Revista Alergia Mexico[JOURNAL]
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200 papers
[Genuine awareness of mammalian meat such as beef and pork: Myth or reality?].
Flores-Montiel A, Hernández-Ojeda M, O Farril-Romanillos PM … +4 more , Herrera-Sánchez DA, Garfias-Zavala DL, Gil-Ruiz A, Rodríguez-Moreno AD
Rev Alerg Mex · 2025 Sep · PMID 41037723 · Publisher ↗
BACKGROUND: Genuine sensitization to beef and pork is rare, with the best-characterized allergens being beef and pork (Bos d 6 and Sus s1). There are different presentations of mammalian meat allergy: cat-pork syndrome,...
BACKGROUND: Genuine sensitization to beef and pork is rare, with the best-characterized allergens being beef and pork (Bos d 6 and Sus s1). There are different presentations of mammalian meat allergy: cat-pork syndrome, alpha-gal syndrome, milk-related allergy, and primary sensitization. CASE REPORT: A 49-year-old man presented with urticaria after ingesting beef and pork and mild intermittent nasal symptoms. The initial approach was aeroallergen testing: positive for cat. Cat-pork syndrome was suspected. A prick-to-prick test was performed on raw and cooked pork: positive; raw beef: positive; cooked beef: indeterminate; oral examination was performed: positive; 40 minutes later, wheal-like lesions were present on the neck, anterior thorax, and face. Fel d 1 (0.92 kcal/L) and Fel d 2 (0.05 kcal/L) were ordered, confirming genuine cat sensitization and ruling out cat-pig syndrome. Specific IgE to pork (0.18 kcal/L), confirming sensitization to pork. Given the presence of symptoms associated with beef and the likelihood of α-Gal syndrome, skin and intradermal polygeline testing was performed: negative. Bos d4 (0.02 kcal/L) and Bos d5 (0.01 kcal/L) were negative, confirming primary sensitization to beef. CONCLUSION: After ruling out other mechanisms, primary sensitization to mammalian meat is presumed. A molecular approach can improve diagnostic accuracy and guide therapeutic decision-making in this case: Total avoidance.
[In vitro profile for allergens and their association with pollen distribution volumes in Mexico City].
Pavón-Romero GF, Cruz-Pérez J, Cabrera-González X … +4 more , Payan-Espíndola E, Ramírez-Jiménez F, Castañeda DG, Terán LM
Rev Alerg Mex · 2025 Sep · PMID 41037722 · Publisher ↗
INTRODUTION: Allergic sensitization (AS) assessed through in vitro methods (iv-M) has shown adequate sensitivity and diagnostic correlation. Recently, AS profiles have been compared with pollen distribution, which streng...
INTRODUTION: Allergic sensitization (AS) assessed through in vitro methods (iv-M) has shown adequate sensitivity and diagnostic correlation. Recently, AS profiles have been compared with pollen distribution, which strengthens the clinical relevance of their results in the population where they are applied. OBJETIVE: Describe the pattern of AS using iv-M, as well as the dispersion volume of the main pollens in Mexico City (CDMX) identified through iv-M. METHODS: Aeroallergen profiles (iv-M-EUROIMMUN/Lübeck) from 197 patients with allergic rhinitis recruited in 2022 were analyzed. Results were grouped by family and species. Similarly, the distribution of the most relevant pollens was studied retrospectively using iv-M data from 2017 to 2022 (www.rema.atmosfera.unam.mx). Frequency/SA (χ) and median/pollen volume (Wilcoxon) analyses were performed using SPSS v.21, considering a p-value< 0.05 as statistically significant. Results: Weeds and trees were the predominant groups (~65% vs. grasses at 42.5%, p<0.01). Specifically, the Chenopodiaceae-Amaranthaceae (Ch-A) family (57.8% vs. Asteraceae at 20.8%, p<0.001) and the Oleaceae family (44.6% vs. Fabaceae/Fagaceae at ~31.9%, p<0.001) shaped the results. Among the main pollens, Salsola kali (50.7%), Atriplex hortensis (41.6%), and Fraxinus sp. (38%) stood out. This profile was not influenced by age or sex. Regarding pollen distribution, the Ch-A family showed high levels until 2021, when they began to decline (p<0.001). In contrast, Fraxinus sp. pollen showed high volumes only during specific months (p<0.001). CONCLUSION: The identification of Ch-A is likely related to the presence of Ole-like-1 in Fraxinus, the species with the highest distribution volume. iv-M found that there was more SA in the Ch-A family and Fraxinus sp., both of which had more pollen spread in the years before the diagnostic evaluation.
[Biblio-informatic analysis of allergens contained in the milpa diet].
Pavón-Romero GF, Manzanilla-Bello R, Galindo-Castañeda D … +4 more , Cabrera-González X, Montero JM, Ramírez-Juárez F, Terán-Juárez LM
Rev Alerg Mex · 2025 Sep · PMID 41037721 · Publisher ↗
INTRODUTION: The milpa diet (MD) is a balanced and accessible nutritional model based on the biodiversity of Mexico. Currently, research on allergens involved in food allergy (FA) has focused on foods with high global co...
