RESUMEN
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Recent researches show that fish is 1 of the most important triggers of FPIES in the Mediterranean countries. Due to the risk of multiple-food FPIES, avoiding foods in the same category or that often occur together may be reasonable. The aim of this study was to evaluate the evolution and follow-up of FPIES related to fish over a period of 20 years. We describe the clinical features of our population, discuss different approaches to oral food challenges, and analyze the possibility of introducing the culprit fish or other nonrelated fish to avoid unnecessary restricted diets.
Asunto(s)
Enterocolitis/inmunología , Peces , Hipersensibilidad a los Alimentos/inmunología , Animales , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios RetrospectivosAsunto(s)
Enterocolitis , Hipersensibilidad a los Alimentos , Humanos , Lactante , Hipersensibilidad a los Alimentos/diagnóstico , Hipersensibilidad a los Alimentos/epidemiología , Proteínas en la Dieta/efectos adversos , Enterocolitis/diagnóstico , Enterocolitis/epidemiología , Enterocolitis/etiología , Encuestas y Cuestionarios , AlérgenosRESUMEN
BACKGROUND: Food allergy markedly impairs quality of life, and avoiding the offending food requires extensive patient education. Social media have been proven a useful source of information for other chronic conditions. Our aim was to describe how pediatric patients with food allergy and their families are using social media. METHODS: We performed a cross-sectional study in the pediatric allergy unit of a tertiary hospital. Patients with food allergy were questioned about their disease and their use of social media. The survey was completed by the patients themselves in the case of those aged over 13 years and by parents or guardians in the case of younger patients. RESULTS: We included 193 patients (162 guardians, 31 adolescents). Social media were used by 109 guardians (67.3%) and 29 adolescents (90.3%), of whom 30.3% and 6.9%, respectively, used them for food allergy-related purposes. The most popular websites were Facebook for guardians (52.2%) and YouTube for teenagers (80.6%). Having cow's milk and/or egg allergy was the only feature related to using social media for food allergy. Using social media for information on food allergy did not correlate with the frequency of recent reactions, self-scored knowledge about food allergy, or opinion on evidence-based or alternative therapies for the disease. CONCLUSIONS: Most patients and guardians of patients with food allergy used social media. However, only a small portion accessed used them to increase their knowledge of the disease.
Asunto(s)
Alergia e Inmunología/educación , Hipersensibilidad a los Alimentos/epidemiología , Internet/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Adulto , Alérgenos/inmunología , Niño , Preescolar , Estudios Transversales , Alimentos , Humanos , Inmunoglobulina E/metabolismo , Tutores Legales , Persona de Mediana Edad , Padres , Calidad de Vida , España/epidemiologíaAsunto(s)
Microbioma Gastrointestinal , Abuelos , Hipersensibilidad a la Leche , Animales , Bovinos , Femenino , Humanos , Leche/efectos adversos , MadresRESUMEN
OBJECTIVE: To compare the skin prick test (SPT) with in vitro techniques (single and multiplex fluorescence enzyme-immunoassay [FEIA]) for detecting sensitization to profilin and lipid transfer protein (LTP). METHODS: We retrospectively studied 181 patients with pollen and/or plant food allergy and 61 controls. SPT was performed with date palm profilin (Pho d 2) and peach LTP (Pru p 3), and specific IgE (sIgE) to Phl p 12 and Pru p 3 was analyzed using single FEIA and microarray. RESULTS: Fifteen of 201 patients with negative results for LTP in the SPT were sensitized to this allergen in the in vitro tests, and 18 of 41 patients with positive results for LTP in the SPT were not sensitized according to the in vitro tests. Seventeen of 186 patients with negative results for profilin in the SPT were sensitized to Phl p 12 by serum sIgE, and 30 out of 56 patients with positive results for profilin in SPT were not sensitized to Phl p 12 according to the other tests. Moderate agreement was observed between the 3 techniques studied. CONCLUSIONS: SPT is a sensitive technique for detecting sensitization to LTP and profilin. Its results are similar to those of in vitro techniques, especially in patients with negative SPT results for peach LTP and palm tree profilin.
