Revista Alergia Mexico[JOURNAL]
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200 papers
[Economic Burden of Hereditary Angioedema from the Perspective of the Public Health System in Mexico].
Rodríguez-Mendoza MM, Piñeyro-Beltrán EE, Contreras-Verduzco FA … +1 more , García U U
Rev Alerg Mex · 2025 Sep · PMID 41037703 · Publisher ↗
OBJECTIVE: This study evaluates the economic burden of hereditary angioedema (HAE) and compares the impact of on-demand treatment versus longterm prophylaxis (LTP) with Lanadelumab, from the perspective of the public hea...
OBJECTIVE: This study evaluates the economic burden of hereditary angioedema (HAE) and compares the impact of on-demand treatment versus longterm prophylaxis (LTP) with Lanadelumab, from the perspective of the public health system in Mexico. METHOD: A systematic literature review and modified Delphi Panel were conducted to understand the resource use of public sector institutions in the diagnosis and treatment of HAE. Costs were obtained from institutional sources such as the IMSS contracting portal and the Diagnosis Related Groups (DRG-2017). The economic burden considered direct medical costs. The results express the annual cost per patient with and without long-term prophylaxis. RESULTS: With a correct diagnosis, the cost is $5,154.78 MXN (250.20 USD). Without long-term prophylaxis, the annual cost per patient is $3,446,790.56 MXN (167,229.63 USD), with 70% peripheral attacks, 28% abdominal attacks, and 1% laryngeal attacks. Medical expenses are divided into 38% treatment, 36% complications, and 20% hospitalizations. With LTP, the annual cost is $2,641,682.18 MXN (128,221.44 USD), with 8% for attack treatment and 92% for prophylaxis. Prophylactic treatment reduces the economic burden of HAE attacks by 94.2% compared to on-demand treatment and decreases the economic burden by 23% from an institutional perspective. CONCLUSIONS: HAE represents a high economic burden, affecting hospitalizations and productivity. LTP with Lanadelumab reduces the burden on the Mexican healthcare system.
[Drug addiction and hereditary angioedema type 1, a dangerous combination].
Rodríguez-Carbajal A, Quintanar Félix N, Rodríguez Dumas MI … +5 more , Soto Domínguez JA, Rosaldo Solis ML, Castillo León VD, Cisneros MO, Madrigal-Beas IM
Rev Alerg Mex · 2025 Sep · PMID 41037702 · Publisher ↗
INTRODUCTION: Hereditary angioedema (HAE) is a rare disease characterized by episodes of cutaneous and submucosal inflammation. Its global prevalence ranges from 1:50,000 to 1:100,000 individuals and is often underdiagno...
INTRODUCTION: Hereditary angioedema (HAE) is a rare disease characterized by episodes of cutaneous and submucosal inflammation. Its global prevalence ranges from 1:50,000 to 1:100,000 individuals and is often underdiagnosed. It is classified into three main types based on C1 inhibitor (C1-INH) levels and functionality. Type 1 is the most common (85% of cases). It is characterized by low plasma concentrations of functional C1-INH as a result of mutations in the SERPING1 gene. CASE REPORT: We present the case of a 20-year-old male resident of Guadalajara with HAE type 1 diagnosed at age 12 and a history of drug use. He was admitted with edema in the left posterior thoracic region, which progressed to the neck, causing respiratory distress. During ambulance transport, the patient suffered cardiorespiratory arrest, requiring cardiopulmonary resuscitation. He was administered a bradykinin type 2 receptor antagonist and systemic steroid without success, and was admitted to the emergency department under advanced airway management. Laboratory tests and a CT scan revealed no significant findings. Given the persistence of facial edema, a human C1 esterase inhibitor was administered, and the patient was admitted to the intensive care unit for monitoring. CONCLUSION: Based on laboratory and CT results, substance abuse was suspected as a triggering factor. The literature reports that individuals with cocaine dependence present a persistent proinflammatory state characterized by reduced baseline levels of the anti-inflammatory interleukin IL-10 and a significant increase in the proinflammatory cytokine TNF-α after exposure to stressful stimuli or use. Although the evidence in the medical literature is limited, the use of psychoactive substances could act as a triggering factor for seizures in patients with hereditary angioedema type 1. This case underscores the importance of identifying potential less-studied aggravating factors and suggests the need for a targeted history of psychoactive substance use in patients with HAE. This could be explained by their effects on vasodilation, the release of inflammatory mediators, and increased vascular permeability, mechanisms that promote bradykinin accumulation. Given the potential risk, it is essential to consider drug use in the comprehensive evaluation of precipitating factors in these patients.
