Revista Alergia Mexico[JOURNAL]
Sun
200 papers
[Omalizumab for the treatment of severe solar urticaria].
Pereda S, Torre AC, Bejar N … +2 more , Ritchie C, Mazzuoccolo L
Rev Alerg Mex · 2025 Dec · PMID 41420587 · Publisher ↗
BACKGROUND: Solar urticaria is a rare condition induced by exposure to ultraviolet radiation. Although it typically resolves spontaneously, like other dermatoses, it often affects patients' quality of life. We report the...
BACKGROUND: Solar urticaria is a rare condition induced by exposure to ultraviolet radiation. Although it typically resolves spontaneously, like other dermatoses, it often affects patients' quality of life. We report the case of a patient with solar urticaria successfully treated with omalizumab. CASE REPORT: A 36-year-old female patient with a history of allergies presented with pruritic wheals in sun-exposed areas for four years. Despite unremarkable physical findings, erythematous-edematous plaques were observed. Serum IgE levels were elevated (507 IU/ml), and antinuclear antibodies and rheumatoid factor were negative. Initial treatment with levocetirizine (up to 20 mg/day) and photoprotection failed, with a UCT score of 10. Omalizumab (300 mg/4 weeks) was added, achieving complete control of the condition (UCT score 16) after five months, allowing for a reduction in the dose and dosing interval. However, episodes during the spring season (UCT score 6) necessitated reintroducing the initial dose to regain full disease control. CONCLUSION: Omalizumab is a second-line anti-IgE monoclonal antibody for the off-label treatment of patients who do not respond to systemic antihistamines.
[Overview of Chromoblastomycosis, a neglected tropical disease: case report and narrative review].
Paternina-Colorado AJ, Melo-Maecha Y, Velasco-Castro JC … +4 more , Garzon-Peñuela AL, Cubillos-Vega HJ, Bernal-Otalora SD, García-Agudelo L
Rev Alerg Mex · 2025 Dec · PMID 41420586 · Publisher ↗
BACKGROUND: Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis present in tropical or subtropical regions, caused by the traumatic inoculation of various species of melanized fungi, the most common being Fonseca...
BACKGROUND: Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis present in tropical or subtropical regions, caused by the traumatic inoculation of various species of melanized fungi, the most common being Fonsecaea pedrosoi and Cladophialophora carrionii. It is characterized in early stages by erythematous macules or papules with a verrucous or hyperkeratotic appearance, which progress to nodular, verrucous, tumoral, plaque, or scar-like morphologies. OBJECTIVE: to describe a classic presentation and conduct a narrative review of CBM with a prolonged evolution time and multifocal extension. CASE REPORT: 69-year-old man, a farmer by occupation, with a history of hypertension, heart failure with preserved ejection fraction, colonic diverticulosis, and umbilical hernia. He was admitted to the emergency department with a one-day history of dyspnea, chills, asthenia, adynamia, and fever, consistent with exacerbated chronic lung disease and pneumonia. Given a 10-year history of progressive growth of painless and pruritic papular skin lesions that spread with various presentations to other areas of the body, a potassium hydroxide (KOH) test was performed, revealing mycotic structures and the presence of yeasts. Meanwhile, the skin biopsy reported findings of pseudoepitheliomatous hyperplasia and intraepidermal abscesses with Medlar bodies, pathognomonic of CBM. CONCLUSION: The case highlights the importance of an accurate diagnosis of an overlooked tropical disease and the establishment of personalized antifungal treatment, as well as the need for long-term monitoring due to the chronic nature of the pathology and its marked resistance to treatment.
[Needs, limitations and opportunities to create a center of excellence for severe asthma care in the public healthcare system in Mexico].
Chávez-García AA, Lemus-Rangel R, Juárez-León JE … +3 more , Aguilar-Hinojosa NK, González-Tuyub YH, Flores-González JV
Rev Alerg Mex · 2025 Dec · PMID 41420585 · Publisher ↗
BACKGROUND: Asthma is a common chronic respiratory condition that affects from 1 to 18% of the world population. In Mexico, 8% of the population lives with asthma. Severe asthma represents up to 10% of cases. The proposa...
BACKGROUND: Asthma is a common chronic respiratory condition that affects from 1 to 18% of the world population. In Mexico, 8% of the population lives with asthma. Severe asthma represents up to 10% of cases. The proposal of an Asthma Center of Excellence has the main goal to develop key procedures, establishing methods and developing clinical experience based in modern technology and focused on critical procedures that allow institutions to build more efficient management procedures. OBJECTIVE: To bring to consensus the needs and opportunities identified in the public sector to create a center of excellence for severe asthma management. METHODOLOGY: We used the RAND/UCLA method for consensus, through scientific evidence and the opinions of an asynchronous online modified Delphi panel of 14 experts from different institutions with experience in severe asthma management. : The panel provided considerations and recommendations to facilitate and standardize the diagnosis, management, treatment, and follow-up of patients with severe asthma, with particular emphasis on management of comorbidities, international considerations and strategies to evaluate treatment adherence and key resources for the development of a Center of Excellence. CONCLUSION: The development of a Center of Excellence would allow to accelerate scientific innovation, education and advocacy, promoting excellence in education, research and training in the management of asthma.