INTRODUTION: The milpa diet (MD) is a balanced and accessible nutritional model based on the biodiversity of Mexico. Currently, research on allergens involved in food allergy (FA) has focused on foods with high global consumption, without analyzing foods included in MD. OBJECTIVE: To describe the allergens contained in MD. METHODS: A specific search was performed using the PUBMED-NCBIwebsite for MD and their respective allergens implicated in FA. Of the articles identified, those that had at least one allergen reported in the WHO/IUISsoftware were evaluated, as well as their UniProt code, necessary to access protein sequencing by BLAST software. We then conducted identification analysis using the AllerCatPro 2.0 software, setting a threshold of above 60% correlation of identity among proteins included in MD. RESULTS: Only 11 (16.9%) MD foods have reported associations with FA (pineapple, chili pepper, tomato, amaranth, sapodilla, peanut, avocado, squash, corn, green beans, and papaya). Likewise, 19 protein families were associated; profilins and nsLTP1 were the most frequent, presented in four and six foods, respectively. Five proteins (PR-10, TLP, cyclophilin, class IV chitinase, and nsLTP2) were identified in two foods, while twelve proteins (oleosins, conglutins, defensins, polygalacturonase, cupin, chymopapain, bromelain, L-ascorbate oxidase, 11S and 2S globulins, beta-fructofuranosidase, and ole-1-like protein) were identified in at least one food. The highest identity was found between profilins from chili pepper (cap*a*2.0201) and tomato (Sola*l*1.0101) at 94.7%. CONLUSION: Among 1080 molecules implicated in allergic responses, the bioinformatic analysis identified only ~5% in MD. However, in vitro confirmation of these findings is necessary. Foods in the MD contain a higher proportion of nsLTP1 and profilins.
[Association of IL13 rs1800925 and rs1881457 variants with severe asthma in a population from Western Mexico].
Montoya-Delgado IB, Gutierrez-Zepeda BM, Quintero-Ramos A … +4 more , Ochoa-García IV, Ortega-Cisneros M, Del Toro-Arreola A, Daneri-Navarro A
Rev Alerg Mex · 2025 Sep · PMID 41037720 · Publisher ↗
BACKGROUND: Asthma is a chronic inflammatory disease with variable airflow obstruction. Severe asthma (310% of cases) requires high-dose corticosteroids, increasing the risk of exacerbations. The IL13 rs1800925 and rs188...
BACKGROUND: Asthma is a chronic inflammatory disease with variable airflow obstruction. Severe asthma (310% of cases) requires high-dose corticosteroids, increasing the risk of exacerbations. The IL13 rs1800925 and rs1881457 variants, involved in the regulation of inflammation, have been associated with asthma severity in various populations, but their impact in Mexico has not been studied. OBJECTIVE: To evaluate the association of the IL13 rs1800925 and rs1881457 variants in patients with severe asthma. METHODS: One hundred patients with severe asthma and 150 healthy controls were analyzed. DNA was extracted and quantified for genotyping using allelic discrimination. Lung function, IgE levels, hospitalizations, symptoms, medications, and allergen exposure were assessed. Haplotypes and linkage disequilibrium (LD) were calculated. RESULTS: There were no significant differences in allele/genotype frequencies between groups. A strong LD was observed between rs1800925 and rs1881457 (D=0.83, r=0.77, p<0.05). 77% had an eosinophilic Th2 endotype, 70% had aeroallergen allergy, and 54% had insufficient disease control. Women used more reliever medication and had more nighttime symptoms (p<0.05). CONCLUSION: The variants exhibit a strong LD but do not show a significant association with AG in this population. The high prevalence of the eosinophilic Th2 endotype and sensitization to aeroallergens reinforce the role of allergic inflammation in the disease. Furthermore, sex differences suggest a greater incidence in women, which could influence the clinical management of AG. Larger studies are needed to confirm these findings.
[ sepsis as an initial manifestation of common variable immunodeficiency].
Cabrera-Arias SM, Díaz Terríquez A, López Morales ZA … +3 more , Berrón Ruiz L, Bayardo Gutiérrez B, Núñez Núñez M
Rev Alerg Mex · 2025 Sep · PMID 41037719 · Publisher ↗
INTRODUCTION: Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults, diagnosed by exclusion in cases of hypogammaglobulinemia without an identifiable cause. Its manifestations...
INTRODUCTION: Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults, diagnosed by exclusion in cases of hypogammaglobulinemia without an identifiable cause. Its manifestations range from recurrent infections to autoimmunity and risk of malignancy. CASE REPORT: A previously healthy 11-year-old female patient was originally from and resides at Rancho El Nogal in Arandas, Jalisco, a community of approximately 250 inhabitants. There was no significant family history; there was no known consanguinity or presence of genetic diseases in the family. : After trauma to the left leg, she developed osteomyelitis. Upon admission, pancytopenia, enlarged lymph nodes, hepatosplenomegaly, and abscesses with positive cultures for Staphylococcus aureus were detected. An approach to detecting inborn errors of immunity was initiated, revealing decreased immunoglobulin G and A levels. Due to the severe systemic infection, intravenous immunoglobulin was administered at 1 gram/kilogram, and the immunosuppression study was expanded. Abnormalities in the lymphocyte subpopulation were detected, with decreased CD19+ counts: 71 mm, CD3+ counts: 915 mm, CD4+ CD45RA+ T cells (naive): 92 mm, total memory B cells (3%), non-isotype-switched (2.5%), isotype-switched (0.5%), plasmablasts (0.3%), and decreased CD21 counts (9%). The patient was classified as Freiburg 1B common variable immunodeficiency. Monthly intravenous immunoglobulin was started at a dose of 400 milligrams/kilogram. The patient responded favorably to immunoglobulin treatment, with no subsequent serious infections. She remains stable and is being monitored by immunologists. CONCLUSION: CVID, although more common in adults, can present in children. S. aureus sepsis as an initial manifestation, as in this patients case, should raise concerns about possible underlying immunodeficiencies. This case highlights the importance of suspecting primary immunodeficiencies in patients with severe infections, underscoring the need for early diagnosis and treatment to optimize prognosis.