[Transferon Oral reduces IgE levels and cellular infiltration in NALT in a murine model of allergic rhinitis].
Trejo-Martínez I, Fragozo A, Mendoza-Salazar I … +4 more , Pavón L, Pérez-Torres A, Vallejo-Castillo L, Pérez-Tapia SM
Rev Alerg Mex · 2025 Sep · PMID 41037701 · Publisher ↗
Allergic rhinitis (AR) affects the quality of life of 400 million patients worldwide, and while the pharmacological treatment options are extensive, more effective and safer treatments continue to be developed. The immun...
Allergic rhinitis (AR) affects the quality of life of 400 million patients worldwide, and while the pharmacological treatment options are extensive, more effective and safer treatments continue to be developed. The immunomodulator Transferon Oral (TO) improves the clinical presentation of patients with AR; however, the immunological mechanisms by which it exerts its therapeutic effect are under investigation. This study aimed to develop an ovalbumin (OVA)-induced AR murine model. AR was established in female BALB/c mice (5-8 weeks old) by intraperitoneal inoculation of 200 μL of OVA (1 mg/mL)/Al(OH) (1.3%) on days 0, 1, 2, 7, 8, 14 and 21, and subsequently stimulated daily intranasally (RIN) with 20 μL of OVA (1 mg/mL) until day 42. The establishment of RA was evidenced by the increase in serum IgE against OVA by ELISA (OD > 0.5) and clinical signs. Subsequently, the effect of TO (0.75 μg) orally and dexamethasone (Dexa; 125 μg) intraperitoneally was evaluated in RA mice (n=6) for 21 days with daily RIN. TO significantly decreased specific IgE levels (p < 0.0001) at 7 and 14 days of treatment, while Dexa did so until day 14 (p < 0.0001) compared to the RA control group. Additionally, an analysis showed that TO reduced basal lamina thickness and decreased eosinophil and mast cell infiltration in NALT compared with RA controls. This work demonstrates that TO modulates the core RA molecule, IgE, and cell migration in NALT, and is the first step toward understanding its mechanism of action in this disease.
[Angioedema associated with hyaluronic acid injection].
Andrade-Hernández PK, Hernández-Chávez LA, Hernández-Alvarez AE … +1 more , Vallejo-Pérez E
Rev Alerg Mex · 2025 Sep · PMID 41037700 · Publisher ↗
INTRODUCTION: Angioedema is a form of localized swelling involving the deeper layers of the skin and mucous membranes, caused by fluid extravasation and lasting for several days. While aging of the skin is a natural proc...
INTRODUCTION: Angioedema is a form of localized swelling involving the deeper layers of the skin and mucous membranes, caused by fluid extravasation and lasting for several days. While aging of the skin is a natural process, various compounds such as hyaluronic acid, active amino acids, and peptides are used for their anti-aging properties. However, in some individuals, these substances can overstimulate the immune system, triggering hypersensitivity reactions. CASE REPORT: A 38-year-old woman with a medical history of controlled hypertension and allergy to quinolones. She underwent hyaluronic acid injections in the lips and glabellar region four months before presenting symptoms. Over the last three months, she experienced intermittent, firm, painful, erythematous lip swelling with paresthesia, which did not respond to antihistamines or steroids. Immunological tests showed positive antinuclear antibodies (ANA) with a granular pattern, but rheumatology ruled out autoimmune disease. An ultrasound revealed encapsulation of the injected material. CONCLUSION: Hyaluronic acid, widely used in aesthetic medicine, can cause immune mediated adverse effects, including angioedema. Though rare with an incidence of 0.42% such reactions can be serious. Treatment options include dissolving the material using hyaluronidase, applying radiofrequency, administering intralesional corticosteroids, or performing surgery. Type IV hypersensitivity angioedema is rare and may be caused by bacterial proteins or impurities in hyaluronic acid. It does not respond to antihistamines and requires treatment with hyaluronidase, intralesional steroids, radiofrequency, or surgery. This raises questions about the mechanisms underlying the immunogenicity of hyaluronic acid that warrant further investigation.
[Effectiveness and safety of Lanadelumab according to disease activity: pooled analysis of EMPOWER/ENABLE].