[The impact of heat waves in allergic diseases: Group Report of the Environmental Committee of the Mexican College of Clinical Immunology and Allergy (CMICA)].
Cid Del Prado Izquierdo ML, de Lira Quezada CE, Aguirre Ramírez DL … +2 more , Azuara Trujillo HA, Terán Olvera M
Rev Alerg Mex · 2025 Dec · PMID 41420584 · Publisher ↗
BACKGROUND: The increasing frequency and intensity of heat waves, as a consequence of climate change, represents a growing risk to public health, particularly in populations with allergic and respiratory diseases. OBJECT...
BACKGROUND: The increasing frequency and intensity of heat waves, as a consequence of climate change, represents a growing risk to public health, particularly in populations with allergic and respiratory diseases. OBJECTIVE: A review to describe the available evidence on the relationship between heat waves and the exacerbation of allergic diseases, with emphasis on the environmental and pathophysiological mechanisms involved. METHODS: A structured search was conducted in Scopus and Web of Science (2015-2025), complemented with regional literature, identifying 304 references. After applying inclusion and exclusion criteria, 120 full-text articles were assessed, and 79 were included in the qualitative synthesis. RESULTS: Evidence confirms that heat waves are associated with an increase in hospital admissions for asthma and with more frequent consultations for atopic dermatitis in pediatric patients. The mechanisms identified include intensified pollen production and dispersal, synergy with air pollutants, disruption of the epithelial barrier, and activation of transient receptor potential (TRP) channels. CONCLUSIONS: The lack of well-defined study protocols for managing allergic patients during heat waves represents a gap not only in Mexico and Latin America but also worldwide. Key limitations include the absence of standardized definitions, the scarcity of multi-exposure analysis models, and the lack of comprehensive strategies for urban mitigation and clinical adaptation to protect the most vulnerable groups. In the case of allergic rhinitis, the available data remain inconclusive regarding exacerbations associated with heat waves.
[Position paper on procedures in allergology. Asociación Colombiana de Alergia Asma e Inmunología (ACAAI)].
Ocampo J, Olaya M, Vásquez E … +12 more , Morales E, Betancur-Castro K, Mopan J, Ramírez R, Serrano C, Silva D, Ramirez-Zuluaga LF, de Zubiria D, Cherrez-Ojeda I, Larco JI, Guidos-Fogelbach G, Sánchez J
Rev Alerg Mex · 2025 Dec · PMID 41420583 · Publisher ↗
BACKGROUND: Allergic diseases affect approximately 25% of the global population. Accurate diagnosis is essential to prevent unnecessary restrictions and to implement precision medicine tailored to each patient's specific...
BACKGROUND: Allergic diseases affect approximately 25% of the global population. Accurate diagnosis is essential to prevent unnecessary restrictions and to implement precision medicine tailored to each patient's specific needs. OBJECTIVE: This manual establishes clear guidelines for the main clinical allergy procedures, detailing their indications, diagnostic performance, and applicability in the Latin American context. METHODS: The Colombian Association of Allergy, Asthma, and Immunology (ACAAI) conducted a thorough literature review to compile the most utilized clinical allergy procedures. We provide specific recommendations for each procedure, incorporating operational guidelines, diagnostic accuracy, and clinical indications. Furthermore, allergists from various Latin American countries reviewed this manual to ensure its regional applicability. RESULTS: We formulated evidence-based and operationally feasible recommendations for the execution and interpretation of nine critical allergy procedures: skin prick tests, intradermal tests, patch tests, nasal provocation tests, oral provocation tests, provocation tests for inducible urticarias, drug desensitization, food tolerance induction, and allergen immunotherapy. Our document was validated by allergists from Ecuador, Mexico, and Peru, confirming its relevance and applicability in their clinical practices. CONCLUSION: This position paper delivers a practical manual for executing and interpreting allergy procedures. Its implementation will enhance diagnostic and therapeutic precision, ensuring a safe and effective approach to allergic disease management across Latin America.
[Cow's Milk Allergy].
