ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Drug hypersensitivity in the fast lane: What clinicians should know about phenotypes, endotypes, and biomarkers Authors: Baruch D Jakubovic  1 , Leticia de Las Vecillas  2 , Teodorikez Wilfox Jimenez-Rodriguez  3 , Soledad Sanchez-Sanchez  4 , Mariana Castells  5 Abstract Objective: To review novel concepts in drug hypersensitivity and the management of immediate hypersensitivity reactions. Data sources: English language literature on MEDLINE and Embase surrounding drug hypersensitivity and desensitization. Study selections: References were selected based on relevance, date of publication, and originality. Results: There are numerous citations looking at categorizing drug reactions, pathogenesis, biomarkers, and desensitization. Current understanding supports the use of a phenotype-endotype-biomarker model for categorizing immediate hypersensitivity reactions. Drug desensitization is a powerful therapeutic strategy that enables temporary induction of...

Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study Authors: Nicole Schoepke  1 , Riccardo Asero  2 , André Ellrich  1 , Marta Ferrer  3 , Ana Gimenez-Arnau  4 , Clive E H Grattan  5 , Thilo Jakob  6   7 , George N Konstantinou  8 , Ulrike Raap  9 , Per Stahl Skov  10   11 , Petra Staubach  12 , Arno Kromminga  13   14 , Ke Zhang  15 , Carsten Bindslev-Jensen  16 , Alvaro Daschner  17 , Tamar Kinaciyan  18 , Edward F Knol  19 , Michael Makris  20 , Nadine Marrouche  21 , Peter Schmid-Grendelmeier  22   23 , Gordon Sussman  24 , Elias Toubi  25 , Martin K Church  1 , Marcus Maurer  1 Abstract Background: Autoimmune chronic spontaneous urticaria (aiCSU) is an important subtype of chronic spontaneous urticaria (CSU) in which functional IgG autoantibodies to IgE or its high-affinity re...

Hypersensitivities to sesame and other common edible seeds Authors: A. Patel  S. L. Bahna Abstract Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1–0.2%. In this review, we summarize the information relevant to each of the six seeds and t...

Risk and Management of Patients with Mastocytosis and MCAS in the SARS-CoV-2 (COVID-19) Pandemic: Expert Opinions  Authors: PeterValentM.D.1CemAkinM.D., Ph.D.2PatriziaBonadonnaM.D.3KnutBrockowM.D.4MarekNiedoszytkoM.D., Ph.D.5BoguslawNedoszytkoPh.D.6Joseph H.ButterfieldM.D.7IvanAlvarez-TwoseM.D., Ph.D.8KarlSotlarM.D.9JulianaSchwaabM.D.10MohamadJawharM.D.10AndreasReiterM.D.10MarianaCastellsM.D., Ph.D.11Wolfgang R.SperrM.D.1Hanneke C.Kluin-NelemansM.D., Ph.D.12OlivierHermineM.D., Ph.D.13JasonGotlibM.D., M.S.14RobertaZanottiM.D. Abstract The COVID-19 (SARS-CoV-2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase and patients at risk can only be protected to a degree, since the virulent state may be asymptomatic. Risk factors concerning COVID-19-induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obe...

Risk Factors Influencing Tolerance and Clinical Features of Food Protein-induced Allergic Proctocolitis Authors: Betul Buyuktiryaki  1 , Ilknur Kulhas Celik  1 , Semiha B Erdem  2 , Murat Capanoglu  3 , Ersoy Civelek  1 , Belgin Usta Guc  4 , Hakan Guvenir  1 , Murat Cakir  5 , Emine Dibek Misirlioglu  1 , Omer Akcal  2 , Burcu Volkan  3 , Muge Toyran  1 , Elif Sag  5 , Alev C Kertel  3 , Tayfur Ginis  1 , Can N Kocabas  6 , Fazıl Orhan  5 , Demet Can  2   7 Abstract Objective: Continued progress in our understanding of the food protein-induced allergic proctocolitis (FPIAP) will provide the development of diagnostic tests and treatments. We aimed to identify precisely the clinical features and natural course of the disease in a large group of patients. Also, we investigated the predicting risk factors for persistent course since influencing parameters has not yet been established. ...

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis Authors: Derek K Chu, Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub, Holger J Schünemann, on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors* Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person- to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to- person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respirato...