Martinez-Saguer I, Zanichelli A, Aygören-Pürsün E … +14 more , Mager M, Banerji A, Busse PJ, Betschel SD, Cancian M, Kinaciyan T, Kessel A, Goodyear MD, Estepan DN, Andresen I, Juethner S, Khutoryansky N, Wuillemin W, Rodriguez JC
Rev Alerg Mex · 2025 Sep · PMID 41037699 · Publisher ↗
METHODS: Patients with HAE type I/II, aged ≥12 years, were included from the EMPOWER and ENABLE studies, who received lanadelumab at the approved dose and had data on the initial attack rate. Subgroups were created based...
METHODS: Patients with HAE type I/II, aged ≥12 years, were included from the EMPOWER and ENABLE studies, who received lanadelumab at the approved dose and had data on the initial attack rate. Subgroups were created based on baseline HAE activity (moderate: ≥1 to <2, high: ≥2 to <, very high: ≥3 attacks/month). The effectiveness of lanadelumab was measured by the reduction in monthly attacks compared to baseline. Safety was assessed by treatment-emergent adverse events (TEAEs). RESULTS: A total of 123 patients were analyzed, divided into subgroups by baseline activity: moderate (29), high (15), and very high (79). The mean follow-up duration ranged from 577.5 ± 251.7 days (moderate) to 741.1 ± 281.0 days (high). Average HAE attack rates decreased in all three subgroups after lanadelumab initiation: moderate (1.3 ± 0.3 to 0.3 ± 0.4), high (2.0 ± 0.2 to 0.5 ± 0.5), and very high (5.8 ± 3.0 to 0.4 ± 0.7). TEAEs were not severe, mild/moderate, and unrelated to lanadelumab treatment. CONCLUSION: HAE attack rates decreased after lanadelumab initiation, regardless of baseline activity. Safety was similar across groups; most TEAEs were mild and unrelated to treatment. These data support lanadelumab as a first-line option for long-term prophylaxis.
[Late diagnosis of allergic pulmonary aspergillosis in a patient with post-tuberculosis pulmonary sequelae: a fatal case].
Guendulain-Velázquez B
Rev Alerg Mex · 2025 Sep · PMID 41037698 · Publisher ↗
INTRODUCTION: Allergic pulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus antigens. Its diagnosis can be delayed when it overlaps with other pulmonary conditions. We present the case o...
INTRODUCTION: Allergic pulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus antigens. Its diagnosis can be delayed when it overlaps with other pulmonary conditions. We present the case of a patient with a history of childhood asthma and post-tuberculosis pulmonary sequelae, treated for years as severe asthma without improvement. ABPA was confirmed, but the late diagnosis limited therapeutic options, resulting in a fatal outcome. CASE REPORT: A 61-year-old woman with a history of childhood asthma, hypertension, sleep apnea, and chronic cor pulmonale presented with pulmonary tuberculosis in 2000, which resolved after treatment, leaving sequelae such as bronchiectasis and oxygen dependence. She presented with persistent dyspnea and frequent exacerbations, with no improvement with treatment for severe asthma. Paraclinical tests: total IgE 2321 IU/mL, eosinophilia 908.4. Skin tests and specific IgG/IgE for Aspergillus fumigatus were positive. ABPA was diagnosed according to the International Society of Human and Animal Mycology (ISHAM) criteria. The patient was started on itraconazole and steroids. However, he developed massive hemoptysis, septic shock, and died in March 2025. CONCLUSION: Allergic bronchopulmonary aspergillosis is an immunologically mediated disease. It occurs in patients with a history of asthma or cystic fibrosis. In susceptible individuals, Aspergillus produces an exaggerated immune response. In this case, the history of tuberculosis and bronchiectasis delayed diagnosis, resulting in delayed management and fatal complications. This scenario underscores the need for a high index of suspicion for ABPA in patients with bronchiectasis, asthma, and cystic fibrosis with refractory respiratory symptoms. Early diagnosis and timely treatment can improve the prognosis and reduce potentially fatal complications.
[Asthma: A preventable cause of hospital mortality. what has been the trend in Mexico in Recent Years?].
García-González ED, García-Gómez DB, Lara-Lona E
Rev Alerg Mex · 2025 Sep · PMID 41037697 · Publisher ↗
INTRODUCTION: Asthma has a significant global impact, affecting approximately 260 million people worldwide. Although mortality has decreased in recent years, it still causes around 420,000 deaths annually. This study aim...