Ortiz-Fonseca E, Hernández-Soto A
Rev Alerg Mex · 2025 Dec · PMID 41420582 · Publisher ↗
Cow's Milk Allergy (CMA) is the name used to cover several adverse reactions to its protein components. Caseins and whey proteins mediate the reaction. α-lactalbumin and β-lactoglobulin can trigger allergy through a spec...
Cow's Milk Allergy (CMA) is the name used to cover several adverse reactions to its protein components. Caseins and whey proteins mediate the reaction. α-lactalbumin and β-lactoglobulin can trigger allergy through a specific immune response mediated or not by immunoglobulin E (IgE). Breastfeeding is a feeding mechanism, but it is also a key element in overcoming this type of allergy, using adequate feeding of the mother that allows for achieving oral tolerance. Breastfeeding provides sufficient nutrition and the development of the intestinal microbiota. Developing the microflora and the process of oral tolerance mediated by breastmilk is key, as it also provides a minimal load of allergens, as demonstrated even in model organisms such as mice. This topic must be shared to offer nutrition experts, doctors, and parents the correct way to feed a nursing child to recover from a milk protein intolerance. The review provides the technical background of the pathology.
[High-dose omega-3 fatty acid supplementation in patients with persistent allergic rhinitis sensitized to perennial allergens: a randomized, placebo-controlled clinical trial].
Armenta-Morales J, Rivero-Yeverino D, López-García AI … +5 more , Papaqui-Tapia JS, Caballero-López CG, Ríos-López JJ, Pacheco Jiménez YE, Villada-Villada E
Rev Alerg Mex · 2025 Dec · PMID 41420581 · Publisher ↗
OBJECTIVE: To evaluate the effect of high-dose eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the severity of allergic rhinitis and the quality of life of patients affected by this conditio...
OBJECTIVE: To evaluate the effect of high-dose eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the severity of allergic rhinitis and the quality of life of patients affected by this condition. METHODS: Randomized, double-blind, placebo-controlled study. Both groups received pharmacological treatment with intranasal fluticasone and allergy immunotherapy during the escalation phase. The control group received a placebo, while the experimental group received EPA capsules: 1340 mg and DHA: 924 mg daily for 2 months. RESULTS: The experimental group included 10 patients (2 men and 8 women), with a mean age of 31.5 ± 15.1 years, while the control group included 12 patients (5 men and 7 women) with a mean age of 27.4 ± 14.3 years (p = 0.56 for age). After the intervention, the median quality of life and nasal symptom scores were also similar between both groups (p = 0.668 and p = 0.920, respectively), with no significant differences. CONCLUSION: Supplementation with high doses of EPA and DHA in patients with persistent allergic rhinitis was safe, but there was no evidence of a reduction in severity or improvement in quality of life compared to the placebo group. Further clinical trials are required to clarify its potential role as an adjunctive strategy.
[Sensitization to polyethylene glycol and polysorbate in allergic patients with systemic adverse reactions following COVID-19 vaccination].
Flores-Gonzaga E, Caballero-López CG, López-García AI … +7 more , Rivero-Yeverino D, Ríos-López JJ, Papaqui-Tapia JS, Ruiz-Sánchez DM, Alvarez-Rivera A, Jordá-Rodríguez EO, Villada-Villada E
Rev Alerg Mex · 2025 Dec · PMID 41420580 · Publisher ↗
OBJECTIVE: To determine the frequency of sensitization to polyethylene glycol and polysorbate in allergic patients with a complete vaccination schedule against COVID-19 who presented systemic adverse reactions. METHODS:...
OBJECTIVE: To determine the frequency of sensitization to polyethylene glycol and polysorbate in allergic patients with a complete vaccination schedule against COVID-19 who presented systemic adverse reactions. METHODS: Cross-sectional, descriptive, observational and prolective study. Allergic patients between 18 and 60 years old, with complete vaccination schedule against COVID-19, with systemic adverse reactions were included. Skin tests were performed with polyethylene glycol 2000 and PS 80. The results were analyzed by calculating averages, percentages and frequencies. RESULTS: Fifty-five patients were included, 74.5% were women, average age was 31.4 (SD 11.6), the most prevalent allergologic diagnosis was allergic rhinitis, adverse reactions after vaccination were late in 54 patients, with myalgias being the most common. Sensitization was found in 40%, of these 32.7% were positive to polysorbate 80. The vaccines with the highest prevalence of sensitization were AstraZeneca and Sputnik. Adverse reactions during skin testing occurred in 5 patients and the most frequent adverse event was headache. CONCLUSIONS: A high frequency of sensitization to polyethylene glycol 2000 and polysorbate 80 was found. In sensitized patients, alternatives with vaccines that do not contain the excipients to which they were positive can be recommended to avoid the risk of subsequent adverse events.
[Poor prognostic factors in rheumatoid arthritis patients].
