ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Histamine (Scombroid) Fish Poisoning: a Comprehensive Review. Authors: Feng C1, Teuber S1, Gershwin ME2. 1 Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA. 2 Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA. megershwin@ucdavis.edu. Abstract Histamine fish poisoning, also known as scombroid poisoning, is the most common cause of ichythyotoxicosis worldwide and results from the ingestion of histamine-contaminated fish in the Scombroidae and Scomberesocidae families, including mackerel, bonito, albacore, and skipjack. This disease was first described in 1799 in Britain and re-emerged in the medical literature in the 1950s when outbreaks were reported in Japan. The symptoms associated with histamine fish poisoning are similar to tha

Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. Authors: Bousquet J1, Schünemann HJ2, Togias A3, Bachert C4, Erhola M5, Hellings PW6, Klimek L7, Pfaar O8, Wallace D9, Ansotegui I10, Agache I11, Bedbrook A12, Bergmann KC13, Bewick M14, Bonniaud P15, Bosnic-Anticevich S16, Bossé I17, Bouchard J18, Boulet LP19, Brozek J2, Brusselle G20, Calderon MA21, Canonica WG22, Caraballo L23, Cardona V24, Casale T25, Cecchi L26, Chu DK2, Costa EM27, Cruz AA28, Czarlewski W29, D'Amato G30, Devillier P31, Dykewicz M32, Ebisawa M33, Fauquert JL34, Fokkens WJ35, Fonseca JA36, Fontaine JF37, Gemicioglu B38, van Wijk RG39, Haahtela T40, Halken S41, Ierodiakonou D42, Iinuma T43, Ivancevich JC44, Jutel M45, Kaidashev I46, Khaitov M47, Kalayci O48, Kleine Tebbe J49, Kowalski ML50, Kuna P51, Kvedariene V52, La Grutta S53, Larenas-Linemann D5

Quinolone Allergy. Authors: McGee EU1, Samuel E1, Boronea B1, Dillard N1, Milby MN2, Lewis SJ3,4. 1 School of Pharmacy, Philadelphia College of Osteopathic Medicine, Suwanee, GA 30024, USA. 2 College of Pharmacy, University of Findlay, Findlay, OH 45840, USA. 3 Department of Pharmacy Practice, College of Pharmacy, University of Findlay, Findlay, OH 45840, USA. slewis@findlay.edu. 4 Mercy Health-St. Anne Hospital, Toledo, OH 43623, USA. slewis@findlay.edu. Abstract Quinolones are the second most common antibiotic class associated with drug-induced allergic reactions, but data on quinolone allergy are scarce. This review article discusses the available evidence on quinolone allergy, including prevalence, risk factors, diagnosis, clinical manifestations, cross-reactivity, and management of allergic reactions. Although the incidence of quinolone allergy is still lower than beta-lactams, it has been increasingly reported in recent decades, most likely from its e

Capítulo A4.  Methods for IgE antibody testing: singleplex and multiplex assays Authors: Robert G. Hamilton, Jörg Kleine-Tebbe                                            Abstract   IgE antibody tests are run as singleplex (one), multi-allergen (<10) and multiplex (>100 allergen specificities) assays, all with particular design and performance features. Allergen extracts remain the principal reagents for IgE assays; allergenic molecules supplement labile or missing allergens in extracts or are analyzed individually. Allergenic molecules enhance the IgE assay’s analytical sensitivity, and improve its analytical specificity by separating serological cross-reactivity from primary (genuine) sensitization to an allergen source or by identifying risk-associated allergens. The relevance of positive allergen-specific IgE antibody responses, either to extracts or molecules, can only be determined by the physician based on the clinical context (history, challeng

Work Group report: oral food challenge testing. Authors: Nowak-Wegrzyn A1, Assa'ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS; Adverse Reactions to Food Committee of American Academy of Allergy, Asthma & Immunology. 1 Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY, USA. Abstract Oral food challenges are procedures conducted by allergists/immunologists to make an accurate diagnosis of immediate, and occasionally delayed, adverse reactions to foods. The timing of the challenge is carefully chosen based on the individual patient history and the results of skin prick tests and food specific serum IgE values. The type of the challenge is determined by the history, the age of the patient, and the likelihood of encountering subjective reactions. The food challenge requires preparation of the patient for the procedure and preparation of the office for the organized conduct of the challenge, for a careful assessment of the symptoms and signs