Asunto(s)
Proteínas Portadoras/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Profilinas/inmunología , Prunus/inmunología , Rinitis Alérgica Estacional/diagnóstico , Pruebas Cutáneas , Humanos , Inmunoglobulina E/sangre , Técnicas In Vitro , Estudios RetrospectivosAsunto(s)
Alérgenos/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Fragaria/inmunología , Administración Oral , Niño , Reacciones Cruzadas , Diagnóstico Diferencial , Femenino , Hipersensibilidad a los Alimentos/epidemiología , Humanos , Inmunización , Inmunoglobulina E/sangre , Masculino , Región Mediterránea/epidemiología , Profilinas/inmunología , AutoinformeAsunto(s)
Contaminación del Aire/efectos adversos , Anafilaxia/diagnóstico , Anafilaxia/etiología , Cannabis/efectos adversos , Fumar Marihuana/efectos adversos , Adolescente , Femenino , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Masculino , Evaluación de Síntomas , Adulto JovenAsunto(s)
Anafilaxia/tratamiento farmacológico , Broncodilatadores/administración & dosificación , Epinefrina/administración & dosificación , Hipersensibilidad a los Alimentos/tratamiento farmacológico , Adolescente , Niño , Preescolar , Femenino , Humanos , Inyecciones , Masculino , AutoadministraciónRESUMEN
Allergic skin tests have to be performed 4-6 weeks after an allergic anesthetic reaction. Patients with allergic reactions during anesthesia were prospectively included (n = 44). Skin tests were performed in two stages: (i) Stage 1 (S1), 0-4 days after the reaction; and (ii) Stage 2 (S2), 4-8 weeks after. Five (11.5%) surgical procedures were suspended due to the reaction. Positive skin tests were obtained in 25/44 patients (57%). Allergic diagnosis was carried out at S1 in 15/25 (60%) and at S2 in 10/25 (40%). Three patients resulted positive only in S1. Overall agreement among S1 and S2 skin tests was 70.45%. The kappa statistic was 0.41 (P-value = 0.002). Odds ratio of obtaining a false negative in S1 (compared with S2) was 3.33. Early allergological study is useful, could minimize false negatives, but should be considered as a complement to late skin tests.
Asunto(s)
Anafilaxia/diagnóstico , Anestesia , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad Inmediata/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anafilaxia/inducido químicamente , Niño , Hipersensibilidad a las Drogas/etiología , Diagnóstico Precoz , Reacciones Falso Negativas , Femenino , Humanos , Hipersensibilidad Inmediata/inducido químicamente , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Pruebas Cutáneas , Adulto JovenRESUMEN
BACKGROUND: Few data on the diagnostic accuracy in pollinosis of the microarray ISAC of allergens are available. OBJECTIVE: We aim to comparatively analyse ISAC CRD103 with the whole-extract ImmunoCAP in grass and cypress pollen allergy, evaluating the suitability of the manufacturer's recommended cut-off points for both techniques. METHODS: We studied 120 atopic patients grouped into grass and cypress pollen-allergic patients and controls based on clinical history and skin prick tests. Specific IgE against Phleum pratense and Cupressus arizonica by ImmunoCAP and ISAC CRD103 were performed on all subjects. RESULTS: In the grass pollen group (43 allergic/26 controls), both microarray and CAP showed high sensitivity (Se) and specificity (Sp) values (ISAC: Se 97.7, Sp 92.3; CAP: Se 95.3, Sp 96.1) for recommended cut-off points. Comparing the optimal (ISAC: 0.4 ISU; CAP: 0.33 kU/L) with the recommended cut-off points within the same technique, diagnostic agreement was observed in both techniques. Thus, CAP and ISAC showed similar diagnostic performance in grass pollen allergy when using recommended cut-off points. In cypress pollen group (12 allergic/92 controls), the microarray (Se: 91.7, Sp 91.3) showed similar Se but significantly higher Sp (P=0.034) than CAP (Se: 91.7, Sp: 80.4) using recommended cut-off points. However, although diagnostic performance of the microarray did not change when comparing the optimal (0.82 ISU) with the recommended cut-off point, CAP improved diagnosis of cypress pollen allergy, when applying the optimal (0.66 kU/L)(CAP Se: 91.7, Sp: 89.1) instead of the manufacturer's recommended cut-off point. Thus, when the most suitable cut-off point for both techniques (ISAC: 0.3 ISU; CAP: 0.66 kU/L) is selected, microarray and CAP provide equivalent diagnoses. CONCLUSIONS AND CLINICAL RELEVANCE: Component-based microarray ISAC CRD103 and whole-allergen CAP showed high Se and Sp diagnosing equally grass and cypress pollen allergy. The cut-off point for each allergen should be properly applied for both techniques.
