ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Antihistamines: Recommended Dosage - Divergence between Clinical Practice and Guideline Recommendations. Authors: Manti S, Salpietro C, Cuppari C. Unit of Pediatrics, Department of Pediatrics, “G. Martino” Hospital, University of Messina, Messina, Italy Abstract:  The updosing of second-generation antihistamines for chronic urticaria is based on inconsistent findings. Herein, we report data on the treatment of children with chronic spontaneous urticaria (CSU) unresponsive to single doses of second-generation H(1)-antihistamines in whom an increase in antihistamine was performed without improvement and with a high prevalence of adverse events. Thus, it appears that well-controlled, well-designed clinical trials are needed to clarify which nonsedating antihistamines should be used, in what dose, and for how long in patients not responding to the standard treatment, despite the improvement in health care that guidelines help to incorporate. Furthermore, a critical use of su

Visión integral de los mecanismos de hipersensibilidad (Dra. Gloria Gil y Dr. Ricardo Cardona)

Comparison and interpretability of the available urticaria activity scores. Authors: Hawro T1, Ohanyan T1, Schoepke N1, Metz M1, Peveling-Oberhag A2, Staubach P2, Maurer M1, Weller K1. 1 Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany. 2 Department of Dermatology, University Medical Center Mainz, Mainz, Germany. Abstract:  The urticaria activity score (UAS) is the gold standard for assessing disease activity in patients with chronic spontaneous urticaria (CSU). Two different versions, the UAS7 and UAS7TD , are currently used in clinical trials and routine care. To compare both versions and to obtain data on their interpretability, 130 CSU patients applied both versions and globally rated their disease activity as none, mild, moderate, or severe. UAS7 and UAS7TD values correlated strongly (r = .90, P < .001). Interquartile ranges for UAS7 and UAS7TD values for mild, moderate, and severe CSU were 11-20

Biologic Agents for the Treatment of Chronic Rhinosinusitis With Nasal Polyps. Authors: Kartush AG1, Schumacher JK2, Shah R1, Patadia MO1 1 Department of Otolaryngology, Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois. 2 Department of Internal Medicine. Affiliate clinician: Loyola University Medical Center, Maywood, Illinois. Abstract:  BACKGROUND: Chronic rhinosinusitis with nasal polyposis is a complex inflammatory disorder, which is often recalcitrant to medical and surgical management. Recently, biologic agents have been studied as an adjunct treatment for this patient population. OBJECTIVE: The purpose of this study is to examine the role of biologic agents for chronic rhinosinusitis patients by reviewing literature and clinical trials. METHODS: A comprehensive review of literature and clinical trials-both recently completed and ongoing-was undertaken to examine up-to-date evidence of current biologic therapy and its role in chronic rh

Phenotypic Characterization of Eosinophilic Esophagitis in a Large Multicenter Patient Population from the Consortium for Food Allergy Research Authors: Chehade M1, Jones SM2, Pesek RD2, Burks AW3, Vickery BP3, Wood RA4, Leung DYM5, Furuta GT6, Fleischer DM6, Henning AK7, Dawson P7, Lindblad RW7, Sicherer SH8, Abonia JP9, Sherrill JD9, Sampson HA8, Rothenberg ME9 . 1 Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: mirna.chehade@mssm.edu. 2 Division of Pediatric Allergy and Immunology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark. 3 Division of Pediatric Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC. 4 Division of Pediatric Allergy and Immunology, Johns Hopkins University Medical Center, Baltimore, Md. 5 Division of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colo. 6 Department of

Reacciones transfusionales (Dra. July Ospina)

Evaluation and Management of Penicillin Allergy: A Review. Authors: Shenoy ES1,2,3, Macy E4, Rowe T5, Blumenthal KG1,6,7. 1 Harvard Medical School, Boston, Massachusetts. 2 Infection Control Unit, Massachusetts General Hospital, Boston. 3 Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston. 4 Department of Allergy, Southern California Permanente Medical Group, San Diego Medical Center. 5 General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 6 Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston. 7 Edward P. Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston. Abstract: IMPORTANCE: β-Lactam antibiotics are among the safest and most effective antibiotics. Many patients report allergies to these drugs that limit their use, resulting in the use of broad-spectrum antibiotics that incr

Fisiopatología de la alergia alimentaria (Dr. Jaime Sosa)

The microbiome in patients with atopic dermatitis. Authors: Paller AS1, Kong HH2, Seed P3, Naik S4, Scharschmidt TC5, Gallo RL6, Luger T7, Irvine AD8. 1 Dermatology and Infectious Disease, Northwestern University Feinberg School of Medicine and the Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Ill. Electronic address: apaller@northwestern.edu. 2 Dermatology Branch, National Institute of Arthritis and Musculoskletal and Skin Diseases, Bethesda, Md. 3 Dermatology and Infectious Disease, Northwestern University Feinberg School of Medicine and the Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Ill. 4 Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY. 5 Department of Dermatology, University of California, San Francisco, Calif. 6 Dermatology, University of California, San Diego, Calif. 7 Dermatology, University of Muenster, Munster, Germany. 8 Paediatric Dermatology, Our Lady's Chil