Hernández-Morales MDR, Garcia-Vences EE, García-López CL … +3 more , Castellanos-Guerrero AK, Cristóbal-Jiménez P, Rojas-Guzmán IV
Rev Alerg Mex · 2025 Dec · PMID 41420579 · Publisher ↗
OBJECTIVE: To determine the factors associated with a poor prognosis in patients with RA at a 3rd level hospital. METHODS: Observational, analytical, longitudinal study of a cohort of patients with RA. The study continue...
OBJECTIVE: To determine the factors associated with a poor prognosis in patients with RA at a 3rd level hospital. METHODS: Observational, analytical, longitudinal study of a cohort of patients with RA. The study continued for one year. The following were assessed as PPFs: sex, comorbidities, smoking, DAS 28 (disease activity), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), ACCP (anti-citrullinated peptide antibody), RF (rheumatoid factor), and bone erosions. To statistical analysis: A Cox proportional hazards analysis was performed to analyze PPFs. RESULTS: A total of 260 patients were included, 26 failures and 234 censored, predominantly female sex, mean age 47 ± 11.7 years, the PPFs were: ACCP, late start of DMARD, and smoking. ACCP positive have 5.8 times the risk of escalating treatment, late DMARD have 4.6 times and those who smoked 7.7 times the risk. CONCLUSIONS: Defining the PPFs remains a great challenge for researchers, however, it is imperative to identify them to predict the response to treatment and thus limit the functional and life damage of patients.
Allergic comorbidities among inborn errors of immunity in children attended in a high-complexity center in Cali, Colombia.
Triviño-Arias J, Martínez-Betancur S, Arias-Valderrama O … +8 more , Guzmán TM, Diaz-Solórsano JP, Medina D, Franco A, Patiño J, Pérez PM, Pachajoa H, Olaya-Hernández M
Rev Alerg Mex · 2025 Dec · PMID 41420578 · Publisher ↗
OBJECTIVE: To describe the clinical characteristics of allergic diseases (AD) as comorbidities-distinct from primary atopic diseases (PAD)-in pediatric patients diagnosed with IEI. METHODS: An observational and retrospec...
OBJECTIVE: To describe the clinical characteristics of allergic diseases (AD) as comorbidities-distinct from primary atopic diseases (PAD)-in pediatric patients diagnosed with IEI. METHODS: An observational and retrospective study was made. We included pediatric population diagnosed with IEI and allergic comorbidity between 2013-2023. The diagnosis was done considering the criteria from the ESID and IUIS-2022. We performed a descriptive analysis of the variables (frequencies/percentages). For qualitative variables, we used OR to obtain the probability of occurrence of allergic sensitization among patients with AD and IEI. Every analysis was performed with the software R Studio version 3.2.2. RESULTS: There were 366 patients with diagnosis of IEI, 238 had concomitant AD. 59.6% were males. Mean age was 5 years. 84% had antibody-specific deficiencies, 8% combined immunodeficiencies associated to well-defined syndromes, 2.9% congenital defects in phagocytes, 2.5% combined-immunodeficiencies, 1.7% autoinflammatory diseases, and 0.8% defects in intrinsic and innate immunity. The distribution of the ADs was asthma 48.7%, rhinitis 18.9%, atopic-dermatitis 15.1%, food-allergy 8.4%, acute urticaria 5%, and chronic urticaria 3.8%. CONCLUSION: Allergic diseases are increasingly recognized as key indicators for early IEI diagnosis. These conditions may coexist without representing PAD, emphasizing the need for comprehensive care. Recognizing this heterogeneity supports a multidisciplinary approach to improve early detection and management of IEI.
Exploring the repertoire of cross-reactive allergens among and mites: an in-silico approach.
Vasquez JJ, Sanchez A, Sancez J … +2 more , García E, Múnera M
Rev Alerg Mex · 2025 Dec · PMID 41420577 · Publisher ↗
OBJECTIVE: To examinate the potential cross reactivity among A. fumigatus and mites, both important allergenic source in tropical regions, using mainly a bioinformatic approach. METHODS: Amino acid sequences from allerge...
OBJECTIVE: To examinate the potential cross reactivity among A. fumigatus and mites, both important allergenic source in tropical regions, using mainly a bioinformatic approach. METHODS: Amino acid sequences from allergens from reported in the allergome database were retrieved and used as input to perform PSI-BLAST against proteome. Results with similitudes and query cover values above 25% and 80%, respectively, were selected to further analysis. B cell epitope prediction was done by using the Ellipro tool. Just epitopes conserved between both allergenic sources were informed and displayed on 3D model surfaces obtained by modeling based on homology. RESULTS: Twelve allergens from shared homology with proteins reported in . All 3D models obtained showed typical folding to the protein family they belonged. Ribosomal protein L3, Molecular chaperone Mod-E/Hsp90, Acidic ribosomal protein P2, Enolase, and peptidyl-propyl cis-trans isomerase were allergens with the highest identity score (>60%). At least four B linear epitopes were predicted to be shared between allergens and homologous in . CONCLUSION: Results indicated that cross-reactivity between Aspergillus fumigatus and is feasible. At least twelve allergens could be involved, and this could explain how molds increase sensitization to mites. In vitro analyses are needed to confirm these results.