INTRODUCTION: Asthma has a significant global impact, affecting approximately 260 million people worldwide. Although mortality has decreased in recent years, it still causes around 420,000 deaths annually. This study aims to describe hospital mortality due to asthma in Mexico during the period 20202024. METHODS: A descriptive, observational, cross-sectional, and retrospective analysis was conducted using public records from the General Directorate of Health Information. Deaths with a diagnosis of asthma (ICD-10 codes J45, J46) were analyzed. Hospital mortality, averages, frequencies, and proportions were calculated. The variables included: year, age, sex, and federal entity. RESULTS: In Mexico, between 2020 and 2024, a total of 188 hospital deaths due to asthma were recorded, with an overall hospital mortality rate of 0.09% and an annual average of 0.1%. Mexico City reported the highest number of deaths (n=21), while Hidalgo registered the highest mortality rate (0.42%). The year with the most deaths was 2023 (n=46), and 2021 had the highest mortality rate (0.14%). Of all deaths, 56.45% were in women and 43.55% in men, with mortality rates of 0.1% and 0.08%, respectively. Adults aged 60 years and older accounted for the highest number of deaths (n=64) and the highest mortality rate (0.31%). The 10 to 14-year-old age group had the highest number of discharges but only 7 deaths, with a low mortality rate (0.01%). CONCLUSIONS: Although asthma mortality has shown a decreasing trend in recent years, it remains a public health problem in Mexico. Between 2011 and 2021, an estimated 36,009 Years of Life Lost due to Premature Death occurred annually due to asthma, highlighting its ongoing epidemiological burden. Since most asthma-related complications and deaths are largely preventable, more effective strategies must be implemented to support its prevention.
[Case report. Job syndrome as an unusual finding in a pediatric patient].
Morales-Reyes AO, Juárez-Mendoza VA, Ávila-Silva AM … +2 more , Ramos-Gómez CJ, Sánchez-Jaime FJ
Rev Alerg Mex · 2025 Sep · PMID 41037696 · Publisher ↗
BACKGROUND: Job Syndrome is a primary immunodeficiency disorder with an incidence of 1 per million people. It is characterized by elevated IgE levels, eosinophilia, recurrent infections (bacterial and fungal), eczematous...
BACKGROUND: Job Syndrome is a primary immunodeficiency disorder with an incidence of 1 per million people. It is characterized by elevated IgE levels, eosinophilia, recurrent infections (bacterial and fungal), eczematous dermatitis, musculoskeletal and vascular anomalies. Diagnosis is based on IgE > 1000 IU/ml and eosinophilia. Treatment is multidisciplinary, including bone marrow transplantation, stem cell therapy, and human immunoglobulin. CASE REPORT: : We present a 13-year-old male with a history of asthma and atopic dermatitis treated with subcutaneous immunotherapy since 2016. He developed furunculous lesions that progressed to the frontal area, nose, forearms, abdomen, legs, ankles, and feet. Despite treatment with hydroxyzine, mupirocin, tacrolimus, clobetasol, and deflazacort, he showed no improvement. In 2021, he was admitted to the pediatric department, where the diagnosis was confirmed based on Grimbacher criteria. Treatment with human immunoglobulin was initiated, with adequate response. Currently, the patient is in good general condition with persistence of some skin lesions. CONCLUSIONS: The therapeutic strategy focuses on the prevention and management of infections and symptoms. It is important to identify complications in the early stages of the disease to treat them effectively. This syndrome, although rare, should be considered a serious condition; early identification of this condition is crucial to improve outcomes in patients with similar presentations.
[Anaphylaxis to ceftriaxone in pediatric patients: Challenges and management].
López-Forte MR, Perea-Valle P
Rev Alerg Mex · 2025 Sep · PMID 41037695 · Publisher ↗
BACKGROUND: Cephalosporin-induced anaphylaxis is uncommon (6.1/10,000 exposures), and the diagnosis in pediatrics entails challenges due to nonspecific clinical histories and lack of standardized diagnostic tests. G-Peni...