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

  Hypersensitivity reactions to beta-lactams in children. Authors: Graham F1, Tsabouri S2, Caubet JC1. 1 Division of Pediatric Allergy, Department of Pediatrics, Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland. 2 Department of Paediatrics, Child Health Department, University of Ioannina, School of Medicine, Ioannina, Greece. Abstract PURPOSE OF REVIEW: To present the most recent evidence on beta-lactam hypersensitivity reactions in children. RECENT FINDINGS: Drug provocation tests (DPTs) are the gold standard when investigating beta-lactam allergy in children and evidence is increasingly supporting DPTs without skin tests as a safe approach when evaluating children with nonimmediate mild reactions to beta-lactams. Of note, data are limited in the adolescent population, and this attitude may not apply to this age group. Standardization of DPT protocols is required in nonimmediate reactions, as many protoco

Alergia a antibióticos no betalactámicos (Dr. Fernando Steven Abreu)

Inmunodeficiencias primarias (Dr. Ramón Fabricio Luna M.)

Moving Past "Avoid All Nuts": Individualizing Management of Children with Peanut/Tree Nut Allergies. Authors: Schroer B1, Bjelac J2. 1 Akron Children's Hospital, 130 West Exchange Street, Akron, OH 44022, USA. Electronic address: bschroer@akronchildrens.org. 2 Cleveland Clinic Children's Hospital, 9500 Euclid Avenue, A3, Cleveland, OH 44195, USA. Abstract It has been common practice to tell patients with allergy to peanut or tree nuts to avoid all nuts. Evidence that unnecessary avoidance of peanuts and eggs is associated with increased risk for developing anaphylaxis to those foods has changed how allergists view previous recommendations to avoid foods that have not caused a reaction. In the absence of evidence, collaborative decision making between clinicians and families should be used to decide whether to avoid tree nuts and how to safely introduce tree nuts into the diet. DOI:   10.1016/j.iac.2019.07.004

Acute urticaria. Authors: Sabroe RA1. 1 Department of Dermatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK. Electronic address:  rsabroe@doctors.org.uk . Abstract Acute urticaria is a common condition, which presents in all age groups and to multiple specialties. It may be a presenting symptom of anaphylaxis. The following article describes the epidemiology, etiology, clinical features, differential diagnosis, investigations, management, and prognosis of acute urticaria. Contact urticaria and angioedema without urticarial weals are not covered, as these are described elsewhere in this issue. DOI:   10.1016/j.iac.2013.07.010

Capítulo A3.  Molecular allergy diagnostics in clinical practice Authors: Jörg Kleine-Tebbe, Thilo Jakob Abstract: Diagnostic work-up for IgE mediated allergic reactions/diseases starts with the history, followed by sensitization tests (skin, IgE and basophil tests) and optional challenge tests (Top-down approach) Molecular allergens for IgE testing provide additional information, particularly in polysensitized patients and with allergens of low abundance, low stability or associated risks IgE reactivity to members of the same allergen family reflect the degree of protein homology and IgE cross-reactivity. If it is high, the relevance needs to be sorted out clinically. In case it is low, selected IgE testing of other family members can provide additional information. Proper interpretation should complete diagnostic testing: Positive sensitizations to allergen extracts or molecules are only clinically relevant in case of corresponding symptoms EAACI link

Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper.  + Authors: Meyer R1, Chebar Lozinsky A2, Fleischer DM3, Vieira MC4, Du Toit G5, Vandenplas Y6, Dupont C7, Knibb R8, Uysal P9, Cavkaytar O10, Nowak-Wegrzyn A11, Shah N12, Venter C3. Author information 1 Department Paediatrics, Imperial College London, London, UK. 2 Department of Allergy and Immune Disorders, Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 3 Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, CO, USA. 4 Department of Paediatrics, Pontifical Catholic University of Paraná, Center for Pediatric Gastroenterology, Hospital Pequeno Príncipe, Curitiba, Brazil. 5 Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St. Thomas' National Health Service Foundation Trust, London, UK. 6 KidZ Health Castle, UZ Brus

