BACKGROUND: Adverse drug reactions are harmful and unintentional events related to medication use. Stevens-Johnson Syndrome is a serious adverse drug reaction that can progress to toxic epidermal necrolysis and is relate...BACKGROUND: Adverse drug reactions are harmful and unintentional events related to medication use. Stevens-Johnson Syndrome is a serious adverse drug reaction that can progress to toxic epidermal necrolysis and is related to certain medications. It can even be triggered by infections and genetic factors. CASE REPORT: A 62-year-old female patient with high blood pressure developed severe skin lesions after self-medicating with paracetamol and ibuprofen. She recovered favorably after several treatments and admissions to the Intensive Care Unit. CONCLUSION: It is important to promptly identify the triggering factors of adverse drug reactions in order to intervene appropriately. The administration of corticosteroids and IV immunoglobulin is still under discussion. Immediate attention is required to improve clinical outcomes and comprehensive treatment, thus optimizing the outcome.
BACKGROUND: The treatment of eosinophilic esophagitis (EoE) is based on diets or drugs, with either being the first choice. Proton pump inhibitor (PPI) or swallowed topical corticosteroids (STC) are classically used, and...BACKGROUND: The treatment of eosinophilic esophagitis (EoE) is based on diets or drugs, with either being the first choice. Proton pump inhibitor (PPI) or swallowed topical corticosteroids (STC) are classically used, and more recently the use of dupilumab has been described as a therapeutic option. CASE REPORT: A pediatric patient with difficult-to-manage eosinophilic esophagitis, diagnosed before the age of 2 years, in which the simultaneous use of triple pharmacological therapy (Dupilumab, PPI and STC) has been necessary for the histological control of the disease. CONCLUSION: It is a case of interest since in current guidelines the use of combined pharmacological therapies is not recommended or fully described. In addition, it is a case in which a good response to treatment with dupilumab is observed despite not meeting the indication criteria of the pharmacological label, in terms of age and weight.
This article analyzes the effects of a histamine- and pseudoallergen-restricted diet as an additional strategy in the treatment of chronic spontaneous urticaria (CSU). A comprehensive review of the literature was conduct...This article analyzes the effects of a histamine- and pseudoallergen-restricted diet as an additional strategy in the treatment of chronic spontaneous urticaria (CSU). A comprehensive review of the literature was conducted using PubMed and Google Scholar, employing both MeSH and non-MeSH terms related to urticaria, histamine, and diet. The review included 78 selected articles published between 2014 and 2024. CSU is a persistent disease in which a considerable number of patients do not respond optimally to standard treatments. Up to one-third of these patients may benefit from reducing the intake of pseudoallergens and histamine-rich foods. Bioactive amines present in various foods tend to exacerbate CSU symptoms by promoting the release of histamine and other inflammatory mediators. The restriction of dietary histamine and the enhancement of diamine oxidase (DAO) enzyme function appear to alleviate symptoms, although variability in reported histamine levels across studies complicates the development of standardized guidelines. It is concluded that a low-histamine and pseudoallergen diet is a promising option for reducing symptoms in patients with chronic spontaneous urticaria (CSU), particularly those who do not achieve adequate control with antihistamines. Evaluating the effectiveness of this diet over a period of three to four weeks is recommended to observe potential benefits. Nevertheless, additional studies and further standardization are necessary to define safe histamine levels in foods and improve therapeutic recommendations.
Contact dermatitis to cosmetic products is a common condition. It is likely the most frequent reason for performing patch tests because many substances used in cosmetics are potent allergens. Cosmetic contact dermatitis...Contact dermatitis to cosmetic products is a common condition. It is likely the most frequent reason for performing patch tests because many substances used in cosmetics are potent allergens. Cosmetic contact dermatitis most frequently affects the face. Patch test series need to be continuously revised to identify outdated and emerging allergens. The aim of this study is to propose a reformulation of the patch test series for cosmetics. The list of European Surveillance System on Contact Allergies was initially used to select the allergens. Publications in PubMed from the last 10 years were sought, showing the frequency of positive reactions to cosmetic allergens that were tested as part of a baseline series or cosmetics series. Subsequently, large international databases evaluating retail products were consulted to verify if these substances were present in cosmetics, because the relevance would be their presence in commercially sold cosmetics. It was adopted a threshold of 0.3% positive patch test reactions for including a substance in cosmetics series. It was deleted those present in the baseline series (Associação Brasileira de Alergia e Imunologia), fragrances, and allergens limited to hair products. It is believed that choosing too few allergens may result in the non-identification of relevant allergens and treatable cases. On the other hand, testing a series with many allergens is time-consuming and more costly. Therefore, it seems appropriate to create cosmetics series with 20 elements.