BACKGROUND: Cephalosporin-induced anaphylaxis is uncommon (6.1/10,000 exposures), and the diagnosis in pediatrics entails challenges due to nonspecific clinical histories and lack of standardized diagnostic tests. G-Penicillin has demonstrated diagnostic utility in the absence of penicilloilpolylisin, with a negative predictive value up to 95.2% when combined with controlled oral challenge. The basophil activation test (BAT) has a variable sensitivity (3875%), depending on the assessed biomarker. CASE REPORT: A 13-year-old male presented anaphylaxis two minutes after receiving intramuscular ceftriaxone. He presented with pharyngeal pruritus, facial angioedema, dyspnea, vomiting, and altered alertness. The condition resolved with intramuscular adrenaline and intravenous crystalloid administration. : BAT for ceftriaxone and cefuroxime were negative. Skin tests were negative for penicillin and cefuroxime and positive for ceftriaxone. : Oral challenge with amoxicillin was tolerated. The use of ceftriaxone and cephalosporins with an identical R1 side chain were contraindicated. CONCLUSIONS: When dealing with a patient with drug allergy, clinicians should implement diagnostic tools that include skin testing with specific antibiotics and oral challenge. It is important to reconsider unconfirmed allergy labels, as it is estimated that between 58% and 75% of pediatric patients diagnosed with cephalosporin allergy present low-risk symptoms and could be delabeled with appropriate protocols. Cephalosporin anaphylaxis requires a combined evaluation. Penicillin G skin testing and oral challenge are key tools to guide safe antibiotic treatment.
[Successful benralizumab therapy for severe asthma secondary to EGPA refractory to mepolizumab].
García-Vaca AO, Nava-Ramírez CI
Rev Alerg Mex · 2025 Sep · PMID 41037694 · Publisher ↗
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem inflammatory disease. It presents a type 2 inflammatory profile and IL-5 overexpression which stimulates eosinophil production and contrib...
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem inflammatory disease. It presents a type 2 inflammatory profile and IL-5 overexpression which stimulates eosinophil production and contributes to the development of severe and late-onset asthma. CASE REPORT: We present the case of a female in her sixth decade of life, diagnosed with EGPA 37 years ago and currently with severe asthma. Despite being on triple inhaled therapy, she exhibited persistent severe airflow obstruction (ACT: 13; ACQ- 5: 2; blood eosinophils: 545 cells/μL). Mepolizumab 100 mg monthly (institutionally approved dosage) was initiated for over a year, with poor clinical response and multiple exacerbations. A switch to benralizumab 30 mg every two months was made, achieving sustained clinical control within four months: normalized spirometry, ACT: 22, ACQ-5: 0.2, undetectable serum eosinophils, and no exacerbations. This allowed discontinuation of the second controller inhaler and reduction to a low dose of inhaled corticosteroid, without adverse events attributable to treatment. CONCLUSION: A significant challenge in institutional clinical practice is that both biologics are approved only at doses indicated for severe eosinophilic asthma, resulting in suboptimal dosing according to international guidelines for EGPA. In institutional practice, benralizumab at 30 mg every two months may be a viable therapeutic option for patients with severe asthma secondary to EGPA, aiming to reduce corticosteroid dependence and improve respiratory function.
[Erythema nodosum: a case report].
López-Reynoso MP, Fernández-Mendoza LT, Bernal-Ocampo AJ
Rev Alerg Mex · 2025 Sep · PMID 41037693 · Publisher ↗
BACKGROUND: Erythema nodosum is the most common clinical-pathological variant of panniculitis, presenting with erythematous nodular lesions. Infections are the most common cause. However, other causes cannot be ruled out...
BACKGROUND: Erythema nodosum is the most common clinical-pathological variant of panniculitis, presenting with erythematous nodular lesions. Infections are the most common cause. However, other causes cannot be ruled out: immunological, inflammatory, or metabolic. Therefore, the diagnosis must be multidisciplinary and direct treatment toward the underlying cause, as in most cases, it is usually the tip of the iceberg of a significant pathological process. CASE REPORT: An 18-year-old female patient with a history of hepatoblastoma, nephrocalcinosis, and recurrent infections presented one month later with characteristic erythematous lesions on the left tibia, with subsequent edema and limited movement. Paraclinical studies were performed, and the diagnosis of septal panniculitis without vasculitis and perivascular inflammatory infiltrate was confirmed by biopsy. CONCLUSION: Although erythema nodosum usually heals spontaneously, it can be the initial expression of infectious, immunological, or genetic diseases, so an early and multidisciplinary diagnostic approach is important to guide treatment and improve prognosis.
[Respiratory manifestations associated with cyclic neutropenia and innate immune deficiency (IgG3 deficiency): a case report].