[Ocular challenge protocol with a DPT/DF mixture for the diagnosis of local allergic conjunctivitis. Report of 2 cases (pediatric and adult)].
Reyes RW
Rev Alerg Mex · 2025 Sep · PMID 41037718 · Publisher ↗
BACKGROUND: Ocular allergy encompasses pathologies mediated by type I hypersensitivity, affecting the ocular surface. For diagnosis, it is essential to take a clinical history, perform an examination, and verify sensitiz...
BACKGROUND: Ocular allergy encompasses pathologies mediated by type I hypersensitivity, affecting the ocular surface. For diagnosis, it is essential to take a clinical history, perform an examination, and verify sensitization to aeroallergens using in vivo and/or in vitro tests. There are cases of patients with negative serum IgE levels, low serum IgE levels, and persistent symptoms and clinical manifestations. In these cases, ocular challenge tests are useful to confirm local allergy. CASES REPORT: : A 10-year-old male diagnosed with allergic conjunctivitis. Skin prick tests were negative. Serum IgE 35 IU/ml, tear sIgE, DPT 0.37 kUA/L, DF 0.14 kUA/L. : A 28-year-old male diagnosed with allergic conjunctivitis. Skin tests were negative: serum IgE 1 IU/ml, tear sIgE DPT 0.12 kAU/L, DF 0.1 kAU/L. An ocular challenge was performed with a DPT/DF mixture containing a standardized ALK-abelló extract mixture-DPT/DF-10,000 AU/ml. The TOSS (Total Ocular Symptom Score) scale was used to confirm the ocular challenge. The challenge was positive in both patients for DPT/DF [100 AU/ml] in a 1:100 dilution, with a TOSS score of 8 points each. A provocation test was performed on a healthy control patient. No local ocular reaction occurred. TOSS score = 0 points. : Patients were receiving topical ocular drug treatment. CONCLUSION: Local reactions were positive in both patients, confirming local ocular allergy. A standardized allergen extract (ALK-abelló) with a DPT/DF mixture of 10,000 AU/ml was used, and the test was positive at 100 AU/ml at a 1:100 dilution. No local ocular reaction was observed in a healthy control patient at the highest concentration (10,000 AU/ml) and at a 1:1 dilution. Ocular challenge with a standardized DPT-DF extract is a safe and reproducible test that confirms local allergic conjunctivitis in both pediatric and adult patients. No adverse effects were observed with the presented protocol.
[Egg Sensitization in Pediatric and Adult Populations with Compatible Symptoms: A Prospective Study].
Melendez-Diaz GM
Rev Alerg Mex · 2025 Sep · PMID 41037717 · Publisher ↗
INTRODUCTION: Egg allergy is a common cause of food hypersensitivity, especially in the pediatric population, with an estimated prevalence of 9%. The main proteins involved are ovomucoid (Gal d 1), the most allergenic, a...
INTRODUCTION: Egg allergy is a common cause of food hypersensitivity, especially in the pediatric population, with an estimated prevalence of 9%. The main proteins involved are ovomucoid (Gal d 1), the most allergenic, and ovalbumin (Gal d 2), the most abundant. Although most cases remit in childhood, certain factors are associated with persistence into adulthood, such as elevated levels of specific IgE, the presence of other food allergies, and atopic diseases. OBJECTIVE: To determine the frequency of egg sensitization in patients with symptoms reported after egg consumption and to describe the clinical characteristics of the sensitized population. METHODOLOGY: A prospective study was conducted between August 2024 and February 2025. 57 patients (pediatric and adult) with symptoms suggestive of egg allergy were included. Skin tests to ovalbumin, ovomucoid, and egg yolk were performed. In pediatric patients, serum-specific IgE was determined. RESULTS: Sensitization was positive in 37.5% of children and 14% of adults. Reactivity to ovomucoid was observed in 66% of sensitized children and 85% of sensitized adults, to ovalbumin in 100% of children and 57% of adults, and to egg yolk in 33.3% and 42%, respectively. The most common comorbidities were allergic rhinitis (60%), allergy to other foods (40%), and atopic dermatitis (10%). 57% of adults had a history of anaphylaxis. CONCLUSIONS: Sensitization to egg was more frequent in the pediatric population. Ovomucoid was the most frequently implicated allergen. The presence of atopic diseases was common, especially in adults. Although skin prick tests do not confirm the diagnosis of allergy, their high negative predictive value makes them useful as an exclusion tool.
[Characterization of patients with ant sting allergy: a 9 case serie and immunotherapy response].
Torreros-Lara DD, Pérez-Sánchez IY, Velázquez-Sámano G … +3 more , Velasco-Medina A, Albarrán-Godinez A, Alvarado-Carrillo DL
Rev Alerg Mex · 2025 Sep · PMID 41037716 · Publisher ↗
BACKGROUND: Ant sting allergy can trigger from local cutaneous manifestations to fatal anaphylaxis, last one with an incidence of 23.5% in adults. Immunotherapy is effective in 9798% of cases to reducing the frequency an...