OBJECTIVE: To evaluate, through in silico analysis, the cross-reactivity between Sco m 5 and arthropod proteins and to identify potential IgE-binding epitopes. METHODS: The homology between Sco m 5 and 15 arthropod aller...OBJECTIVE: To evaluate, through in silico analysis, the cross-reactivity between Sco m 5 and arthropod proteins and to identify potential IgE-binding epitopes. METHODS: The homology between Sco m 5 and 15 arthropod allergens ( and ) was assessed using the ALLERMATCH server for pairwise alignments and PRALINE for multiple alignments. Phylogenetic trees were constructed using Molecular Evo-lutionary Genetics Analysis (MEGA). Epitope prediction was performed with the Ellipro server. Protein visualization was carried out through PyMOL. RESULTS: The multiple alignment showed 50% identity, and the pairwise alignments between Sco m 5 and arthropod proteins revealed diverse homology. Two linear epitopes and one conformational epitope were identified in Sco m 5, which were highly conserved in the studied arthropod proteins, such as bees, wasps, and ants. CONCLUSION: The high homology between Sco m 5 and allergens from other arthropods supports the potential for cross-reactivity. The identification of potential epitopes in conserved regions reinforces this idea and could serve as important targets for therapeutic interventions in allergies triggered by arthropod venoms, especially Further and studies are needed to confirm these findings.
OBJECTIVE: To establish the prevalence of sensitization to dog and cat epithelium in a pediatric population aged 3 to 6 years. METHODS: A descriptive, cross-sectional prevalence study was conducted as part of the study "...OBJECTIVE: To establish the prevalence of sensitization to dog and cat epithelium in a pediatric population aged 3 to 6 years. METHODS: A descriptive, cross-sectional prevalence study was conducted as part of the study "Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city." The study population consisted of children from the city of Cuenca, Ecuador, who were administered the culturally validated ISAAC survey and underwent inhalant skin testing. RESULTS: A total of 600 children were enrolled, with a prevalence of atopy of 33.45% (n = 179), sensitization to dog epithelium of 1.76% (n = 10), and sensitization to cat epithelium of 2.12% (n = 12), representing 5.59% and 6.70% of the atopic population, respectively. CONCLUSION: The prevalence of sensitization to cat and dog epithelium in children under 6 years of age is lower than expected in the clinical setting. Future studies should assess the sample size in relation to the prevalence of sensitization to cat and dog epithelium.
OBJETIVES: To determine the clinical and epidemiological characteristics and factors associated with immuno-suppression in children living with HIV. METHODS: Observational, analytical, cross-sectional study of patients t...OBJETIVES: To determine the clinical and epidemiological characteristics and factors associated with immuno-suppression in children living with HIV. METHODS: Observational, analytical, cross-sectional study of patients treated at the Outpatient Center for the Prevention and Care of AIDS and Sexually Transmitted Infections in the State of Puebla. Statistical analysis: percentages, frequencies, means, standard deviation and medians; Inferential analysis: X and univariate logistic regression. Statistical Package, for the Social Sciences 24. RESULTS: A total of 83 patients aged 0 to 17 years (mean 7 years; SD ± 6.3) were selected, with an average age at diagnosis of 2.6 years. Vertical transmission was found in 90% of cases; women 47% and men 53%. The most frequent diseases were recurrent infections, lymphadenopathy, diarrhea; four cases of tuberculosis were reported, malnutrition 35%. Clinical category: N 25%, A 66%. Immunological category: 1-72%, 2-13%. Factors associated with immunosuppression were vertical transmission (p < 0.008) and CD4 level (p < 0.007). CONCLUSIONS: Knowing the characteristics that describe pediatric HIV/AIDS, its clinical presentation, and its limitations, may guide to install improvements in care and follow-up, improving the prognosis of children.