Domestic hypersensitivity pneumonitis caused by inadvertent exposure to feathers.
Pose K, De Las Vecillas L, Tomás-Pérez M … +3 more , Barranco P, Quirce S, Domínguez-Ortega J
Rev Alerg Mex · 2025 Dec · PMID 41420576 · Publisher ↗
OBJECTIVE: Case series of patients with domestic hypersensitivity pneumonitis, focusing on hidden avian exposures or other non-suspected antigens (feather comforters and pillows). METHODS: Seven female patients diagnosed...
OBJECTIVE: Case series of patients with domestic hypersensitivity pneumonitis, focusing on hidden avian exposures or other non-suspected antigens (feather comforters and pillows). METHODS: Seven female patients diagnosed with non-occupational HP were evaluated using clinical records from La Paz University Hospital (2014-2022). Data collected included exposure history, HRCT findings, IgG antibodies, BAL, biopsies, and treatment outcomes. RESULTS: Patients had a median age of 53.5 years (range: 15-75), with varied exposure to birds or indirect sources like feather duvets. Diagnosis was made based on HRCT, BAL, and biopsy findings. Five patients removed the antigen source, resulting in symptom improvement and pulmonary function in non-fibrotic cases. Corticosteroid treatment was given to all, with one patient requiring oxygen therapy. The median FEV1 improvement was 50 ml, and three patients with a non-fibrotic pattern showed improved DLCO after treatment. CONCLUSIONS: Early diagnosis and antigen avoidance are key to managing hypersensitivity pneumonitis (HP), especially in cases of hidden bird-related exposures. A multidisciplinary approach improved outcomes, particularly in non-fibrotic cases. Larger studies and broader antigen testing are needed to validate these findings and enhance diagnostic accuracy.
Changes in the Nijmegen Questionnaire in severe asthma patients treated with dupilumab.
De Agrela-Mendes I, Correa-Borit J, Lopez V … +5 more , Ifrim M, Turiel C, De Las Vecillas L, Quirce S, Dominguez-Ortega J
Rev Alerg Mex · 2025 Dec · PMID 41420575 · Publisher ↗
OBJECTIVE: To assess changes in Nijmegen Questionnaire (NQ) scores in patients with severe asthma treated with dupilumab and their relationship with disease control. METHODS: A retrospective study was conducted in patien...
OBJECTIVE: To assess changes in Nijmegen Questionnaire (NQ) scores in patients with severe asthma treated with dupilumab and their relationship with disease control. METHODS: A retrospective study was conducted in patients with severe asthma treated with dupilumab. Epidemiological and clinical data were collected, as well as results of questionnaires: NQ, asthma control test (ACT) and Asthma Quality of Life Questionnaire (AQLQ), assessing the changes after one year of treatment. RESULTS: A total of 18 patients were included, 12 males, with a median age of 54 years and a range between 27 and 67 years old. The median result of the NQ at the start of dupilumab was 15.5 points (1-34) and at 12 months was 7 points (0-35). Before treatment, five patients (27.77%) had a NQ greater than 23 points compatible with hyperventilation syndrome (HVS). The median ACT score was 19 (10-24) and at the 12-month control it was 23 (12-25). The median AQLQ was 5 points (3-7) at the start of dupilumab and 6.08 points (3.50-7) after 12 months of dupilumab. This study observed changes in NQ scores after 12 months of dupilumab treatment, irrespective of initial NQ scores. CONCLUSIONS: Incorporating the NQ into the assessment of biologic response in severe asthma may provide additional insights into patient monitoring. Proper management of comorbidities, including HVS, is essential for optimizing asthma outcomes, as uncontrolled comorbidities can confound asthma control.
[Sensitization to aeroallergens in the population of a third-level hospital in the north of Mexico City].
Moncayo-Coello CV, Ríos-Nuñez EB, Bello-López JM … +1 more , Mellado-Ábrego J
Rev Alerg Mex · 2025 Dec · PMID 41420574 · Publisher ↗
OBJECTIVE: To determine the frequency of sensitization to aeroallergens in skin prick tests and its association with the geographic distribution, time of year, age, and sex of patients with asthma and/or allergic rhiniti...