BACKGROUND: Ant sting allergy can trigger from local cutaneous manifestations to fatal anaphylaxis, last one with an incidence of 23.5% in adults. Immunotherapy is effective in 9798% of cases to reducing the frequency and severity of these reactions, to reduce the risk of anaphylaxis to 5% compared to 60% in patients without immunotherapy. OBJECTIVE: Describe the clinical characteristics, course, and response to specific immunotherapy in patients with ant sting allergy. METHODS: A retrospective, observational, and descriptive study was conducted in nine patients with allergic reactions to ant stings from 2017 to 2025. Age, sex, history of atopy, type of reaction, skin testing, and clinical course were analyzed. RESULTS: The mean age was 37.8 years (range 1159), with a female predominance (66.7%). Of the patients, two (22.2%) had local reactions and seven (77.8%) had systemic reactions, including two cases of anaphylaxis. Thirty-three percent (33.3%) had a history of allergic rhinitis, and 22.2% had an allergy to other insects. Five patients received immunotherapy; during follow-up, none presented systemic reactions after re-exposure, and one patient had a mild cutaneous reaction without requiring hospitalization. CONCLUSION: A high frequency of systemic reactions was observed in patients allergic to ant venom, exceeding that reported in the literature. Immunotherapy reduced the severity of reactions after re-exposure. Ant venom immunotherapy is effective in reducing the severity of allergic reactions and the risk of anaphylaxis during future exposures, being the only treatment shown to modify the natural history of the disease.
[Patient with severe congenital neutropenia associated with ELANE gene mutation: c.684C>G, p.Tyr228Ter].
Sotelo-de Jesús SD, Gutiérrez-Hernández A
Rev Alerg Mex · 2025 Sep · PMID 41037715 · Publisher ↗
INTRODUCTION: Severe congenital neutropenia type 1 (SCN1) is a rare inherited disorder caused by arrested granulocyte maturation, frequently associated with mutations in the ELANE gene, which encodes neutrophil elastase....
INTRODUCTION: Severe congenital neutropenia type 1 (SCN1) is a rare inherited disorder caused by arrested granulocyte maturation, frequently associated with mutations in the ELANE gene, which encodes neutrophil elastase. CASE REPORT: A 3-year-5-month-old female patient with a history of recurrent perianal infections and necrotizing fasciitis secondary to appendicitis complicated by septic shock. She required laparotomy, appendectomy, ileostomy, debridement, and vasoactive amine support. During her hospitalization, persistent severe neutropenia, lymphopenia, and eosinophilia were identified. Bone marrow aspirate showed arrested myeloid leukemia with an absence of neutrophils. Among the infectious isolates, the following were isolated: P. aeruginosa and Stenotrophomonas maltophilia, as well as rhinovirus/enterovirus. The neutrophil count remained persistently low (100-530/μL), responding to G-CSF (5 mcg/kg/dose). Genetic sequencing revealed a heterozygous missense mutation in ELANE (c.684C>G, p.Tyr228Ter). CONCLUSION: The diagnosis of NCG1 was clinically supported by severe infections, persistent neutropenia, absence of mature granulocytes in the bone marrow, and genetic confirmation. This mutation generates a premature stop codon. Other relevant variants include GFI1, HAX1, VPS45, JAGN1, CSF3R, and WAS. NCG1 should be suspected in pediatric patients with recurrent severe infections and persistent neutropenia. Early identification and the use of G-CSF can improve clinical outcome and reduce infectious complications.
[Autoimmunity in Patients with CTLA-4 Haploinsufficiency].
Saad Manzanera MI, García Acevedo IG, Jiménez Fonseca MG … +6 more , Aviles Tenorio SK, Ramirez Molina PI, Mut Quej JE, O Farrill Romanillos PM, Herrera Sánchez DA, López Herrera G
Rev Alerg Mex · 2025 Sep · PMID 41037714 · Publisher ↗
BACKGROUND: CTLA4 deficiency is a disorder caused by mutations in the CTLA4 gene. T (TL) and B (BL) lymphocyte activity is affected, generating complex autoimmune dysregulation and immunodeficiency syndromes with variabl...
BACKGROUND: CTLA4 deficiency is a disorder caused by mutations in the CTLA4 gene. T (TL) and B (BL) lymphocyte activity is affected, generating complex autoimmune dysregulation and immunodeficiency syndromes with variable clinical spectrum and diagnostic difficulty. CASE REPORT: : A 16-year-old male with no significant family history presented with autoimmune hemolytic anemia, thrombocytopenia, episodes of diarrhea, atopic dermatitis, respiratory tract infections, rhinosinusitis, and recurrent otitis media, with multiple antibiotic therapies. Laboratory tests indicated immunoglobulin replacement and prophylactic antibiotic therapy with improvement. He continued to experience intermittent diarrhea and skin lesions. Biopsies ruled out infectious etiologies, and the patient was diagnosed with lichen planus, nummular eczema, and enteropathy associated with immunodeficiency. Treatment with immunosuppressants was initiated. Genetic testing diagnosed heterozygous CTLA4 deficiency. : IgA 1 mg, IgG 356 mg, IgM 2 mg, Leukocytes 9700/mm3, Neutrophils 8179/mm3, Monocytes 442/mm3, Lymphocytes 1055/mm3, LT 86.12% 909/mm3, LB 0.85% 9/mm3, NK cells 14.75% 156/mm3, LTCD4+ 60.82% 553/mm3, LTCD8+ 35.44% 322/mm3, isotype-switched memory LB 0%, non-isotype-switched memory LB 1.83%, CD21low LB 30.94%, LTnaive 8.84%, LTLmemory 82.66%. CONCLUSION: The diagnosis of this pathology is difficult due to its wide clinical presentation. Impaired LT and LB function leads to severe autoimmune processes and progressive hypogammaglobulinemia, recurrent infections, and malignancies. Immunoglobulin, prophylactic antibiotics, immunosuppressants, and bone marrow transplantation are the mainstays of treatment. Recognizing this genetic defect allows for targeted treatment (abatacept) that will improve the quality of life and prognosis of patients.
