ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Capítulo B05. Cockroach allergy Authors:   Luis Caraballo, Thomas Platts-Mills                                            Abstract   Cockroach allergens are strong inducers of sensitization and asthma. Clinically important species include American, German, Oriental, Asian, brownbanded and smoky-brown cockroaches. Bla g 2 and Bla g 5 have the higher frequency of IgE positivity among cockroach allergens but there are important differences among individual patients and populations. Currently, diagnosis is performed by skin testing and/or measurement of specific IgE to cockroach, using crude extracts EAACI link:  www.eaaci.org

α-Gal and other recent findings that have informed our understanding of anaphylaxis. Authors: Wilson JM1, Platts-Mills TAE2. Author information 1Division of Allergy & Immunology, University of Virginia, Charlottesville, VA, 22908. 2Division of Allergy & Immunology, University of Virginia, Charlottesville, VA, 22908. Electronic address: tap2z@virginia.edu. Abstract OBJECTIVE: To summarize the current understanding of anaphylaxis, with an emphasis on major findings that have been reported within the last 10 years. DATA SOURCES: Queries relating to anaphylaxis, immunoglobulin E (IgE), and mast cells were conducted with PubMed and Google Scholar, searching for primary articles and review papers. STUDY SELECTIONS: We focused on articles written in English and which were reported in major allergy and immunology journals. RESULTS: Anaphylaxis represents an extreme manifestation of a form of allergic immunity that appears to have evolved to protect against "tox...

Etiologies and management of cutaneous flushing: Nonmalignant causes. Authors: Sadeghian A1, Rouhana H2, Oswald-Stumpf B1, Boh E1. Author information 1Department of Dermatology, Tulane University, New Orleans, Louisiana. 2Department of Dermatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana. Electronic address: hrouha@lsuhsc.edu. Abstract The flushing phenomenon may represent a physiologic or a pathologic reaction. Although flushing is usually benign, it is prudent that the physician remains aware of potentially life-threatening conditions associated with cutaneous flushing. A thorough investigation should be performed if the flushing is atypical or not clearly associated with a benign underlying process. The diagnosis often relies on a pertinent history, review of systems, physical examination, and various laboratory and imaging modalities, all of which are discussed in the 2 articles in this continuing medical education series. This article r...

Management of adverse reactions to first-line tuberculosis antibiotics. Authors: Nagarajan S1, Whitaker P2. Author information 1 Department of Paediatric Immunology, Manipal Hospital, Malleshwaram, Bangalore, India. 2 Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, UK. Abstract PURPOSE OF REVIEW: Tuberculosis (TB) is the commonest infectious cause of death globally. Adverse reactions to first-line tuberculosis antibiotics are common and have a major impact on the outcomes of patients as second-line antibiotics are less effective and more toxic. The present review addresses the most recent literature regarding epidemiology, investigating reactions, and reintroducing treatment in patients who have had their treatment interrupted. RECENT FINDINGS: Studies have demonstrated that up to 60% of patients experience adverse reactions to TB treatment; around a third of these are idiosyncratic and may relate to immune sensitization. There is an increased ri...

Pruebas de función pulmonar (Dra. Catalina López Ceballos)

Capítulo B04. Dust mite allergy Authors:   Thomas Platts-Mills, Luis Caraballo                                            Abstract   House dust allergy is an important risk factor for asthma and rhinitis Most recognized house dust mites are Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis In the majority of cases skin test with mite extracts is able to detect sensitization and define the specificity of immunotherapy in asthmatic patients The use of species specific components might be necessary in places like the Tropics where coexposure to non-crossreacting mites genera is common EAACI link:  www.eaaci.org

Conducting an Oral Food Challenge: An Update to the 2009 Adverse Reactions to Foods Committee Work Group Report. Authors: Bird JA1, Leonard S2, Groetch M3, Assa'ad A4, Cianferoni A5, Clark A6, Crain M6, Fausnight T7, Fleischer D8, Green T9, Greenhawt M8, Herbert L10, Lanser BJ11, Mikhail I12, Mustafa S13, Noone S3, Parrish C14, Varshney P15, Vlieg-Boerstra B16, Young MC17, Sicherer S3, Nowak-Wegrzyn A18. Author information 1University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: drew.bird@utsouthwestern.edu. 2University of California, San Diego, Calif; Rady Children's Hospital, San Diego, Calif. 3Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY. 4Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 5Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa. 6Children's Health, Dallas, Texas. 7Penn State College of Medicine, Hershey, Pa. 8Children's Hospital Color...

Chronic urticaria phenotypes: clinical differences regarding triggers, activity, prognosis and therapeutic response. Authors: Curto-Barredo L1, Pujol RM1, Roura-Vives G2, Gimenez-Arnau AM1. Author information 1Department of Dermatology, Hospital del Mar - Institut Mar d'Investigacions Mèdiques (IMIM). Departament de Medicina de la UAB. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. 2Adknoma Health Research. Barcelona, Spain. Abstract BACKGROUND: The subtypes of chronic urticaria (CU) share a common clinical expression, but phenotypically may show differences. OBJECTIVES: To evaluate sociodemographic and clinical differences in CU phenotypes, including: (1) isolated chronic spontaneous urticaria (CSU); (2) isolated chronic inducible urticaria (CIndU); (3) CSU with concomitant CIndU (CSU-CIndU); (4) CSU with single or multiple episodes; (5) early and late-onset CSU (<45/65 years vs ≥45/65 years); and (6) CSU with presence vs absence of serum autoreactivit...

Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy. Authors: Sánchez-Borges M1, Thong B, Blanca M, Ensina LF, González-Díaz S, Greenberger PA, Jares E, Jee YK, Kase-Tanno L, Khan D, Park JW, Pichler W, Romano A, Jaén MJ. Author information 1 Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad, Caracas, Venezuela. sanchezbmario@gmail.com. Abstract Antibiotics are used extensively in the treatment of various infections. Consequently, they can be considered among the most important agents involved in adverse reactions to drugs, including both allergic and non-allergic drug hypersensitivity [J Allergy Clin Immunol 113:832-836, 2004]. Most studies published to date deal mainly with reactions to the beta-lactam group, and information on hypersensitivity to each of the other antimicrobial agents is scarce. The present document has been produced by the Special Committee on Drug Allergy...

Capítulo B03. Weed pollen allergy Authors:   Gabriele Gadermaier, Janet M. Davies, Thomas Hawranek, Richard Weber                                            Abstract   Common invasive weeds like ragweed, mugwort and plantain, are frequently important allergen sources typically flowering in summer through to autumn. The biogeographical range and pollination periods of allergenic weeds can overlap confounding accurate allergy diagnosis. Specific IgE to Amb a 1 can be a useful marker for ragweed sensitization but it shows cross- reactivitywithArtv6frommugwort. Likewise specific IgE to Art v 1 can be a useful marker for mugwort sensitization, but its shows partial cross-reactivity with Amb a 4 from ragweed. Art v 3 reactivity is frequently associated wi...

Clinical Management of Seafood Allergy. Authors: Davis CM1, Gupta RS2, Aktas ON3, Diaz V4, Kamath SD5, Lopata AL5. 1 Texas Children's Hospital Food Allergy Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. Electronic address: carlad@bcm.edu. 2 Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill. 3 Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Ill. 4 Texas Children's Hospital Food Allergy Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. 5 College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, Molecular Allergy Research Laboratory, James Cook University, Townsville, QLD, Australia. Abstract Seafood plays an important role in human nutrition and health. A good patient workup a...

Itching as a Systemic Disease Authors: Takashi Hashimoto  1 , Gil Yosipovitch  2 1 Dr Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, Miller School of Medicine, University of Miami, Miami, Fla. 2 Dr Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, Miller School of Medicine, University of Miami, Miami, Fla. Electronic address: gyosipovitch@med.miami.edu. Abstract Pruritus is a sensation that emanates from the skin and is transferred through peripheral nerve fibers to the central nervous system. It is easily understood that primary skin disorders, such as atopic eczema, skin dryness, psoriasis, and urticaria, can elicit pruritus. However, certain systemic diseases can cause chronic pruritus, which has a significant effect on the patient's quality of life. In this rostrum we provide an overview of the characteristics, pathophysiology, and mechanisms of pruritus of major systemic underlying diseases,...

Progestogen Hypersensitivity: Heterogeneous Manifestations With a Common Trigger Authors: Kathleen M Buchheit  1 , Jonathan A Bernstein  2 Abstract Hypersensitivity to progestogen, previously known as autoimmune progesterone dermatitis, is an increasingly recognized clinical entity that presents specific diagnostic and treatment challenges. Clinical presentations are heterogeneous, but can consist of hypersensitivity symptoms associated with the progesterone surge during the luteal phase of the menstrual cycle or after exposure to exogenous progestins. With the increasing use of exogenous progesterone for contraception and fertility, more cases of hypersensitivity to exogenous progestins have been described. Here we will review proposed pathomechanisms for progestogen hypersensitivity (PH) as well as the clinical presentation of PH, testing strategies to aid in diagnosis, and treatment options for patients with hypersensitivity to progestogens. Keywords: Autoimmune p...

Capítulo B02. Grass pollen allergy Authors:   Janet M. Davies, Paolo M. Matricardi, Johannes Schmid                                            Abstract   IgE to group 1 allergens (eg Phl p 1) is a marker of true grass pollen sensitisation. Whilst IgE to other major grass pollen allergens are rarely observed in the absence of IgE to Phl p 1, IgE to Phl p 5 or Phl p 2 can serve as a markers of true grass pollen sensitisation. A number of allergen families exist in grass pollens, but IgE reactivity to Phl p 4, Phl p7, Phl p 11 or Phl 12 may be due to cross-reactivity (CCD or panallergenicity). Early onset of IgE sensitisation to grass pollen allergens, particularly Phl p 1, and a high number of sensitisations (Phl p 5, 7 and 12) may be prognostic markers ...

Reacciones de hipersensibilidad  (Dra. Valeria Zapata Marin) Esteroides topicos (Dr. Steven Abreu)

Update on risk factors for food allergy. Authors: Lack G1. Abstract Despite efforts to prevent food allergy (FA) in children, IgE-mediated FAs are increasing in westernized countries. Previous preventive strategies, such as prolonged exclusive breast-feeding and delayed weaning onto solid foods, have recently been called into question. The present review considers possible risk factors and theories for the development of FA. An alternative hypothesis is proposed, suggesting that early cutaneous exposure to food protein through a disrupted skin barrier leads to allergic sensitization and that early oral exposure to food allergen induces tolerance. Novel interventional strategies to prevent the development of FA are also discussed. DOI:  http://doi.org/10.1016/j.jaci.2012.02.036

Treatment of urticarial vasculitis: A systematic review. Authors: Kolkhir P1, Grakhova M2, Bonnekoh H3, Krause K3, Maurer M4. Abstract Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by the severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in 7 databases, including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique patients with UV were included in the systematic review. Most patients with UV are adult women with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic but can be associated with drugs, malignancy, autoimmunity, and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of ski...

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions. Authors : Garvey LH1,2, Ebo DG3, Mertes PM4, Dewachter P5, Garcez T6, Kopac P7, Laguna JJ8, Chiriac AM9,10, Terreehorst I11, Voltolini S12, Scherer K13. Abstract Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper ...