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1.
Int Arch Allergy Immunol ; 177(4): 365-369, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30176659

RESUMEN

Cross-reactions between Polistes dominula and Vespula species are common in southern Europe. Currently, only CAP-inhibition demonstrates high accuracy in identifying genuine sensitizations, but this method is time-consuming and expensive, so a new approach is required. This study investigates skin tests, molecular diagnostics, total IgE (tIgE), and the Ves v 5/Pol d 5 (or vice versa) ratio. The ratio generated low-accuracy results and poor agreement with CAP-inhibition, and we did not find any agreement between CAP-inhibition test and double values of Ves v 5/Pol d 5. Nevertheless, a slight diagnostic improvement was obtained when Ves v 5/tIgE and Pol d 5/tIgE were measured.


Asunto(s)
Alérgenos/inmunología , Anafilaxia/diagnóstico , Reacciones Cruzadas , Desensibilización Inmunológica/métodos , Hipersensibilidad/diagnóstico , Mordeduras y Picaduras de Insectos/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Europa (Continente) , Femenino , Humanos , Inmunización , Inmunoglobulina E/sangre , Masculino , Persona de Mediana Edad , Patología Molecular , Reproducibilidad de los Resultados , Pruebas Cutáneas , Ponzoñas/inmunología , Avispas/inmunología , Adulto Joven
2.
Am J Hematol ; 91(7): 692-9, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27060898

RESUMEN

Systemic mastocytosis is a rare heterogeneous myeloproliferative neoplasm characterized by abnormal proliferation and activation of mast cells. We describe a large multicentre series of 460 adult patients with systemic mastocytosis, with a diagnosis based on WHO 2008 criteria, in a "real-life" setting of ten Italian centers with dedicated multidisciplinary programs. We included indolent forms with (n = 255) and without (n = 165) skin lesions, smouldering (n = 20), aggressive (n = 28), associated with other hematological diseases mastocytosis (n = 21) and mast cell leukemia (n = 1). This series was uniquely characterized by a substantial proportion of patients with low burden of neoplastic mast cells; notably, 38% of cases were diagnosed using only minor diagnostic criteria according to WHO 2008 classification, underlying the feasibility of early diagnosis where all diagnostic approaches are made available. This has particular clinical relevance for prevention of anaphylaxis manifestations, that were typically associated with indolent forms. In multivariate analysis, the most important features associated with shortened overall survival were disease subtype and age at diagnosis >60 years. Disease progression was correlated with mastocytosis subtype and thrombocytopenia. As many as 32% of patients with aggressive mastocytosis suffered from early evolution into acute leukemia. Overall, this study provides novel information about diagnostic approaches and current presentation of patients with SM and underlines the importance of networks and specialized centers to facilitate early diagnosis and prevent disease-associated manifestations. Am. J. Hematol. 91:692-699, 2016. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Mastocitosis Sistémica/clasificación , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Manejo de la Enfermedad , Progresión de la Enfermedad , Diagnóstico Precoz , Femenino , Humanos , Italia , Masculino , Mastocitosis Sistémica/diagnóstico , Mastocitosis Sistémica/mortalidad , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Encuestas y Cuestionarios , Tasa de Supervivencia , Adulto Joven
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