[Hypocomplementemic urticarial vasculitis in SLE: between urticaria and autoimmunity].
Mut Quej JE, Ramirez Molina PI, Saad Manzanera MI … +4 more , O Farrill Romanillos PM, Jimenez Fonseca MG, Aviles Tenorio SK, Herrera Sánchez DA
Rev Alerg Mex · 2025 Sep · PMID 41037713 · Publisher ↗
BACKGROUND: Urticarial vasculitis (UV) is a rare entity affecting small blood vessels, characterized by persistent (>24 hours) urticarial lesions with histopathological findings of leukocytoclastic vasculitis. It is clas...
BACKGROUND: Urticarial vasculitis (UV) is a rare entity affecting small blood vessels, characterized by persistent (>24 hours) urticarial lesions with histopathological findings of leukocytoclastic vasculitis. It is classified as normocomplementemic (NUV) and hypocomplementemic (HUV), the latter associated with systemic diseases such as systemic lupus erythematosus (SLE). Its incidence is 0.5 per 100,000 person-years. CASE REPORT: : A 66-year-old female with a history of SLE, hypothyroidism, and osteoarthritis developed in 2022. In 2022, she developed a dermatosis disseminated to all four body segments with pruritic wheals lasting up to 72 hours, persisting for more than six weeks, and followed by post-inflammatory hyperpigmentation. No triggering factors were identified. She also presented episodes of palpebral and labial angioedema. Given the clinical features, a skin biopsy and complement measurement were performed. : : Superficial neutrophilic vasculitis (venulitis) with erythrocyte extravasation. : C3: 79.7 mg/dL. C4: 10.8 mg/dL. CONCLUSION: This case highlights the importance of considering hypocomplementemic urticarial vasculitis in patients with SLE and persistent urticarial lesions, as well as conducting a targeted history. Given the risk of systemic involvement, close follow-up and a multidisciplinary approach are essential. The diagnosis of UV requires clinical-histopathological correlation, with biopsy recommended for persistent lesions (>24 h), residual bruising, or systemic manifestations. Early identification and appropriate management are essential to prevent systemic complications. Treatment focuses on addressing underlying autoimmune diseases and managing symptoms with antihistamines, corticosteroids, or immunosuppressants, depending on the severity and systemic involvement.
[Sensitization to aeroallergens in adults with allergic rhinitis in a tertiary care hospital in Mexico City].
Loredo Colunga ME, López Rivera MG, Silva Goytia LM … +3 more , Martínez VA, O Farrill Romanillos PM, Herrera Sánchez DA
Rev Alerg Mex · 2025 Sep · PMID 41037712 · Publisher ↗
BACKGROUND: Allergic rhinitis is the most common allergic disease in the world. Asthma and conjunctivitis are highly associated comorbidities, with dust mites being one of the main sources of involved allergens. The prim...
BACKGROUND: Allergic rhinitis is the most common allergic disease in the world. Asthma and conjunctivitis are highly associated comorbidities, with dust mites being one of the main sources of involved allergens. The primary objective was to identify the most frequent aeroallergens in patients with allergic rhinitis, as well as to evaluate demographic factors and determine the most prevalent comorbidities. METHOD: This was a cross-sectional, descriptive, observational, and retrospective study through the review of clinical records of patients diagnosed with allergic rhinitis treated in the Immunotherapy Clinic of the Allergy and Clinical Immunology Service. RESULTS: A total of 200 patients were studied, 74% of whom were women, with a median age of 38 years. The majority of the population evaluated were from the southern areas of Mexico City, mainly from the Iztapalapa delegation (22.50%), Álvaro Obregón (14%), and Coyoacán (12.50%). The most frequent comorbidities were asthma (61%) and conjunctivitis (60%). 88% of the patients showed polysensitization. Fraxinus excelsior was the most frequent aeroallergen (47.50%), followed by dust mites, Dermatophagoides Pteronyssinus (42%) and Dermatophagoides Farinae (40%). CONCLUSIONS: Although dust mites are typically considered the most frequent allergens, in this study, Fraxinus was the most prevalent. The comorbidities correspond exactly as described in the literature. The study successfully achieved its primary objective of identifying the most common comorbidities and demographic factors, providing better insight into the characteristics of our current population.
[Acquired angioedema associated with non-Hodgkin lymphoma: a clinical case report].
Alvarado-Carrillo DL, Sánchez-Pérez IY, Velasco-Medina A … +2 more , Albarrán-Godinéz A, Velázquez-Sámano G
Rev Alerg Mex · 2025 Sep · PMID 41037711 · Publisher ↗
BACKGROUND: Acquired angioedema (AEA) is rare and usually appears after the fourth decade of life. It is characterized by recurrent episodes of nonpuriginous angioedema affecting the skin, gastrointestinal tract, and upp...