OBJECTIVE: To determine the frequency of sensitization to aeroallergens in skin prick tests and its association with the geographic distribution, time of year, age, and sex of patients with asthma and/or allergic rhinitis. METHODS: This was an observational, descriptive, and retrospective study conducted in patients older than 2 years with a diagnosis of asthma and/or allergic rhinitis. The results of skin prick tests collected between January and December 2023 at the Allergy Service of the Juárez Hospital in Mexico City were analyzed. A total of 23 allergens were evaluated. The results were categorized by age, sex, and allergen type using descriptive statistics. RESULTS: 734 tests were analyzed, of which 587 (79.9%) were positive. The positivity rate was highest in children (62.5%), followed by adults (22%) and older adults (1.4%). 52.5% of the cases were in women. The most frequently identified aeroallergens were tree pollen (37.6%), dust mites (20.4%), grasses (12.9%), and animal dander (12.5%). The most prevalent tree pollens were (6.7%) and (4.7%), while the most common dust mites were (11.1%) and (9.3%). A high rate of polysensitization was observed (85.7%). CONCLUSIONS: Sensitization to aeroallergens was more frequent in children and women. The most common allergens identified were tree pollens, particularly **, and house dust mites, especially **. These findings underscore the need for targeted preventive and therapeutic strategies that consider environmental factors such as climate change and the geographic distribution of allergens.
Risk factors for atopic eczema in Colombia, a tropical country.
García E, Peñaranda A, Barragán AM … +5 more , Rondón MA, Pérez A, Rojas MX, Caraballo L, Dennis RJ
Rev Alerg Mex · 2025 Dec · PMID 41420573 · Publisher ↗
OBJECTIVE: This study aimed to estimate the prevalence of atopic eczema (AE) in children/adolescents and adults and variables associated with risk factors. METHODS: We used data from a cross-sectional, population-based s...
OBJECTIVE: This study aimed to estimate the prevalence of atopic eczema (AE) in children/adolescents and adults and variables associated with risk factors. METHODS: We used data from a cross-sectional, population-based study performed in six cities of Colombia during 2009-2010. A nested case-control study was used to determine AE-associated risk factors. RESULTS: In adults, AE was mainly associated with a family history of AE (adjusted OR [aOR] 4.66, 95%IC:3.18 to 6.82) and Allergic Rhinitis (AR) (aOR 2.21, 95%CI: 1.61 to 3.03). We also found a dose-dependent positive association between acetaminophen use and AE, being more assertive at once per week (aOR 2.12, 95%CI: 1.47 to 3.06) than once per month (aOR 1.82, 95%CI: 1.28 to 2.59). Female gender (aOR 1.49, 95%CI: 1.15 to 1.93), smoking (aOR 1.60, 95%CI: 1.19 to 2.14), and cats at home (aOR 1.57, 95%CI: 1.06 to 2.31), were positively associated with AE. In contrast, meat (aOR 0.45, 95%CI: 0.27 to 0.74), and seafood consumption (aOR 0.71, 95%CI: 0.56 to 0.91) were negatively associated. In children/adolescents, family history of AR (aOR 2.97, 95%CI: 1.79 to 4.93) and acetaminophen consumption once per week (aOR 4.00, 95%CI: 1.39 to 11.50) were associated with AE. CONCLUSIONS: The most critical risk factors for AE were a family history of atopy and acetaminophen exposure, supporting an essential contribution of both genetic and environmental factors in disease presentation.
[DRESS syndrome associated with levetiracetam use in a pediatric patient. A case report].
Gómez-Moreno TG, Ramírez-Hernández JJA, Ramírez-Ibarra OR
Rev Alerg Mex · 2025 Sep · PMID 41037728 · Publisher ↗
BACKGROUND: DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) is a drug-related hypersensitivity reaction that manifests with eosinophilia, systemic symptoms, and is sometimes life-threatening. It is...
BACKGROUND: DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) is a drug-related hypersensitivity reaction that manifests with eosinophilia, systemic symptoms, and is sometimes life-threatening. It is clinically characterized by a generalized rash, fever, facial edema, and multiorgan failure. It may be accompanied by paraclinical findings such as leukocytosis, eosinophilia, and abnormalities in renal and liver function tests. CASE REPORT: We present the case of a 10-year-old female patient hospitalized with a diagnosis of pansinusitis complicated by epidural empyema requiring surgical drainage. Prior to this, she was treated with levetiracetam. After surgery, she was maintained on a triple regimen of vancomycin, ceftriaxone, and metronidazole. Upon completion of this treatment, she developed a generalized dermatosis that did not respond to second-generation antihistamines or corticosteroids. After this, the patient presented with fever, facial edema, and a seizure. Laboratory studies were ordered, revealing leukocytosis and eosinophilia. DRESS syndrome was suspected, with a RegiSCAR score of 5, corresponding to a probable case. Treatment with immunoglobulin was initiated, with clinical improvement and resolution of the condition observed. CONCLUSIONS: DRESS syndrome is a severe drug-induced reaction, with an estimated mortality rate of 10%. Early recognition and timely initiation of treatment are essential for prognosis and prevention of potential complications.