AAAAI Mast Cell Disorders Committee Work Group Report: Mast Cell Activation Syndrome (MCAS) Diagnosis and Management. Authors:  Weiler CR1, Austen KF2, Akin C3, Barkoff MS4, Bernstein JA5, Bonadonna P6, Butterfield JH1, Carter M7, Fox CC8, Maitland A9, Pongdee T1, Mustafa SS10, Ravi A11, Tobin MC12, Vliagoftis H13, Schwartz LB14. 1 Department of Internal Medicine, Division of Allergy, Mayo Clinic, Rochester, MN, USA. 2 Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham & Women's Hospital, Boston, MA, USA. 3 Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, MI, USA. 4 Private Practice, Endocrinology, Chicago, IL, USA. 5 Internal Medicine, Immunology and Allergy, University of Cincinnati College of Medicine and Partner of Bernstein Allergy Group, Inc. and Bernstein Clinical Research Center, LLC, USA. 6 Allergy Unit, linical Center, Bethesda, MD, USA. 7 NIH Cology, Division of Allergy and Immunology,

Cephalosporin Allergy: Current Understanding and Future Challenges. Authors: Khan DA1, Banerji A2, Bernstein JA3, Bilgicer B4, Blumenthal K2, Castells M5, Ein D6, Lang DM7, Phillips E8. 1 Department of Internal Medicine, Division of Allergy & Immunology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: dave.khan@utsouthwestern.edu. 2 Department of Medicine, Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, Mass. 3 Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio. 4 Department of Chemical and Biomedical Engineering, Notre Dame, Ind. 5 Department of Medicine, Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, Boston, Mass. 6 Department of Internal Medicine, George Washington University Medical Center, Washington, DC. 7 Department of Internal Medicine, Cleveland Clinic, Respiratory Institute, Department of A

Future perspectives of anticholinergics for the treatment of asthma in adults and children. Authors : Buhl R1, Hamelmann E2,3. 1 Pulmonary Department, Johannes Gutenberg University Hospital Mainz, Mainz, Germany, roland.buhl@unimedizin-mainz.de. 2 Children's Center Bethel, Evangelic Hospital Bethel, Department of Pediatrics, Bielefeld, Germany. 3 University Children's Hospital, Allergy Center Ruhr, Ruhr University Bochum, Bochum, Germany. Abstract Despite major advances in therapeutic interventions and the availability of detailed treatment guidelines, a high proportion of patients with symptomatic asthma remain uncontrolled. Asthma management is largely guided by the Global Initiative for Asthma (GINA) strategy and is based on a backbone of inhaled corticosteroid (ICS) therapy with the use of additional therapies to achieve disease control. Inhaled long-acting bronchodilators alone and in combination are the preferred add-on treatment options. Although long-ac

Changing the history of anaphylaxis mortality statistics through the World Health Organization's International Classification of Diseases-11. Authors : Tanno LK1, Chalmers R2, Bierrenbach AL3, Simons FER4, Martin B5, Molinari N6, Annesi-Maesano I7, Worm M8, Cardona V9, Papadopoulos NG10, Sanchez-Borges M11, Rosenwasser LJ12, Ansontegui I13, Ebisawa M14, Sisul JC15, Jares E16, Gomez M17, Agache I18, Hellings P19, Muraro A20, Thien F21, Pawankar R22, Sublett JL23, Casale T24, Demoly P25; Joint Allergy Academies. 1 Hospital Sírio-Libanês, São Paulo, Brazil; University Hospital Montpellier, Montpellier, France; Sorbonne Université, INSERM UMR-S 1136, Paris, France; World Health Organization Collaborating Centre on Scientific Classification Support, Montpellier, France; ICD-11 Medical and Scientific Advisory Committee, World Health Organization, Geneva, Switzerland. Electronic address: luciana.tanno@gmail.com. 2 ICD-11 Medical and Scientific Advisory Committee, World Health O

Pitfalls in anaphylaxis Authors: De Feo G1, Parente R, Triggiani M. 1 Division of Allergy and Clinical Immunology, University of Salerno, Fisciano, Italy. Abstract PURPOSE OF REVIEW: Anaphylaxis is an acute medical emergency characterized by sudden presentation of life-threatening respiratory and cardiovascular symptoms. Rapid diagnosis of anaphylaxis is crucial to implement an appropriate treatment and management plan. However, mistakes in the diagnosis of anaphylaxis may occur because of the limited time during which the diagnosis must be made, the stressful environment of the emergency room, the often aspecific or incomplete clinical features of early anaphylaxis and the lack of useful laboratory markers. RECENT FINDINGS: Several disorders may mimick anaphylaxis and cause wrong or delayed diagnosis increasing chances of fatal outcomes. In addition, certain clinical situations, like general anesthesia, may complicate detection of early signs of anaphylaxis. Drugs l