BACKGROUND: Acquired angioedema (AEA) is rare and usually appears after the fourth decade of life. It is characterized by recurrent episodes of nonpuriginous angioedema affecting the skin, gastrointestinal tract, and upper respiratory tract, making it difficult to distinguish from hereditary angioedema. CASE REPORT: Clinical presentation: A 44-year-old man with a history of non-Hodgkin lymphoma (NHL) in 2021, which was remitted. He presented with facial angioedema lasting 5 hours in June 2024, painless and non-puriginous. He denies recognizing any environmental factors, medications, or foods that exacerbate the condition, nor does he have a history of atopy. Laboratory/imaging studies: normal bile duct, IgE, ANA, C3, and C4. Thyroid profile was unremarkable. ESR and stool samples were normal. Autologous serum albumin (ASL) was negative. Physical urticaria tests were negative. C1 inhibitor was pending. Possible infectious processes were ruled out. Outcome: Partial improvement with antihistamines. In January 2025, the patient presented with a dry cough, which progressed to hemoptysis. A chest CT scan demonstrated a tumor in the right apex. Bronchoscopy with biopsy confirmed infiltration by NHL. CONCLUSION: There are two forms of AEA: type I with a recognized association with lymphoproliferative disorders, with NHL accounting for 20% of cases. It can precede the onset of NHL by an average of 2.3 years; in this case, it was the first manifestation of relapse. She has currently started chemotherapy without further episodes of angioedema. Late-onset angioedema in adulthood can be associated with a wide variety of underlying diseases, with hematologic malignancies being a significant group. A deliberate search for clinical data on malignancies leads to their timely identification.
[Ormond syndrome: a rare diagnosis in a patient with hypogammaglobulinemia secondary to rituximab].
Soto-Domínguez JA, Castillo-Leon VD, Rodríguez-Carbajal A … +2 more , Solís-Rosaldo ML, Hernandez-Noemí G
Rev Alerg Mex · 2025 Sep · PMID 41037710 · Publisher ↗
INTRODUCTION: Ormond syndrome, or idiopathic retroperitoneal fibrosis, is a rare disease with an annual incidence of 0.1 to 0.4 cases per 100,000 inhabitants and a prevalence of 1.4 per 100,000 inhabitants. It primarily...
INTRODUCTION: Ormond syndrome, or idiopathic retroperitoneal fibrosis, is a rare disease with an annual incidence of 0.1 to 0.4 cases per 100,000 inhabitants and a prevalence of 1.4 per 100,000 inhabitants. It primarily affects men (2-3:1), with diagnosis between 40 and 60 years of age. It is characterized by the growth of fibroinflammatory tissue in the retroperitoneum, with possible compression of vascular and urinary structures. Its diagnosis is complex and requires ruling out malignancy or other secondary causes. We present a case with a late diagnosis and referral to immunology due to hypogammaglobulinemia secondary to rituximab. CASE REPORT: A 54-year-old male patient with chronic kidney disease on hemodialysis was diagnosed in 2006 with retroperitoneal fibrosis after findings of ureteral stenosis and periaortic masses. Biopsies were performed, ruling out malignancy and IgG4-RD. In 2023, the patient received rituximab for inflammatory reactivation, with clinical improvement, but developed severe hypogammaglobulinemia (IgG <500 mg/dL), prompting referral to the immunology department. Subcutaneous immunoglobulin was started, with clinical stabilization. A relevant prior finding was low IgG3 levels before rituximab, with no clear relationship to Ormond syndrome. CONCLUSION: This case highlights the importance of considering Ormond syndrome in unexplained retroperitoneal fibrosis and the need for a multidisciplinary approach. It also underscores the importance of early diagnosis and close follow-up in patients with chronic fibroinflammatory disease, as well as immunological monitoring in those receiving immunosuppression, to prevent and treat associated complications. Given its rarity, it is essential to document more cases to improve understanding and management of this condition.
[Adverse reactions to biotechnological agents targeting IL-5].
Pérez-Dimas G, Ramírez-Casillas C, Sánchez-Pérez IY … +3 more , Velasco-Medina A, Albarrán-Godínez A, Velázquez-Samano G
Rev Alerg Mex · 2025 Sep · PMID 41037709 · Publisher ↗
CASE REPORT: A 24-year-old woman with asthma (2013) and allergic rhinitis (2014) was treated for 3 years with subcutaneous immunotherapy, inhaled salmeterol/fluticasone, and external antihistamines. She presented to our...
CASE REPORT: A 24-year-old woman with asthma (2013) and allergic rhinitis (2014) was treated for 3 years with subcutaneous immunotherapy, inhaled salmeterol/fluticasone, and external antihistamines. She presented to our department (2019). Upon admission, her asthma persisted with uncontrolled asthma, daily use of a rescue inhaler, and persistent moderate-severe rhinitis. Asthma treatment was adjusted according to guidelines, reaching step 4 of treatment, with persistent lack of control (ACT 16 points), meeting criteria for starting Benralizumab 30 mg (July 26, 2024). Two doses were completed with clinical improvement (ACT). However, during two doses, the patient presented with fever, headache, myalgia, and arthralgia, so treatment was discontinued. Symptoms worsened. A decision was made to switch from the biotechnological agent to mepolizumab (February 4, 2025), with adverse effects after the third dose. CONCLUSION: A percentage of patients with asthma presented with severe symptoms, 80% with an eosinophilic phenotype, associated with difficult control and increased exacerbations. Monoclonal antibodies are indicated in these patients. Benralizumab, which targets IL-5Rα, induces eosinophil depletion through antibody-mediated cytotoxicity. Several studies (MELTEMI) have been conducted to evaluate the safety of long-term use. The most common non-serious adverse effects include upper respiratory tract viral infections (47.3%), while less common adverse effects are headache and arthralgia, which account for 20.9% and 6.4%. Biotechnological agents reduce exacerbations, reduce corticosteroid use, and improve control and quality of life. However, they are not exempt from adverse effects, and even the less common ones should be identified to assess continued treatment.