Asunto(s)
Cupressus/inmunología , Hipersensibilidad Inmediata/diagnóstico , Inmunoensayo/métodos , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Poaceae/inmunología , Polen/inmunología , Rinitis Alérgica Estacional/diagnóstico , Adolescente , Adulto , Anciano , Alérgenos/química , Alérgenos/genética , Alérgenos/inmunología , Niño , Preescolar , Femenino , Fluorescencia , Humanos , Hipersensibilidad Inmediata/inmunología , Inmunoglobulina E/sangre , Masculino , Persona de Mediana Edad , Rinitis Alérgica Estacional/inmunología , Sensibilidad y Especificidad , Pruebas Cutáneas , Adulto JovenAsunto(s)
Basófilos/inmunología , Chironomidae/inmunología , Hipersensibilidad/diagnóstico , Hipersensibilidad/inmunología , Pruebas Cutáneas , Adulto , Alérgenos/inmunología , Animales , Antígenos CD/inmunología , Antígenos CD/metabolismo , Cetirizina/uso terapéutico , Femenino , Antagonistas de los Receptores Histamínicos H1 no Sedantes/uso terapéutico , Humanos , Hipersensibilidad/tratamiento farmacológico , Inmunoglobulina E/inmunología , Larva/inmunología , Glicoproteínas de Membrana Plaquetaria/inmunología , Glicoproteínas de Membrana Plaquetaria/metabolismo , Tetraspanina 30 , Resultado del TratamientoAsunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Complicaciones de la Diabetes , Diabetes Mellitus Lipoatrófica/tratamiento farmacológico , Hipersensibilidad a las Drogas/tratamiento farmacológico , Hipotiroidismo/tratamiento farmacológico , Insulina/efectos adversos , Piel/efectos de los fármacos , Adulto , Complejo Antígeno-Anticuerpo/metabolismo , Autoanticuerpos/inmunología , Autoanticuerpos/metabolismo , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/inmunología , Enfermedades Autoinmunes/fisiopatología , Diabetes Mellitus Lipoatrófica/complicaciones , Diabetes Mellitus Lipoatrófica/inmunología , Diabetes Mellitus Lipoatrófica/fisiopatología , Hipersensibilidad a las Drogas/complicaciones , Hipersensibilidad a las Drogas/inmunología , Hipersensibilidad a las Drogas/fisiopatología , Femenino , Humanos , Hipotiroidismo/complicaciones , Hipotiroidismo/inmunología , Hipotiroidismo/fisiopatología , Inmunoglobulina E/inmunología , Inmunoglobulina E/metabolismo , Insulina/administración & dosificación , Insulina/análogos & derivados , Lipodistrofia , Neutrófilos/patología , Piel/inmunología , Piel/metabolismo , Piel/patologíaAsunto(s)
Hipersensibilidad/diagnóstico , Inmunoglobulina E/metabolismo , Análisis por Matrices de Proteínas , Juego de Reactivos para Diagnóstico/normas , Pruebas Serológicas/métodos , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina E/inmunología , Variaciones Dependientes del Observador , Estándares de Referencia , Reproducibilidad de los Resultados , Pruebas Serológicas/instrumentación , Programas Informáticos/normasAsunto(s)
Atropina/inmunología , Basófilos/inmunología , Hipersensibilidad a las Drogas/diagnóstico , Atropina/administración & dosificación , Niño , Técnicas de Diagnóstico Oftalmológico , Hipersensibilidad a las Drogas/complicaciones , Hipersensibilidad a las Drogas/inmunología , Femenino , Humanos , Pruebas CutáneasAsunto(s)
Antifúngicos/efectos adversos , Hipersensibilidad a las Drogas/inmunología , Micosis/inmunología , Nistatina/efectos adversos , Infecciones Oportunistas/inmunología , Enfermedades Dentales/inmunología , Administración Oral , Amoxicilina/administración & dosificación , Amoxicilina/efectos adversos , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Antifúngicos/administración & dosificación , Erupciones por Medicamentos/prevención & control , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/fisiopatología , Hipersensibilidad a las Drogas/prevención & control , Eritema/inducido químicamente , Eritema/prevención & control , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/inmunología , Masculino , Persona de Mediana Edad , Micosis/complicaciones , Micosis/tratamiento farmacológico , Nistatina/administración & dosificación , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/tratamiento farmacológico , Pruebas del Parche/métodos , Factores de Tiempo , Enfermedades Dentales/complicaciones , Enfermedades Dentales/tratamiento farmacológico , Enfermedades Dentales/cirugía , Privación de TratamientoRESUMEN
In recent years, thanks to advances in molecular biology, allergological diagnosis has improved and specific IgE (sIgE) against an allergenic source has been transformed into sIgE against an allergenic protein or glycoprotein. This change, which has resulted in a more precise diagnosis of sensitisation, could explain the different dangers of certain molecular sensitisations and in many cases cross-reactivity phenomena, and could change indications for immunotherapy or clinical management. Here, we present two cases of children where the indication for immunotherapy and management of the disorder changed due to component-resolved diagnosis. However, the clinical history and skin prick tests should complement molecular in vitro diagnosis to improve routine clinical practice.