factors in classrooms of public preschool institutions of Cuenca city and allergic rhinitis in students. Methodology: Retrospective analytical study of case-control designs.The universe of study is made up of all children from 3 to 5 years old who attendedpublic initial education centers (INEC 2010) in the peri-urban and urban area of Cuenca during the period of the study. The sample corresponded to 351 childrenfrom 16 public institutions, whose parents signed an informed consent and solved the ISAAC questionnaire. The data included climatic measurements of temperature, and relative humidity recorded in classrooms; together with the prevalence of AR obtained in the ISAAC survey. Therefore, by using an statisticalmethod of odds ratio, it is indicated the presence or absence of association between AR and exposure to non-comfort ranges of variables studied. RESULTS: After conducting the chi-square test, the presence of statistical association between relative humidity and temperature out of comfort, with the presence of AR in preschool children is absent. CONCLUSIONS: Since a statistical association between RA and the variables studied is not determined, it is concluded that theydo not influence the presentation of the disease under the conditions analyzed.
García-Acevedo IG, Gil-Ruíz A, Rodríguez-Moreno AD
… +6 more, Flores-Montiel A, Garfias-Zavala L, Jiménez-Fonseca MG, O'Farrill-Romanillos PM, Herrera-Sánchez DA, Lemini-López A
BACKGROUND: Pulmonary infection with is a rare infestation in healthy individuals. In Mexico, this disease has only been reported in immunocompromised patients. CASE REPORT: A 30-year-old male patient presented with chr...BACKGROUND: Pulmonary infection with is a rare infestation in healthy individuals. In Mexico, this disease has only been reported in immunocompromised patients. CASE REPORT: A 30-year-old male patient presented with chronic respiratory symptoms, including a productive cough and hemoptysis, which did not improve with antibiotics. After several unsuccessful treatments and a bronchoscopy, the protozoan was identified, leading to a diagnosis of pulmonary lophomoniasis. He received treatment with metronidazole, but the symptoms persisted and recurred. A second bronchoscopy confirmed the recurrence. Months later, due to persistent cough, an allergist diagnosed a moderate obstructive pattern. The patient finally found symptomatic relief with a long-acting bronchodilator and an inhaled corticosteroid, adjusting his treatment after remission. CONCLUSIONS: Pulmonary lophomoniasis infection should be considered in the differential diagnosis of patients with pulmonary symptoms who are receiving various treatment regimens without achieving the expected improvement, even with risk factors such as immunosuppression, rural living, poor hygiene, and recurrent symptoms. It is also important to suspect and identify underlying respiratory conditions, especially in patients with poorly controlled asthma or those receiving conventional medications.
BACKGROUND: Atopic dermatitis is a chronic inflammatory disease that affects the skin and is characterized by intense pruritus and eczema. It requires systemic therapies and the use of novel treatments, such as Dupilumab...BACKGROUND: Atopic dermatitis is a chronic inflammatory disease that affects the skin and is characterized by intense pruritus and eczema. It requires systemic therapies and the use of novel treatments, such as Dupilumab and Janus kinase inhibitors. The approval of these drugs has revolutionized treatment during the last years. CASE REPORT: We present a case of a patient with severe atopic dermatitis, refractory to immunosuppressive treatment and his evolution after starting treatment with monoclonal antibodies. CONCLUSIONS: Monoclonal antibodies are advanced and novel therapies that have demonstrated efficacy in patients with moderate to severe atopic dermatitis. In this article we present a case of a patient with switch of treatment, who had improvement in his evolution and quality of life, demonstrating an adequate response according to the dermatitis scoring index (SCORAD) after treatment with Abrocitinib.
BACKGROUND: Congenital neutropenia is a primary immunodeficiency characterized by a low neutrophil count, which predisposes to recurrent infections. A mutation in the ELANE gene is the most common cause of this disorder....BACKGROUND: Congenital neutropenia is a primary immunodeficiency characterized by a low neutrophil count, which predisposes to recurrent infections. A mutation in the ELANE gene is the most common cause of this disorder. CASE REPORT: A 3-month-old infant with a history of recurrent bacterial infections since birth. The patient had presented with omphalitis and preseptal cellulitis, associated with a low blood neutrophil count. Suspecting congenital neutropenia, a genetic panel was performed, identifying a pathogenic mutation in the ELANE gene (c.164G>A, p.Cys55Tyr). Treatment with granulocyte colony-stimulating factor (G-CSF) was initiated, resulting in a significant improvement in the neutrophil count and resolution of the recurrent infections. The patient showed significant clinical improvement and is currently on a therapeutic protocol and receiving regular follow-up. CONCLUSION: This case illustrates the importance of early diagnosis of congenital neutropenia. In every case where a pediatric patient with recurrent and difficult-to-manage bacterial infections is studied.