[Evaluation of the accelerated stability of an allergen extract in combination with an inactivated bacterial suspension using the Advanced Kinetic Model (AKM)].
Hernandez J, Guidos G, Reyes-López C
Rev Alerg Mex · 2025 Sep · PMID 41037727 · Publisher ↗
INTRODUCTION: The coadministration of allergen extracts with bacterial preparations has gained clinical relevance in subcutaneous immunotherapy for respiratory allergic diseases. However, there are no systematic studies...
INTRODUCTION: The coadministration of allergen extracts with bacterial preparations has gained clinical relevance in subcutaneous immunotherapy for respiratory allergic diseases. However, there are no systematic studies evaluating the physicochemical stability or preservation of immunological activity of these mixtures. This study aimed to characterize the stability of a combined formulation using the Advanced Kinetic Model (AKM), a mathematical approach to shelf-life prediction based on nonlinear kinetics. METHODS: A lyophilized mite extract (D. pteronyssinus/D. farinae) and an inactivated bacterial suspension (IPI-Asac) were used. Incubations were performed at 4, 15, 30, 37, and 45°C for up to 90 days, with chromatographic (SEC-HPLC), electrophoretic (SDS-densitometric PAGE), and functional (ELISA-IgE) analyses. The samples were studied separately and in a 4:1 ratio (extract:bacteria). The AKM model was applied to the IgE-binding loss data to extrapolate long-term stability. RESULTS: No significant differences were observed between the extract alone and the mixture in terms of aggregation, protein degradation, or loss of IgE-binding capacity. At 15°C, >90% activity was retained for up to 90 days. Conclusion: The AKM model predicted a retention of 75% functional activity at 4°C for up to 1.5 years. The bacterial suspension did not alter the degradation kinetics or biophysical profiles. CONCLUSIONS: The data obtained suggest that the inclusion of an inactivated bacterial suspension does not compromise the conformational or functional stability of the allergens. The maintenance of IgE-specific activity under simulated storage conditions supports the technical feasibility of a coformulation. The application of the AKM model provided robust predictions of biological longevity without requiring prolonged stability studies under real-world conditions. The blending of allergenic extracts with inactivated bacterial suspensions preserves their immunological and biophysical properties under accelerated thermal conditions. These findings support the possibility of formulating combination products without negatively impacting immunotherapeutic efficacy, justifying additional clinical studies and multi-batch validation.
[Non-allergic immediate hypersensitivity to Brentuximab vedotin in pediatrics: usefulness of skin testing to guide provocation testing].
González-Silva KD, Perea-Valle P, Gutiérrez-Hernández JA
Rev Alerg Mex · 2025 Sep · PMID 41037726 · Publisher ↗
BACKGROUND: Hypersensitivity reactions to monoclonal antibodies represent a clinical challenge, especially when there are no equivalent therapeutic alternatives. Brentuximab vedotin (BV), an anti-CD30 monoclonal antibody...
BACKGROUND: Hypersensitivity reactions to monoclonal antibodies represent a clinical challenge, especially when there are no equivalent therapeutic alternatives. Brentuximab vedotin (BV), an anti-CD30 monoclonal antibody indicated for relapsed Hodgkin lymphoma, has been associated with immediate hypersensitivity in 1.2% of cases. CASE REPORT: An 11-year-old patient with relapsed Hodgkin lymphoma presented with grade 3 anaphylaxis (Brown scale) with hypotension, dyspnea, cough, wheezing, bipalpebral edema, conjunctival injection, nausea, and altered consciousness during the fifth cycle of chemotherapy with AVD (doxorubicin, vinblastine, and dacarbazine) + BV. Intramuscular epinephrine and fluid therapy were administered, with resolution of the condition. Laboratory Studies: BV skin tests performed 2 weeks after the event were negative. Outcome: Given the immediacy and severity of the event, and the need to continue treatment, a successful pharmacological challenge with AVD agents was performed. Subsequently, two cycles of BV desensitization were performed (cycles 6 and 7), using different protocols, without adverse reactions. CONCLUSION: Although skin tests were negative, the clinical presentation was consistent with immediate non-allergic hypersensitivity. Desensitization allowed treatment to continue with adequate tolerance and without recurrence. Repeat skin tests are currently being considered 4 to 6 weeks after the index event; if negative, a BV challenge test is considered. Skin tests support safety prior to a controlled challenge. Desensitization is an effective strategy for continuing essential treatments in pediatric oncology.