Rodríguez-Flores DA, Ortiz-Jiménez MDP
Rev Alerg Mex · 2025 Sep · PMID 41037692 · Publisher ↗
BACKGROUND: Inborn errors of immunity are a heterogeneous group of diseases caused by a diminished or absent response of one or more components of the immune system. IgG subclass deficiency is more common in childhood, e...
BACKGROUND: Inborn errors of immunity are a heterogeneous group of diseases caused by a diminished or absent response of one or more components of the immune system. IgG subclass deficiency is more common in childhood, especially in boys than in girls. IgG2 deficiency is the most common, followed by IgG3 deficiency. CASE REPORT: A male pediatric patient experienced respiratory distress of viral and bacterial origin and asthma in his early years, with frequent emergency room admissions and/or hospitalizations. At age 5, he was diagnosed with cyclic neutropenia, so the Pediatric Hematology Department decided to offer conservative treatment. At age 6, he was evaluated by an Otorhinolaryngologist, who diagnosed allergic rhinitis and performed a septumplasty and turbinectomy. At age 7, he was evaluated by an Allergist, with normal laboratory results: immunoglobulin profile, lymphocyte subpopulations, and blood count. Subcutaneous allergen-specific testing was positive. Treatment with subcutaneous immunotherapy was initiated. At age 9, the patient relapsed, with symptoms of upper respiratory tract infection and asthma. Laboratory studies revealed IgG3 deficiency (7.81 mg/dL), so treatment with intravenous immunoglobulin was initiated. CONCLUSION: The administration of human immunoglobulin and monoclonal antibodies is associated with a reduction in respiratory symptoms in patients with inborn errors of immunity and a better quality of life.
[Diosmin-hesperidin-induced DRESS syndrome: immune reactivation by herpesvirus].
Flores-García N, Correa-Serrano C, Cardenas-Favela JC … +2 more , Cadenas-García D, Villarreal-González R
Rev Alerg Mex · 2025 Sep · PMID 41037691 · Publisher ↗
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse reaction. The incidence is 1-1,000,000 with a mortality rate of 3.8-10%, and it is a disease associated with reactiv...
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse reaction. The incidence is 1-1,000,000 with a mortality rate of 3.8-10%, and it is a disease associated with reactivation of the herpes simplex virus. CASE REPORT: A 34-year-old woman with atopy and venous insufficiency presented with pruritic hives on her face and arms, which progressed to a morbilliform rash, facial edema, fever, lymphadenopathy, and scaling. A complete blood count showed no abnormalities: AST: 837 U/L, ALT: 11352 U/L. Due to the suspicion of DRESS syndrome, treatment with corticosteroids was initiated and a biopsy was obtained. Upon questioning, the patient reported having taken diosmin-hesperidin and undergone systemic sunscreen (Heliocare360°®) 21 days prior to the onset of the rash. Histopathological examination revealed atrophic epidermis, vacuolar degeneration, and inflammatory infiltrate. Systemic corticosteroids were administered for three weeks, with a satisfactory response. Two months later, the patient experienced reactivation of the dermatosis and hypertransaminasemia; the autoantibody panel and serology were positive for IgM for herpes simplex virus. CONCLUSION: This case underscores the need to consider severe hypersensitivity reactions, even with commonly used and apparently low-risk drugs. The importance of a comprehensive approach, including identification of the suspected medication, exclusion of differential diagnoses, prolonged clinical follow-up, and surveillance for possible viral reactivation, is emphasized.
[Update on IgA vasculitis with a focus on diagnosis and prognosis in pediatrics].
Rodríguez-Lozano AL, Delgado-Sánchez BG, Berrón-Ruiz L … +2 more , Nájera-Velázquez RG, Murata C
Rev Alerg Mex · 2025 Sep · PMID 41037690 · Publisher ↗
IgA vasculitis is the most common vasculitis in childhood, and its main feature is leukocytoclastic vasculitis, in which the capillaries are affected by the deposit of IgA immune complexes. Skin rash is the principal cli...