[Omalizumab Withdrawal Protocol for Chronic Spontaneous Urticaria: Clinical Case].
Ramírez-Vázquez D, Caballero-López CG, López-García AI … +4 more , Rivero-Yeverino D D, Ríos-López JJ, Papaqui-Tapia JS, Riley-Pérez J
Rev Alerg Mex · 2025 Sep · PMID 41037708 · Publisher ↗
BACKGROUND: Chronic spontaneous urticaria is characterized by the daily appearance of hives and/or angioedema (Fig. 1) without a specific trigger, lasting more than 6 weeks. Treatment is based on second-generation H1 ant...
BACKGROUND: Chronic spontaneous urticaria is characterized by the daily appearance of hives and/or angioedema (Fig. 1) without a specific trigger, lasting more than 6 weeks. Treatment is based on second-generation H1 antihistamines, and in patients with an insufficient response, therapy with omalizumab has been effective; however, it is a costly and long-term treatment. The WAO (World Allergy Organization) has proposed a tapering regimen upon achieving complete remission. CASE REPORT: A 66-year-old female was referred for evaluation due to generalized hives of 6 years duration under treatment with fexofenadine 180 mg, with a partial response. Triple doses of H1 antihistamines were started, with no improvement, maintaining the UCT (Urticaria Control Test) at 5 points, and omalizumab 300 mg was added every 4 weeks, with an adequate clinical response. After complete remission, omalizumab tapering began in November 2023 according to the WAO protocol (Fig. 2). The final dose was administered in March 2025. CONCLUSION: We present the case of a patient with chronic spontaneous urticaria. After achieving complete remission with omalizumab, the tapering protocol proposed by the WAO was implemented. During this period, our patient remained asymptomatic, with UCT scores greater than 13, allowing for progressive reduction of antihistamine use. The omalizumab tapering protocol for the treatment of chronic spontaneous urticaria is safe and effective, reduces the risk of disease reactivation, and prevents prolonged treatment.
[Desensitization to Acetylsalicylic Acid in patients with coronary artery disease].
Valerdi-Zepeda BM, Rivero-Yeverino D, López-García AI … +2 more , Caballero-López CG, Ríos-López JJ
Rev Alerg Mex · 2025 Sep · PMID 41037707 · Publisher ↗
CASE REPORT: A 77-year-old male patient with a history of facial angioedema 20 years prior after ingesting 500 mg of acetylsalicylic acid (ASA). In 2024, he underwent angioplasty with coronary stenting without ASA. He wa...
CASE REPORT: A 77-year-old male patient with a history of facial angioedema 20 years prior after ingesting 500 mg of acetylsalicylic acid (ASA). In 2024, he underwent angioplasty with coronary stenting without ASA. He was admitted to the emergency department with chest pain. Coronary angiography confirmed acute myocardial infarction requiring stenting and repositioning. The catheterization department recommended triple therapy with clopidogrel, anticoagulant, and ASA. Due to the history of adverse reactions, a consultation was requested to assess tolerance to ASA. An oral challenge/desensitization was performed. Prior to the procedure, he presented with a peak expiratory flow (PEF) of 450 L/min, normal vital signs (VS), and a 5-point clinical score. ASA was administered every 15 minutes in progressive doses of 10 mg, 32 mg, 85 mg, and 174 mg, until reaching a cumulative dose of 301 mg. PEF, SV, and EC were monitored every 15 minutes for up to 4 hours after the start of treatment, with no changes. The following day, a loading dose of 300 mg of ASA was administered prior to coronary catheterization, followed by a maintenance dose of 100 mg/d. CONCLUSION: Various desensitization regimens exist. Khan proposes a regimen with 90-minute intervals using doses of 40.5 mg, 81 mg, 162 mg, and 325 mg. In our case, reducing the intervals to 15 minutes facilitated desensitization in a shorter time, which is useful in cardiac emergencies. Desensitization allowed tolerance to the loading dose prior to cardiac intervention and the maintenance dose without adverse reactions.
[Chronic spontaneous urticaria with overlapping type I/IIb endotypes in a patient with Graves disease].
Martínez-Lee KD, Contreras-Tejada BA, Albarran-Godinez A … +4 more , Sanchez-Perez YI, Velasco-Medina A, Velázquez-Samano G, Ruiz-Palafox CK
Rev Alerg Mex · 2025 Sep · PMID 41037706 · Publisher ↗
BACKGROUND: Urticaria is defined as the presence of hives, angioedema, or both. 1028% of patients have autoimmune diseases. Twenty percent have antithyroid antibodies, and only 510% present with symptoms. Two main endoty...
