Prevalence of sensitization to inhaled and food allergens in a group of children with primary renal tubular acidosis.

OBJECTIVE: Some reports associate certain illnesses of the urinary system with allergies. Thus, we decided to examine the prevalence of sensitization to allergens in a group of children with primary renal tubular acidosis (RTA). METHODS: Children with primary RTA who attended the nephrology department at a third level pediatric hospital during a four-month period, were included. With informed parental consent, a questionnaire and skin prick test, total IgE, specific IgE and milk precipitins were performed. RESULTS: Forty-three children were included, aged 5 months to 9 years (mean, 3.4 ± 1.8 years), and a male/female ratio of 1.7:1. The age of onset of ATR ranged from 2 to 18 months. The most common symptoms at the beginning of disease were: failure to thrive and lack of appetite. Twenty-one parents (48.8%) noticed an association between the introduction of cow´s milk and the beginning of symptoms. Skin tests were positive in 27.9%. Total IgE levels were elevated in 34.9%, ranged from 5.9 to 324 IU/mL. Allergen-specific IgE was positive in 25.6%, mainly for milk, wheat and egg white. The milk precipitins test was positive in 9 patients (21%). CONCLUSIONS: Although this study demonstrated the existence of allergen sensitization in a group of children with RTA, it is necessary to look for this association in studies with larger sample size and to use tests with higher specificity and sensitivity.

Estigmas atópicos en preescolares con rinitis alérgica / Atopic stigmas in chilhood with allergic rhinitis

Se realizó un estudio prospectivo con la finalidad de conocer las características clínicas encontradas más frecuentemente en los pacientes con RA. Se incluyeron a 90 niños con edades de cuatro y cinco años que acudieron al Instituto Nacional de Pediatría, 60 de los cuales tenían diagnóstico de RA y 30 controles libres de enfermedad alérgica. A todos los pacientes con RA se realizaron pruebas cutáneas por el método de punción para demostrar la etiología alérgica y a todos se les determinó IgE total en suero, se realizó exploración física buscando intencionadamente la presencia de stigmas atópicos. Se encontró que la RA se presenta mas frecuentemente en el sexo masculino con una relación de 1.7:1 a esta edad; que un 75 por ciento de los pacientes tenían antecedentes atópicos y que la enfermedad alérgica asociada más frecuentemente es el asma. Las líneas de Dennie Morgan, ojeras alérgicas, conjuntivitis, gesticulaciones, surco nasal, saludo alérgico, xerosis y palidez fueron los estigmas atópicos que se encontraron en mayor porcentaje y con diferencia estadísticamente significativa comparados con el grupo control. Los niveles de IgE se encontraron elevados en 85 por ciento de los pacientes con RA. Se concluye que estos estigmas son dependientes de la presencia de RA