BACKGROUND: Tree tomato (Solanum betaceum or Cyphomandra betaceae) or tamarillo belongs to the Solanaceae family and is widely consumed in Latin American countries. CASE REPORT: We report the case of a 43-year-old male f...BACKGROUND: Tree tomato (Solanum betaceum or Cyphomandra betaceae) or tamarillo belongs to the Solanaceae family and is widely consumed in Latin American countries. CASE REPORT: We report the case of a 43-year-old male from Ecuador who suffered two systemic anaphylaxis after drinking tamarillo juice, with previous tolerance to tamarillo on several occasions. Allergology study showed positivity in prick-prick to tamarillo peel and pulp and negativity to other types. SDS-PAGE immunoblotting with peel-pulp and Western Blot showed multiple bands between 14-75 kDa in tamarillo peel and 11-75 kDa in pulp. ELISA inhibition showed that tamarillo only inhibited itself. CONCLUSIONS: Given the results and tolerance to other types of tomato, we believe that the causative protein could be selective, so we report the first case of primary sensitivity to Solanum betaceum (tamarillo).
BACKGROUND: Ixekizumab is a high-affinity IgG4 monoclonal humanized antibody useful for the treatment of ankylosing spondylitis. Benign skin reactions are a common adverse event with ixekizumab but systemic hypersensitiv...BACKGROUND: Ixekizumab is a high-affinity IgG4 monoclonal humanized antibody useful for the treatment of ankylosing spondylitis. Benign skin reactions are a common adverse event with ixekizumab but systemic hypersensitivity reactions are much more unusual. CASE REPORT: We describe the case of a 54-female patient with HLAB27+ spondyloarthritis. Treatment with ixekizumab 80 mg subcutaneous (containing polysorbate) was prescribed. The patient experienced immediate severe dyspnea, skin erythema and flushing. Intradermal test (0.8 mg/ml) was clearly positive in the immediate reading. The patient was planned to undergo ixekizumab desensitization according to an 8-step protocol with good tolerance. CONCLUSION: We report a patient with HLAB27+ spondyloarthritis treated with ixekizumab who developed a systemic IgE-mediated reaction. A successful and easy to perform subcutaneous desensitization protocol is described.
BACKGROUND: The main cause of allergy to honey is linked to the head of the bee. CASE REPORT: A 44-year-old man with no relevant history presented with pharyngeal, palmo-plantar and axillary itching, dysphagia, dizziness...BACKGROUND: The main cause of allergy to honey is linked to the head of the bee. CASE REPORT: A 44-year-old man with no relevant history presented with pharyngeal, palmo-plantar and axillary itching, dysphagia, dizzinessa nd sweating after ingesting honey. Addiotionally, when he drinks banana yogurt and cow's milk smoothie he notices slight pharyngeal itching. Normal basal tryptase (5.03 ug/L), total IgE 212.2 kU/L, IgEs: honey 37.3 and Apis 0.69 kU/L. SDS-PAGE and immunoblot of honey and banana yogurt extracts with the presence of bands between 12 to 70 kDa (honey); 12 to 35 kDa (banana yogurt) and SDS-PAGE and immunoblot of bee venom extract with the presence of bands from 10 to 50 kDa and the patient's serum recognized two proteins: one compatible with the major allergen Api m 1 at 16 kDa and another compatible with Api m 11 at 50 kDa. CONCLUSION: The patient is sensitized to several honey proteins (2 between 50-75 kDa and 1 between 20-25 kDa). He doesn't recognize any protein in the banana yogurt. Additionally, the patient recognizes a bee venom protein of about 50 kDa (compatible with Api m 11), and this may be the primary sensitization pathway.
Villarreal-González RV, Perea-Valle P, Fraga-Olvera A
… +18 more, Ávila-Lara A, Delgado-Bafuelos A, Correa-Serrano CA, García-Rosas C, Alonso-Bello CD, Rico-Solis GA, Ochoa-García IV, Ramírez-Heredia J, González-Juárez K, Moreno-González MM, Ortega-Cisneros M, García-Cruz MLH, Arias-Martínez MI, Servín-Suárez N, Cortés-Grimaldo RM, Ruiz-López SP, Zecua-Nájera Y, Cadenas-García DE
BACKGROUND: Monoclonal antibodies are a therapeutic option for allergy, autoimmune, oncological diseases, among others, and work by inhibiting interactions between effector molecules and their specific receptors. However...BACKGROUND: Monoclonal antibodies are a therapeutic option for allergy, autoimmune, oncological diseases, among others, and work by inhibiting interactions between effector molecules and their specific receptors. However, the increasing use of these drugs has led to an increase in adverse drug reactions (ADRs). ADRs are defined as unexpected responses to therapeutic treatments. They are divided into type A, derived from the pharmacokinetics of the treatment or as a host immune response type B. OBJECTIVES: Review of the use of monoclonal antibodies in the treatment of allergic diseases, addressing key aspects such as pharmacokinetics, pharmacodynamics, posology, contraindications and adverse reactions. METHODOLOGY: A search of major medical databases on monoclonal antibodies for the treatment of allergic diseases was conducted. It was limited to original articles in English and Spanish, published between 2014 and 2024. RESULTS: Monoclonal antibodies for allergic diseases are described, including their mechanism of action, trade name, indications, posology, contraindications and adverse reactions. CONCLUSION: The collection of data on biological drugs is crucial for a comprehensive and up-to-date understanding of their clinical use. Understanding adverse reactions improves diagnosis and the quality of medical care.
BACKGROUND: Non-IgE-mediated gastrointestinal food allergy includes adverse reactions to food mediated by the innate immune system and cellular immunity. It is characterized by subacute or chronic gastrointestinal sympto...BACKGROUND: Non-IgE-mediated gastrointestinal food allergy includes adverse reactions to food mediated by the innate immune system and cellular immunity. It is characterized by subacute or chronic gastrointestinal symptoms after ingestion of a relevant food allergen, making diagnosis difficult. OBJECTIVE: To carry out an updated bibliographic review of non-IgE-mediated gastrointestinal food allergy, that summarizes incidence, pathophysiology, clinical manifestations, diagnostic tools and treatment. METHODOLGY: A search was conducted in the databases Medline, EMBASE, Scielo, Google Scholar and the Advanced Medicine Informatics Network (RIMA) using the keywords: non-IgE-mediated food allergy, allergic proctocolitis; cow's milk-induced anemia; food protein-induced enteropathy; food protein-induced enterocolitis syndrome; Celiac disease and Heiner syndrome. The search was limited to articles published in English and Spanish from January 2015 to May 2024. RESULTS: While progress has been made in the recognition of these diseases, the prevalence and pathophysiology remain uncertain. Involvement of the innate immune system and cellular immunity in gastrointestinal inflammation has been found, but further studies are needed to clarify the immunopathogenesis and associated biomarkers. CONCLUSIONS: Non-IgE-mediated gastrointestinal food allergy account for an unknown proportion of food allergies. Since there are no biomarkers or non-invasive confirmatory tests, the diagnosis relies on clinical features and is confirmed when the symptoms improve with elimination of the offending food. Management includes avoidance of the causative food from the diet, supportive treatment in case of accidental exposure, and nutritional counseling.