Superior effect of MP-AzeFlu than azelastine or fluticasone propionate alone on reducing inflammatory markers. Authors: Roca-Ferrer J1,2, Pujols L1,2, Pérez-González M1,2, Alobid I1,2,3, Callejas B1,2, Vicens-Artés S1,2, Fuentes M1,2, Valero A1,2,4, Picado C1,2,4, Castor D5, Nguyen D5, Mullol J1,2,3. 1 Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. 2 Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. 3 Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Catalonia Spain. 4 Allergy Section, Respiratory and Allergy Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. 5 Clinical Science & Operations, Meda Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany. Abstract: BACKGROUND: MP-AzeFlu, intranasal formulation of azelas

Insights into tree nut and sesame consumption from a cohort of 80 peanut-allergic children. Author: Anagnostou A 1,2 1 Texas Children's Hospital, Department of Pediatrics, Section of Immunology, Allergy and Rheumatology, Houston, TX, USA. 2 Baylor College of Medicine, Houston, TX, USA. Abstract: Peanut allergy is increasing in prevalence in the US according to reports [1] and has become a global concern. Sensitization to tree nuts is common with reported rates of up to 86% for multi-nut sensitization with increasing age [2] [3]. In addition, peanut allergy has been associated with an increased risk of sesame sensitization and allergy [4]. Patients' attitudes towards tree nut and sesame consumption can be variable following a diagnosis of peanut allergy and have not previously been examined. DOI:   10.1111/pai.13016

Fisiopatología de la dermatitis atópica por el Dr. Steven Abreu Seguridad de los inhibidores de la calcineurina tópicos por la Dra. Susana Uribe

Controversies in drug allergy: Testing for delayed reactions. Authors:  Phillips EJ1, Bigliardi P2, Bircher AJ3, Broyles A4, Chang YS5, Chung WH6, Lehloenya R7, Mockenhaupt M8, Peter J7, Pirmohamed M9, Roujeau JC10, Shear NH11, Tanno LK12, Trubiano J13, Valluzzi R14, Barbaud A15. 1 Vanderbilt University Medical Center, Nashville, Tenn; Institute for Immunology and Infectious Diseases, Murdoch, Australia. Electronic address: elizabeth.j.phillips@vanderbilt.edu. 2 Department of Dermatology, Dermato-Allergy Division, University of Minnesota, Minneapolis, Minn. 3 Department of Dermatology, Allergy Unit, University Hospital, University of Basel, Basel, Switzerland. 4 Boston Children's Hospital and Harvard Medical School, Boston, Mass. 5 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea. 6 Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang G

Atopic dermatitis endotypes and implications for targeted therapeutics. Authors:  Czarnowicki T1, He H2, Krueger JG3, Guttman-Yassky E4 1 Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY. 2 Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY. 3 Laboratory for Investigative Dermatology, Rockefeller University, New York, NY. 4 Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY. Electronic address: emma.guttman@mountsinai.org. Abstract: Recent research advancements indicate that atopic dermatitis (AD) is a complex disease characterized by different subtypes/phenotypes based on age, disease chronicity, ethnicity, filaggrin and IgE status, and u

Recent developments and highlights in rhinitis and allergen immunotherapy Authors: Reitsma S1, Subramaniam S2, Fokkens WWJ1, Wang Y3. 1 Department of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 2 Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore, Singapore. 3 Department of Otolaryngology, National University of Singapore, Singapore, Singapore. Abstract: This review paper aims to provide an overview of recent developments in the field of allergic and non-allergic rhinitis, as well as allergen immunotherapy. Recent advances in phenotyping and endotyping various forms of rhinitis have brought us one step closer towards tailoring treatment more appropriately for a given patient. Updates on local allergic rhinitis are also covered. Allergen immunotherapy (AIT) is an area of significant interest, with multiple original papers and recent position papers and guidelines published. Evidence related to the applicatio

Ara h 1 and Ara h 6 Sensitization Causes Clinical Peanut Allergy in Ara h 2-Negative Individuals Authors: Helga Magnusdottir,a, b; Anna Gudrun Vidarsdóttir, b; Bjorn Runar Ludviksson,a, b, d; Michael Clausen, c, d; Sigrun Helga Lund,e; Anders B. Jensen, f; Sigurveig T. Sigurdardottir, a, b, d. a Faculty of Medicine, University of Iceland, Reykjavík, Iceland; b Department of Immunology, Landspitali University Hospital, Reykavík, Iceland; c Children’s Hospital of Iceland, Reykjavík, Iceland; d Allergy Outpatient Department, Landspitali University Hospital, Reyjavík, Iceland; e  Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland; f  Thermo Fisher Scientific, Allerd, Denmark  Abstract: BACKGROUND: Of the major peanut allergens, sensitivity to Ara h 2 has the highest prediction for clinical allergy. In this study, we evaluated sensitization to peanut components in Iceland and related Ara h 2-negative sensitization to clinical allergy.

