ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Eleven Faces of Coronavirus Disease 2019 Authors: Xiang Dong  1 , Yi-Yuan Cao  2 , Xiao-Xia Lu  3 , Jin-Jin Zhang  1 , Hui Du  3 , You-Qin Yan  4 , Cezmi A Akdis  5 , Ya-Dong Gao  1 Abstract Background and aims: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently spread worldwide and been declared a pandemic. We aim to describe here the various clinical presentations of this disease by examining eleven cases. Methods: Electronic medical records of 11 patients with COVID-19 were collected, and demographics, clinical manifestations, outcomes, key laboratory results, and radiological images are discussed. Results: The clinical course of the eleven cases demonstrated the complexity of the COVID-19 profile with different clinical presentations. Clinical manifestations range from asymptomatic cases to patients with mild and severe symptoms, with or wi...

Peanut allergy diagnosis moving from basic to more elegant testing Autor: Dr. Steven Fuentes 

Equipo de protección personal y COVID-19. New England Journal of Medicine 

COVID-19: risk for cytokine targeting in chronic inflammatory diseases? Authors: Schett G1,2, Sticherling M3,4, Neurath MF3,5. Abstract COVID-19, caused by the SARS-CoV-2 virus, has become pandemic. With sharply rising infection rates, patient groups characterized by an enhanced infection risk will be challenged by the virus. In this context, patients with chronic immune-mediated inflammatory diseases are of particular interest, as these diseases are characterized by an intrinsic immune dysfunction leading to inflammation that may enhance risk for severe infection. DOI:   10.1038/s41577-020-0312-7

Opioid Hypersensitivity: Predictors of Allergy and Role of Drug Provocation Testing Authors: Philip H Li  1 , Kok Loong Ue  2 , Annette Wagner  3 , Ryszard Rutkowski  4 , Krzysztof Rutkowski  5 Abstract Background: True IgE-mediated hypersensitivity to opioids is rare and many reactions are due to direct mast cell degranulation. Opioid drug provocation testing (DPT) is the gold standard for diagnosis but is underutilized. Objective: The objective of this study was to evaluate the clinical characteristics and predictors of opioid hypersensitivity, as well as outcomes of opioid DPT. Methods: Patients referred for opioid DPT over the past 9 years were studied. Patient characteristics, indications for opioid use, symptoms of index reaction, and outcomes of DPT were analyzed. Association analysis was performed to study variables associated with a diagnosis of opioid hypersensitivity. Results: Of the total of 98 patients referred with suspected opioid hyp...

Prurito crónico Dr. Steven Fuentes 

Risk Factors for Hen's Egg Allergy in Europe: EuroPrevall Birth Cohort Authors: Kate E.C. Grimshaw, PhD Graham Roberts, MD  Anna Selby, BM E.N. Clare Mills, PhD Thomas Keil, MD Kirsten Beyer, MD Abstract Background Hen's egg is one of the commonest causes of food allergy, but there are little data on its risk factors. Objective To assess the risk factors, particularly eczema, for hen's egg allergy in the EuroPrevall birth cohort. Methods In the pan-European EuroPrevall birth cohort, questionnaires were undertaken at 12 and 24 months or when parents reported symptoms. Children with suspected egg allergy were invited for skin prick testing, specific IgE assessment, and double-blind, placebo-controlled food challenge (DBPCFC) as indicated. Each egg allergy case (positive DBPCFC or egg-induced anaphylaxis) was allocated up to 2 age- and country-matched controls. Results A total of 12,049 infants were recruited into the EuroPrevall birth cohort, and 9,336 (...

Adverse reactions during procedures hypersensitivity to contrast agents and dyes Authors: Christine Schönmann, MD, Knut Brockow, MD  Abstract Objective This review provides an overview of the literature on hypersensitivity reactions during procedures to commonly used contrast agents and dyes. A synthesis of current knowledge on clinical symptoms, epidemiology and risk factors, pathomechanism, and management of hypersensitivity reactions to these substances is presented. Data Sources A literature search was conducted through Medline. Included were peer-reviewed articles written in English between 2000 and 2019. Study Selections Relevant clinical studies, experimental studies, and review articles have been selected. Additionally, case reports have been included if they carried significant information about rare clinical forms of hypersensitivity reactions, disease mechanisms, or therapy. Results An allergological workup is only indicated for patients with...

“Amóldate a las cosas que te han tocado en suerte y a las personas con las que te ha tocado en suerte vivir, ámalas pero de verdad”  Marco Aurelio

Érase una vez....

Hipersensibilidad a corticosteroides Dra. Yurlany Gutierrez

Fisiopatología Urticaria.  Autor:  Dra. Valeria Zapata 

Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry Authors: Magdalena Kraft et al. Abstract Background Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. Methods Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. Results The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, masto...

Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover Authors: Annarosa Soresina  Daniele Moratto  Marco Chiarini  Ciro Paolillo  Giulia Baresi  Emanuele Focà  Michela Bezzi  Barbara Baronio  Mauro Giacomelli  Raffaele Badolato First published:22 April 2020 Abstract Background The recent SARS‐Cov2 pandemic, which has recently affected Italy since February 21, constitutes a threat for normal subjects, as the Coronavirus Disease 19 (COVID19) can manifest with a broad spectrum of clinical phenotypes ranging from asymptomatic cases to pneumonia or even death. There is evidence that older age and several comorbidities can affect the risk to develop severe pneumonia and possibly the need of mechanic ventilation in subjects infected with SARS‐Cov2. Therefore, we evaluated the outcome of SARS‐Cov2 infection in patients with inborn errors of immunity (IEI) such as X linked agammaglobulinemia (XLA). ...

Antimaláricos y COVID-19, revisión de la literatura a 15 de abril de 2020 Autor: Dr. Steven Fuentes  La infección por SARS-CoV-2 representa un reto actual para la humanidad, no únicamente por el hecho de su comportamiento como pandemia, si no al no haber disponibilidad de un tratamiento especifico contra el microrganismo en cuestión. En los medios de difusión se ha informado de la posibilidad del uso de antimaláricos como un tratamiento efectivo para el COVID-19, sin embargo, a la luz de la literatura científica actualmente publicada, ¿qué tan respaldada esta dicha propuesta? El presente documento es una revisión personal de la literatura con el fin de contestar este interrogante. El COVID-19 como enfermedad emergente propone un reto sanitario como informa Zunyo et al1, ya que el 81 % de los casos tiene un comportamiento leve, 14 % grave y 5% critico con requerimiento de manejo en unidad de cuidados intensivos; es con esta evidencia que se hace imperante la búsqueda de a...

Importance of Diagnostics Prior to Desensitization in New Drug Hypersensitivity: Chemotherapeutics and Biologicals Ricardo Madrigal-Burgaleta MD, PhD, P. Vazquez-Revuelta MD, J. Marti-Garrido MD, R. Lleonart MD, F. R. Ali MBBS, PhD & Emilio Alvarez-Cuesta MD, PhD  Abstract  Purpose of review In this review article, we intend to summarize the diagnostic tools available for the study of drug hypersensitivity reactions to chemotherapy and biologicals, based on the experience and controversies of the main research groups leading the topic. Recent findings Recent publications with large cohorts of patients reacting to these drugs are allowing for a better understanding of phenotyping, endotyping, and optimally managing these patients. Summary There is a remarkable heterogeneity on the diagnostic and therapeutic approach among the different groups, and yet this has allowed for very interesting discoveries. Clinical history alone is insufficient for a diagnosis,...