OBJECTIVE: To analyze the relationship between cellular immune response, assessed through delayed hypersensitivity intradermal tests, and nutritional status in older adult women. METHODS: A correlational observational st...OBJECTIVE: To analyze the relationship between cellular immune response, assessed through delayed hypersensitivity intradermal tests, and nutritional status in older adult women. METHODS: A correlational observational study was conducted on elderly women, without evidence of infection, with an average age of 69.2 ± 5.9 years. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) scale, and the in vivo cell-mediated immune response was measured through delayed hypersensitivity tests to various microbial antigens. RESULTS: A total of 36 older adult women were enrolled in the study. Of these, 83.3% had a normal nutritional status, while 16.7% were at risk of malnutrition, with an average MNA score of 25.6 ± 2.7. The intradermal reaction test at 48 hours, showed an induration greater than 5 mm in 58.3% for Gram-positive bacteria, 38.9% for tetanus/diphtheria, 66.7% for candidin, and 0% for Escherichia coli. A positive response to candidin was more frequent in women at risk of malnutrition (OR: 1.3: CI: 1.1 - 1.7; p = 0.05). After 96 hours, a candidin induration greater than 7 mm showed an area under the ROC curve of 0.75 (CI: 0.57 - 0.94; p = 0.05) for predicting the risk of malnutrition. CONCLUSION: Older adult women with good nutritional status maintain an adequate cellular immune response, whereas those at risk of malnutrition exhibit greater reactivity to candidin, suggesting a possible immunological alteration associated with malnutrition.
OBJECTIVE: Determine the prevalence of allergic rhinitis in school children. METHODS: Cross-sectional, descriptive study in children from 6 to 10 years old. Those who underwent skin testing (mites, pollens, fungi, cockro...OBJECTIVE: Determine the prevalence of allergic rhinitis in school children. METHODS: Cross-sectional, descriptive study in children from 6 to 10 years old. Those who underwent skin testing (mites, pollens, fungi, cockroach, dog and cat hair) were included. The diagnosis of allergic rhinitis was made based on the test recommended by the European Academy of Allergy and Clinical Immunology (EAACI) and the American College of Allergy, Asthma and Immunology (ACAAI) for the diagnosis of allergy mediated by allergen-specific IgE. The statistical analysis included confidence interval for averages and percentages. RESULTS: In the 992 patients, the prevalence of allergic rhinitis was 15.7% (95% CI; 13.4-18.0), the predominant symptom was hyaline rhinorrhea in 94.7% (95% CI; 91.4-94.6), the main allergen was dust mites 60.4% (95% CI; 52.7-68.1) and pollen 59.3% (95% CI; 51.6-67.0). CONCLUSION: The prevalence of allergic rhinitis in school children with positive skin tests is 15.7%, with a predominance of males with 63.1%.
OBJECTIVE: To determine the prevalence and evaluate the distribution of sensitization to aeroallergens in pediatric and adult patients with allergic rhinitis. METHODS: Observational, cross-sectional and retrospective stu...OBJECTIVE: To determine the prevalence and evaluate the distribution of sensitization to aeroallergens in pediatric and adult patients with allergic rhinitis. METHODS: Observational, cross-sectional and retrospective study, carried out from the analysis of clinical records of patients with skin tests, to intentionally identify signs and symptoms of allergic rhinitis, as well as aeroallergens to which they reacted positively. RESULTS: 1531 skin reactivity tests were reviewed, of which 983 corresponded to patients with a diagnosis of allergic rhinitis with a positive test. The prevalence of the disease was 64.2% (n = 983); the pediatric population had a prevalence of 55.8% (n = 549) and the adult population 44.1% (n = 434). The aeroallergens with the higest frequency of sensitization were: Dermatophagoides pteronyssinus (59.5%), Dermatophagoides farinae (45.3%), cat (26.1%), Cupressus arizonica (21.7%), dog (21.6%) and Fraxinus excelsior ([Ash], 19.6%). CONCLUSION: There is a high prevalence of allergic rhinitis in the studied cohort. The house dust mites Dermatophagoides mix (Pteronyssinus and Farinae) were the main allergens. Cosensitization to cat and dog was high. The tree pollen species with the highest impact were: Cupressus arizonica, Fraxinus excelsior and Quercus robur (Roble, Encino, Oak). The grass pollen varieties with the greatest influence: Cynodon dactylon (Bermuda, Capriola) and Lolium Perenne (English grass).