Entradas populares del año 2018 Número 1: EAACI/ENDA Position Paper: Diagnosis and management of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) in children and adolescents.  https://doi.org/10.1111/pai.12915 Comentarios: - Las reacciones de hipersensibilidad por AINES se definen como: "afecciones que se asemejan clínicamente a alergias que provocan síntomas o signos objetivamente reproducibles, iniciados por exposición a este grupo farmacológico a una dosis tolerada por sujetos normales”. Comentario: Consideramos que cuando se habla de alergia se habla de reacciones de hipersensibilidad que tiene de fondo un mecanismo mediado inmunológicamente por lo que el termino “asemeja” no estaría correcto. - En muchos casos en la población pediátrica, la hipersensibilidad a los AINE es un efecto de clase, y los niños a menudo desarrollan reacciones después de tomar medicamentos alternativos, ya sea como antipiréticos o como medicamentos antiinflam

The Diagnosis of Ceftriaxone Hypersensitivity in a Paediatric Population Authors:  Mori F1, Liccioli G2, Piccorossi A3, Sarti L2, Barni S2, Giovannini M2, Azzari C4, Manfredi M5, Novembre E2. 1 Department of Paediatrics, Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italyfrancesca.mori@meyer.it. 2 Department of Paediatrics, Allergy Unit, Anna Meyer Children's University Hospital, Florence, Italy. 3 Department of Paediatrics, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. 4 Section of Paediatrics, Division of Immunology, Department of Health Sciences, Anna Meyer Children's Hospital, University of Florence, Florence, Italy. 5 Laboratory of Immunology and Allergology, S. Giovanni di Dio Hospital, Florence, Italy. Abstract: INTRODUCTION: Penicillins and cephalosporins are the most frequent causes of hypersensitivity reactions (HRs) to drugs in children. Among cephalosporins for intravenous use, ceftriaxone (CT)

Characteristics of persistent diaper dermatitis in children with food allergy. Authors: Celiksoy MH1, Topal E2, Hazıroglu Okmen Z3, Alataş C4, Demirtaş MS4. 1 Department of Pediatric Allergy and Immunology, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey. 2 Department of Pediatric Allergy and Immunology, Medical Faculty, Inonu University, Malatya, Turkey. 3 Department of Pediatrics, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey. 4 Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey. Abstract: BACKGROUND/OBJECTIVES: Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food-allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persiste

A Pediatric Asthma Risk Score to better predict asthma development in young children. Authors: Biagini Myers JM1, Schauberger E2, He H3, Martin LJ4, Kroner J5, Hill GM5, Ryan PH6, LeMasters GK7, Bernstein DI8, Lockey JE7, Arshad SH9, Kurukulaaratchy R9, Khurana Hershey GK10. 1 Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio. 2 Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3 Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 4 Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio. 5 Division of Asthma Research, Cincinnati Children's Hospital Med

Multiple Drug Hypersensitivity. Authors:  Pichler WJ, Srinoulprasert Y, Yun J, Hausmann O.  ADR-AC, Bern, Switzerland. Abstract: Multiple drug hypersensitivity (MDH) is a syndrome that develops as a consequence of massive T-cell stimulations and is characterized by long-lasting drug hypersensitivity reactions (DHR) to different drugs. The initial symptoms are mostly severe exanthems or drug rash with eosinophilia and systemic symptoms (DRESS). Subsequent symptoms due to another drug often appear in the following weeks, overlapping with the first DHR, or months to years later after resolution of the initial presentation. The second DHR includes exanthema, erythroderma, DRESS, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), hepatitis, and agranulocytosis. The eliciting drugs can be identified by positive skin or in vitro tests. The drugs involved in starting the MDH are the same as for DRESS, and they are usually given in rather high doses. Fixed drug combinat

How Not to Be Misled by Disorders Mimicking Angioedema: A Review of Pseudoangioedema. Authors:  Andersen MF, Longhurst HJ, Rasmussen ER, Bygum A . Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Sjaelland, Koege, Denmark. Abstract: BACKGROUND: Angioedema is a vascular reaction involving the lower dermis, subcutis and/or submucosal tissue and causing a temporary localized swelling in any part of the body. For many health care professionals, the diagnosis presents an ongoing challenge; several disorders may manifest with subcutaneous or submucosal swelling and falsely be assumed to be angioedema. The clinicians at the emergency department and in the immunology/allergy clinics must be skilled at recognizing the features of angioedema and its differential diagnosis. METHODS: The review is based on a literature search with specific indexing terms in PubMed, a review of bibliographies and the authors' clinical experience. RESULTS: The most