BACKGROUND: Urticaria is defined as the presence of hives, angioedema, or both. 1028% of patients have autoimmune diseases. Twenty percent have antithyroid antibodies, and only 510% present with symptoms. Two main endotypes are currently recognized: type I (anti-allergic) with IgE anti-TPO autoantibodies, and type IIb (autoimmune) with IgG antibodies and IgE anti-FcER1. However, 51% of patients have a I/IIb overlap. CASE REPORT: : A 46-year-old female with a history of untreated hyperthyroidism presented with generalized pruritic hives with facial angioedema, with more than 50 hives per day, lasting <24 hours, which disappeared without leaving a residual macule, with pruritus of 10/10, interfering with sleep and quality of life, and no triggering factor. : Eo 5.3% (260), IgE T 471, TSH 0.005, FT4 1.65, C3 138, C4 30, Anti-TPO 219, anti-TG 332. Positive autologous serum test. : Treatment with levocetirizine 10 mg every 12 hours was started; after 2 months, symptoms decreased. CONCLUSION: There are no specific statistics on the combined prevalence of hyperthyroidism and chronic urticaria worldwide. In this case, the patient presents elevated IgE, autoimmune disease, and positive autologous serum, leading to a diagnosis of type I/IIb overlap. Currently, there is no classification system for urticaria types that can be applied to any clinical setting, which impacts the patients therapeutic and prognostic decisions.
[Clinical efficacy and safety of sublingual whole bacterial extract as an adjuvant to allergen-specific immunotherapy in allergic rhinitis].
Riley-Pérez J, Ríos-López JJ, Valdés-González NE … +4 more , López-García AI, Rivero-Yeverino D, Caballero-López CG, Papaqui Tapia JS
Rev Alerg Mex · 2025 Sep · PMID 41037705 · Publisher ↗
BACKGROUND: In allergic rhinitis (AR), allergen-specific immunotherapy (SIT) is the only disease-modifying treatment. It may include adjuvants to improve tolerance and safety. OBJECTIVE: To evaluate the efficacy, safety,...
BACKGROUND: In allergic rhinitis (AR), allergen-specific immunotherapy (SIT) is the only disease-modifying treatment. It may include adjuvants to improve tolerance and safety. OBJECTIVE: To evaluate the efficacy, safety, quality of life, medication reduction, and number of infections with sublingual (SL) administration of whole bacterial extract (WBE) as an adjuvant to SIT in AR. METHODS: An experimental, randomized, double-blind, controlled study was conducted with 40 patients aged 5 to 60 years with moderate or severe AR due to SSTN. Patients were randomly assigned to an experimental group (SLIT with a standardized extract for Dermatophagoides pteronyssinus and/or Dermatophagoides farinae and SBE) or a control group (SLIT with a standardized extract for Dermatophagoides pteronyssinus and/or Dermatophagoides farinae). TNSS, RQLQ, medication, infections, and adverse effects were assessed at 30, 60, and 90 days. RESULTS: Both groups showed clinical improvement; however, there was only a significant change in the TNSS in the experimental group (p=0.049). Respiratory infections decreased in both groups, and the reduction in medication use was more evident in the experimental group from the first month. Two patients in the control group reported mild local adverse effects. CONCLUSION: Compared with other studies that used different adjuvants and routes of administration, similarities were observed in the reduction of symptoms and medication use. No previous studies were found comparing the reduction of infections or improvement in quality of life with SIT and bacterial lysates. Bacterial suspension as an adjuvant to SLIT with standardized extracts in AR for mites is effective and safe.
[Relationship between FeNO levels and asthma severity: a cross-sectional study at the University Hospital of Puebla].
Naranjo-Vallejo JA, Ríos-López JJ, López-García AI … +3 more , Rivero-Yeverino D, Caballero-López CG, Papaqui-Tapia JS
Rev Alerg Mex · 2025 Sep · PMID 41037704 · Publisher ↗
INTRODUCTION: The evaluation of patients with asthma uses clinical tools such as the Asthma Control Test (ACT), pulmonary function tests, and biomarkers. Among these, an elevated fractional exhaled nitric oxide (FeNO) le...
INTRODUCTION: The evaluation of patients with asthma uses clinical tools such as the Asthma Control Test (ACT), pulmonary function tests, and biomarkers. Among these, an elevated fractional exhaled nitric oxide (FeNO) level can predict a higher risk of exacerbations and response to corticosteroids and/or biological therapies, although it does not always reflect poor clinical control. Our objective was to determine the relationship between asthma severity and FeNO levels in patients attending our service. METHODS: A cross-sectional study was conducted in patients over 12 years of age with controlled asthma assessed by ACT. FeNO was measured using the NIOX-VERO device. Descriptive analysis and Spearmans correlation coefficient were applied. RESULTS: Thirty-six patients (66.7% women) with a mean age of 36.3 years (SD ± 14.4) were included. According to GINA, 63.9% had mild asthma and 36.1% had moderate asthma. 22.2% had low FeNO levels (<25 ppb) and 52.8% had high levels (>50 ppb). The mean FeNO level in mild asthma was 62.7 ppb (SD ± 62.7) and in moderate asthma, 54.8 ppb (SD ± 36.2). No significant correlation was found between asthma severity and FeNO levels (rs = 0.150, p = 0.306). CONCLUSIONS: Although more than half of the patients had elevated FeNO levels, no significant association was observed with asthma severity. This finding is consistent with previous studies and suggests that FeNO, although useful as a biomarker of type 2 inflammation, should not be used in isolation to assess clinical severity.
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