OBJETIVES: To evaluate the persistent symptoms in subjects with infection of COVID-19, partially or fully recovered. METHODS: An observational, descriptive, cross-sectional, prospective study was conducted in individuals...OBJETIVES: To evaluate the persistent symptoms in subjects with infection of COVID-19, partially or fully recovered. METHODS: An observational, descriptive, cross-sectional, prospective study was conducted in individuals who were infected with SARS-CoV-2. We included Individuals of any gender and age who voluntarily answer a survey after developing infection to identify signs and symptoms associated, we analyzed whether there was any relationship between female sex and obesity, or age related with post-COVID-19 syndrome by X test and t Student test. RESULTS: 197 individuals were included with mean age 41.57 (SD 14.2 years), 61.9% were female. Post-COVID syndrome was present in 52.3%, depression, anosmia, dysgeusia, nausea, alopecia and behavior disorders were greater in women; arthralgia, dyspnea, cough, and odynophagia were greater in obesity being statistically significant (p<0.05). CONCLUSIONS: Post-COVID syndrome was found in 52.3%, with a variety of symptoms female sex had a higher risk of presenting post-Covid syndrome with symptoms such as depression, behavior disorders, anosmia, and baldness.
Vaccines are one of the most important discoveries of humanity, being an effective intervention to protect the population against infectious diseases. When the Covid-19 vaccination campaign, the feat of Doctor Francisco...Vaccines are one of the most important discoveries of humanity, being an effective intervention to protect the population against infectious diseases. When the Covid-19 vaccination campaign, the feat of Doctor Francisco Javier de Balmis y Berenguer in the Royal Philanthropic Vaccine Expedition is remembered due to the importance that vaccination has had over the years and mentioning that The National Vaccination Campaign against COVID-19 in Mexico began at the Dr. Eduardo Liceaga General Hospital of Mexico.
BACKGROUND: Congenital neutropenia is a primary immunodeficiency characterized by quantitative anomalies in neutrophil counts. It is classified as mild, moderate, or severe. Hematopoietic stem cell transplantation stands...BACKGROUND: Congenital neutropenia is a primary immunodeficiency characterized by quantitative anomalies in neutrophil counts. It is classified as mild, moderate, or severe. Hematopoietic stem cell transplantation stands as a potential therapeutic intervention; nevertheless, graft-versus-host disease emerges as a main complication. CASE REPORT: We report the case of a 2-year-old female patient, with a history of congenital neutropenia. She had scalp abscesses and preseptal cellulitis, which were satisfactorily treated. After a multidisciplinary approach, a protocol was initiated to receive an allogenic hematopoietic progenitor cell transplant; graft versus host disease was subsequently diagnosed, ultimately resulting in death of the patient. CONCLUSION: Graft-versus-host disease remains a significant complication in patients who undergo allogeneic hematopoietic stem cell transplants. Its recognition, management, and treatment are clinically relevant aspects given the substantial degree of associated morbidity and mortality.
BACKGROUND: Hereditary Angioedema is an autosomal dominant disorder caused by a lack or decrease in the function of the C1 inhibitor. It is a rare disease with low prevalence. Treatment focuses on symptom relief and shor...BACKGROUND: Hereditary Angioedema is an autosomal dominant disorder caused by a lack or decrease in the function of the C1 inhibitor. It is a rare disease with low prevalence. Treatment focuses on symptom relief and short- and long-term prevention of acute attacks. CASE REPORT: 53-year-old male patient, with recurrent edema in the face, feet, scrotum, associated with abdominal pain since he was 20 years old. Patient has a history of hereditary angioedema in first-degree relatives of consanguinity. Laboratory tests showed low levels of plasma protein (antigenic), functional C1-INH and C4. The patient received several medical treatments. Given the recurrence of symptoms, prophylactic management with Lanadelumab was indicated. However, the patient presented erythema and induration at the application site with subsequent secondary generalized pruritus. For this reason, prophylaxis was suspended. CONCLUSION: This case of hereditary angioedema type 1 presents the difficulty in the treatment and the relapse of the patient after trying various therapies, as well as the finding of the adverse effect presented to the prophylactic medication with Lanadelumab, which has been poorly documented in the literature medical worldwide.