IgA vasculitis is the most common vasculitis in childhood, and its main feature is leukocytoclastic vasculitis, in which the capillaries are affected by the deposit of IgA immune complexes. Skin rash is the principal clinical manifestation, along with arthralgia or arthritis, digestive and renal tract involvement, and is often self-limiting. Although it occurs at any age, it prefers children between 3 and 12 years. It is common to identify a trigger, the most frequently associated with infection, with reports of up to 31% along respiratory tract infections, followed by gastrointestinal infections at 5%. Dermatological manifestations are the characteristic element of the disease; 100% of patients have purpura at some point; however, renal involvement determines the prognosis of these patients. The diagnosis is clinical, supported by laboratory and cabinet assistants and classification criteria; however, since the prognosis is mainly conditioned by renal involvement, having simple and safe alternatives, adequate follow-up, evaluation of the efficacy of the treatment, and the prognosis of the disease are some of the main objectives of biomarkers. Initial treatment consists of general measures, but in the case of gastrointestinal, renal, or other target organ involvement, such as testicles, therapy with corticosteroids and immunosuppressants is necessary. Since the end of the last century, it has been recognized that not all patients with IgA vasculitis had a benign outcome; however, recent data supports a deleterious outcome both in patients with nephritis and in pregnancy.
Evaluation of the allergenic capacity of three pollen grains in a tropical region (Medellín, Colombia).
Ramírez R, Alzate-Guarín F, Espinosa-Correa Á … +2 more , Postigo-Resa I, Sánchez J
Rev Alerg Mex · 2025 Sep · PMID 41037689 · Publisher ↗
OBJECTIVE: To evaluate the frequency of IgE sensitization and allergenic capacity of pollen grains of and in allergic rhinitis patients. METHODS: A cross-sectional study with comparative groups: a rhinitis group and a...
OBJECTIVE: To evaluate the frequency of IgE sensitization and allergenic capacity of pollen grains of and in allergic rhinitis patients. METHODS: A cross-sectional study with comparative groups: a rhinitis group and a control group. The three pollen extracts were prepared, and IgE sensitization was assessed using the skin prick test and serum-specific IgE. Allergenicity and clinical relevance were subsequently evaluated using the basophil activation test (BAT) and the nasal challenge test (NCT). RESULTS: A total of 60 people were included in the control group and 60 in the case group. None in the control group and a total of 8 (13.3%) from the rhinitis group were sensitized to one of the 3 pollen extracts: two (3.3%) to , two (3.3%) to and four (6.6%) to . All three extracts were able to induce basophil activation in patients with IgE sensitization, but not in those without sensitization. NCT was performed in the eight patients with IgE sensitization, resulting positive for 1/2 patients with Artocarpus, 1/2 with y 2/4 with . CONCLUSIONS: All three pollen sources tested induce IgE sensitization and clinical symptoms, highlighting the importance of evaluating the allergenicity of native plant sources for each region.
[Pantry mites as an environmental risk factor triggering allergies in Panama].
Murgas-Centeno IL, Lezcano JJ, Castillo E LY … +3 more , Abarca-Gómez L, Hurtado L, Miranda RJ
Rev Alerg Mex · 2025 Sep · PMID 41037688 · Publisher ↗
OBJECTIVE: To determine the prevalence of house mites in food pantries and assess it as a possible environmental risk factor triggering allergic diseases in the provinces of Panama and Panama Oeste. METHODS: This was a d...
OBJECTIVE: To determine the prevalence of house mites in food pantries and assess it as a possible environmental risk factor triggering allergic diseases in the provinces of Panama and Panama Oeste. METHODS: This was a descriptive, cross-sectional exploratory study with a quantitative approach to the composition of house mites present in home pantries over a 12-month period. Data were processed using Minitab 17, Epi Info 7.2.5.0, and Microsoft Excel. Odds ratios (ORp) were calculated between food and dust contaminated with mites among allergic participants. RESULTS: A total of 326 dust samples and 330 food samples were obtained, with 100% participation (n = 330) for the surveys. The non-economically active population was the occupational group with the highest participation rate, at 64.2%. The OR for dust was CI95%: 1.11 (0.4972.501), p (0.7912), and for powdered foods, CI95%: 1.15 (0.704-1.8920), p (0.5676). CONCLUSIONS: As with bedrooms, pantries provide the right environmental conditions for the development and proliferation of house dust mites, constituting a significant source of allergens within homes.
[The challenge of delabeling antibiotic allergy in Colombian children: do parents trust the negative result of the drug provocation test with the implicated antibiotic?].
Rincón-González AM, Galeano-Tamayo DC, Zuluaga LSD
Rev Alerg Mex · 2025 Sep · PMID 41037687 · Publisher ↗
OBJECTIVE: To explore the factors associated with the use of the antibiotic implicated in an adverse reaction following a negative challenge test in pediatric patients in a clinical allergology service of a health instit...