[Primary immunodeficiency with hypogammaglobulinemia and minimum midline defect].
Castillo-Sigales AA, Acuatla-Munguia P, Palafox-Olvera A … +5 more , Puerto-Díaz EA, Mellado-Ábrego J, Hernández-Nieto L, Castillo-Narváez G, Moncayo-Coello CV
Rev Alerg Mex · 2025 Sep · PMID 41037725 · Publisher ↗
INTRODUCTION: In allergic patients with recurrent respiratory infections, the association of antibody deficiencies, both selective and specific to polysaccharide responses, has been described. CASE REPORT: Male, no signi...
INTRODUCTION: In allergic patients with recurrent respiratory infections, the association of antibody deficiencies, both selective and specific to polysaccharide responses, has been described. CASE REPORT: Male, no significant family history. At age 5, presented with cervical and axillary lymphadenopathy; biopsy ruled out malignancy, followed by remission. At age 7, developed nasal symptoms and wheezing. Admitted to Allergy at age 9 and diagnosed with asthma and rhinitis, sensitized to dust mites and grass. Good response to immunotherapy in the first 2 years; during the third year, developed recurrent respiratory and gastrointestinal infections every 15 days. At age 13, further workup was decided. Physical Examination: Weight 69 kg, height 1.7 m, obstructive turbinates, central bifid uvula, grade I tonsils, no lymphadenopathy, cardiopulmonary system unremarkable. Studies: Hemoglobin 15.6 g/dL, Hematocrit 46%, WBC 4005/μL, Lymphocytes 1200/μL (20%), Eosinophils 210/μL (3.6%), Platelets 219,000/μL. Low IgA 23 mg/dL (45-236), low IgM 27 mg/dL (52-242), IgE 11.9 IU/mL (≤3100), normal IgG 1060 mg/dL (560-1760), reconfirmed. Flow cytometry normal with normal B lymphocytes. Pneumococcal polysaccharide vaccine challenge showed adequate response to only 4 serotypes (<50% response). Management: Temporary treatment with prophylactic antibiotics and immunostimulants, with improvement in infectious episodes. Currently off prophylaxis. Discussion: Adolescent with quantitative IgA and IgM deficiency, currently normal IgG levels but impaired response to polysaccharide vaccine. Maintained under immunological surveillance due to potential progression to common variable immunodeficiency. CONCLUSION: Recurrent or invasive infections in treated asthma patients warrant investigation for antibody deficiency.
[Drug hypersensitivity: When systemic symptoms and pustules converge].
Palafox-Olvera A, Puerto-Díaz EA, Mellado-Ábrego J … +3 more , Hernández-Nieto L, Castillo-Narvaéz G, Moncayo-Coello CV
Rev Alerg Mex · 2025 Sep · PMID 41037724 · Publisher ↗
BACKGROUND: Overlap (SCARs) severe cutaneous adverse drug reactions, are defined as cases that fulfill diagnostic criterio for at least two of these drug-associated reactions, according to scoring systems. We present a c...
BACKGROUND: Overlap (SCARs) severe cutaneous adverse drug reactions, are defined as cases that fulfill diagnostic criterio for at least two of these drug-associated reactions, according to scoring systems. We present a case of an overlapping SCAR. CASE REPORT: A 53-year-old female was diagnosed with diabetes and was being treated with metformin and linagliptin, and with high blood pressure with nifedipine. Secondary to an isolated seizure, she was treated with phenytoin, 5 weeks later, she presented with erythema in the chest region accompanied by pruritus that spread to the abdomen. Treatment was initiated with antihistamines, with poor improvement, progressing to generalized erythema and fever. Upon admission, she presented with generalized polymorphic skin lesions of a maculopapular rash and bullous lesions on the forearms, as well as pustular lesions on the face. Laboratory findings: Leukocytosis with neutrophilia (67%), eosinophilia =3,880/mm3, and acute kidney injury. : Chronic interface dermatitis, superficial perivasculitis, and eosinophilia. According to RegiSCAR scoring system with 4 points and the EuroSCAR score with 6 points, both considered probable The patient began steroid therapy with methylprednisolone at 1.5 mg/kg for 3 days, followed by reduced doses of prednisone. CONCLUSIONS: The patient presented a severe cutaneous adverse reaction 5 weeks after starting phenytoin, which showed overlap according to the scales. Secondary to the ambiguities among SCARs, confirmed cases of overlap are rare. In the acute stage of the disease, early identification of SCARs can be difficult due to overlapping features.
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