Macrolide Allergic Reactions Authors: Kristy M Shaeer  1 , Elias B Chahine  2 , Sheeba Varghese Gupta  3 , Jonathan C Cho  4 Abstract Macrolides are antimicrobial agents that can be used to treat a variety of infections. Allergic reactions to macrolides occur infrequently but can include minor to severe cutaneous reactions as well as systemic life-threatening reactions such as anaphylaxis. Most reports of allergic reactions occurred in patients without prior exposure to a macrolide. Cross-reactivity among macrolides may occur due to the similarities in their chemical structures; however, some published literature indicates that some patients can tolerate a different macrolide. Most published reports detailed an allergic reaction to erythromycin. Desensitization protocols to clarithromycin and azithromycin have been described in the literature. The purpose of this article is to summarize macrolide-associated allergic reactions reported in published literature...

Hypersensitivity Reactions to Food Additives Authors: Guillermo Velázquez-Sámano 1, Rodrigo Collado-Chagoya, Rubén Alejandro Cruz-Pantoja, Andrea Aída Velasco-Medina, Juan Rosales-Guevara Abstract  Food additives are ingredients that are intentionally added to food in order to modify its physical, chemical, biological, or sensorial characteristics. Food additives may act as allergens and generate IgE-mediated immune reactions, or they may act as pseudo allergens and generate non-IgE-mediated immune reactions. Such reactions can generate diverse clinical pictures or they may exacerbate diseases as diverse as eosinophilic esophagitis, bronchial asthma, atopic dermatitis, contact dermatitis, chronic urticaria, or anaphylaxis. Thousands of food additives are being used daily in industrialized countries and, although their use has been globalized, there is not much science information about their adverse effects; especially about their hypersensitivity reactions that, despite be...

Clinical Characteristics of 182 Pediatric COVID-19 Patients With Different Severities and Allergic Status Authors; Hui Du 1, Xiang Dong 2, Jin-Jin Zhang 2, Yi-Yuan Cao 3, Mubeccel Akdis 4, Pei-Qi Huang 1, Hong-Wei Chen 1, Ying Li 1, Guang-Hui Liu 2, Cezmi A Akdis 4, Xiao-Xia Lu 1, Ya-Dong Gao 2 Abstract Background: The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has made widespread impact recently. We aim to investigate the clinical characteristics of COVID-19 children with different severities and allergic status. Methods: Data extracted from the electronical medical records, including demographics, clinical manifestations, comorbidities, laboratory and immunological results and radiological images of 182 hospitalized COVID-19 children were summarized and analyzed. Results: The median age was 6 years old, ranging from 3 days to 15 years, and there were more boys (male-female ratio about 2:...

Glycopeptide Hypersensitivity and Adverse Reactions Authors: Vanthida Huang 1, Nicola A Clayton 2, Kimberly H Welker 3 Abstract Glycopeptides, such as vancomycin and teicoplanin, are primarily used in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections, such as cellulitis, endocarditis, meningitis, pneumonia, and septicemia, and are some of the most commonly prescribed parenteral antimicrobials. Parenteral glycopeptides are first-line therapy for severe MRSA infections; however, oral vancomycin is used as a first-line treatment of Clostridioides difficile infections. Also, we currently have the longer-acting lipoglycopeptides, such as dalbavancin, oritavancin, and telavancin to our armamentarium for the treatment of MRSA infections. Lastly, vancomycin is often used as an alternative treatment for patients with β-lactam hypersensitivity. Common adverse effects associated with glycopeptide use include nephrotoxicity, ototoxicity, and Redman Syndrome (R...

Diagnosis and prevention of food-dependent exercise-induced anaphylaxis Authors: Filipe Benito-Garcia, Ignacio Javier Ansotegui & Mário Morais-Almeida ABSTRACT Introduction: Food-dependent, exercise-induced anaphylaxis (FDEIA) is a rare type of anaphylaxis with a growing incidence. Although the precise mechanism by which the patient reacts only in a combination of a culprit food and cofactors are not currently understood, many advances in diagnosis and management have been made since their first description. Areas covered: A literature search in PubMed was performed to review the diagnosis and management of FDEIA. Clinicians should have a high level of suspicion for identification of the culprit foods and the cofactors involved. Component-resolved diagnosis and more accurate provocation tests have revolutionized the diagnosis accuracy. Management is not easy and involves educating the patient to evict the combination of exposure to the culprit foods and the cofactors t...