OBJECTIVE: To explore the factors associated with the use of the antibiotic implicated in an adverse reaction following a negative challenge test in pediatric patients in a clinical allergology service of a health institution in Medellin. METHODS: Observational cross-sectional study with analytical intent, in pediatric patients with a history of adverse reaction to an antibiotic, who underwent a provocation test and obtained a negative result. Sociodemographic and clinical data were obtained from medical records and parents or caregivers of patients who met the inclusion criteria were surveyed. RESULTS: Between January 2016 and December 2021, 571 antibiotic provocations were performed. Only 19.2% of patients received the implicated antibiotic or antibiotics of the same class after a negative challenge test, without experiencing adverse reactions related to the new use. However, 53% of those who did not receive the antibiotic, despite needing it, mainly because their parents or caregivers continued to report the allergy label. Additionally, 26.9% of parents or caregivers did not recall the negative test result, and 44.2% would refuse future administration of the antibiotic to their children, identifying failure to recall the negative challenge test result as a factor associated with this behavior. CONCLUSIONS: Local strategies (providing individualized forms for parents and healthcare providers) should be designed to explain the meaning of a negative test result, as well as follow-up visits to verify adherence to recommendations, thus increasing the effectiveness of antibiotic allergy delabeling.
[Effects of air pollution on health following on environmental contingencies in Mexico City].
Hernández-Solís A, Hernández-de la Torriente A, Balderas-Salazar LA … +5 more , Navarro-Oropeza G, Hernández-de la Torriente A, Ramírez-Padilla C, Arizmendi-Venegas KH, Velázquez-Samano G
Rev Alerg Mex · 2025 Sep · PMID 41037686 · Publisher ↗
OBJECTIVE: To analyze the effects of air pollution on the health of a vulnerable population in the Mexico City after the nine environmental contingencies presented in the year 2024. METHODS: A cross-sectional, descriptiv...
OBJECTIVE: To analyze the effects of air pollution on the health of a vulnerable population in the Mexico City after the nine environmental contingencies presented in the year 2024. METHODS: A cross-sectional, descriptive study was conducted among outdoor workers (street vendors). Risk factors and respiratory symptoms were documented, and respiratory function tests were performed. RESULTS: A total of 300 patients were enrolled. The most frequent clinical symptoms were increased expectoration (52%), recurrent respiratory infections (44.3%), headache (39.6%), cough (35%), laryngeal irritation (34%), nasal itching (30%), dyspnea (26%), vertigo (22%), conjunctivitis (20.6%), and chest pain (19.6%). Spirometry results showed: 61.3% with a restrictive pattern, 14.3% with an obstructive pattern, 13.3% with a mixed pattern, and 11% with no abnormalities. Forty-four percent of this group experienced exacerbations of diseases such as asthma and chronic obstructive pulmonary disease. CONCLUSIONS: Air pollution constitutes a serious public health problem, especially for low-income people, who live and work in areas with high levels of pollution, as evidenced in our study. Further epidemiological studies are essential to evaluate the impact of ozone and other pollutants on vulnerable groups, to implement more effective preventive measures.
Letter to the editor regarding "Allergic bronchopulmonary aspergillosis in a patient with diabetes mellitus as the only risk factor".
Kleebayoon A, Wiwanitkit V
Rev Alerg Mex · 2025 Jun · PMID 40627143 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Wheat-dependent exercise-induced anaphylaxis: The diagnostic utility of Omega-5 Gliadin in two clinical cases from Lima, Peru].
Veramendi-Espinoza L, Galván C, Durán R
Rev Alerg Mex · 2025 Jun · PMID 40627142 · Publisher ↗
BACKGROUND: Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare, potentially life-threatening condition triggered by wheat ingestion followed by physical activity. CASE REPORT: This report describes two cases...
BACKGROUND: Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare, potentially life-threatening condition triggered by wheat ingestion followed by physical activity. CASE REPORT: This report describes two cases of young individuals in Lima, Peru, diagnosed with WDEIA. The diagnosis was confirmed through skin prick testing and the Allergy Explorer2 (ALEX-2) microarray, identifying omega-5gliadin (Tria19) as the main allergen. Both patients experienced episodes of anaphylaxis, one of which required adrenaline administration. CONCLUSION: The importance of molecular diagnostics to confirm WDEIA is highlighted, and preventive strategies such as avoiding wheat before exercise and emergency plans are discussed. These cases underscore the need for greater clinical awareness and improved access to life-saving interventions in resource-limited regions.
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