[Anamnesis and skin test to prevent fatal reactions to iodinated contrast media]. / Anamnesis y prueba cutánea para prevenir reacciones fatales por medios de contraste yodados.

AIMS: The phenomenon of allergic and toxic reaction to the means of yodates contrast occurs with greater frequency than what registers the literature. For this motive was effected the present study. MATERIAL AND METHOD: 178,439 cases of patients exposed to iodinated contrast media (ICM) corresponding to 137,147 to patients for excretory urography and 41,292 to cholangiography were studied. A direct interrogation making emphasis on personal antecedents of allergy to contrast media, iodinated products usage, nervous system and cardiovascular illnesses was made. Cutaneous test for iodinated contrast media was applied. If the result was positive no study with ICM was made or it was made with special guidelines. RESULTS: 4,302 positive and 1,276 false negatives were found, 287 positive cases were premedicated and preventive medication was administered in cases of urticaria asthma/and angioedema with negative cutaneous test histories. There were no deaths registered. CONCLUSIONS: The means of yodate contrast are susceptible of unfettering adverse reactions of pharmacological type or immunologic. For this reason is emphasised the usefulness of the anamnesis and the tests of intradermorreaction to detect cases of serious reaction.

[Non-fatal reactions to iodinated contrast media: 29 years of experience]. / Reacciones a medios de contraste yodados sin muertes. Experiencia durante 29 años.

178 439 cases of patients exposed to iodinated contrast media (ICM) corresponding to 137 147 to patients for excretory urography and 41 292 to cholangiography were studied. A direct interrogation making emphasis on personal antecedents of allergy to contrast media, iodinated products usage, nervous system and cardiovascular illnesses was made. Cutaneous test for iodinated contrast media was applied. If the result was positive no study with the ICM was made or it was made with special guidelines. 4302 positives and 1276 false negatives were found. 287 positive cases were premeditated and preventive medication was administered in cases of urticaria asthma/and angioedema with negative cutaneous test histories. There were no deaths registered.

[Clinical polymorphism in Epstein-Barr virus infection]. / Polimorfismo clínico en infección por virus de Epstein Barr.

Several diseases was associated with Epstein Barr virus (EBV) infection. In the next three cases, the clinical course was unusual . Case I: Polyclonal hypergammaglobulinemia, female 47 years old, she had systemic lupus erythematosus and clinical data of infectious mononucleosis but she evolved to a polyclonal gammopathy with IgM predominantly against EBV. Case II: Demyelinating encephalitis, male, 32 years old with central neurological alterations, IgM antibodies against EBV and demyelinating lesion in magnetic resonance image in brain steam. Case III. Villous leukoplakia, male, 40 years old developed right tonsil tumor. He had IgM antibodies against EBV. The antiviral and immunomodulator treatment (specific for each case) done a satisfactory clinical response in the three patients.

[Vasculitis and viral infection]. / Vasculitis e infección viral.

Viruses have been implicated in vasculitis. To determine activity of viral infection associated with vasculitis. 17 patients with vasculitis had been in immunological and antiviral antibodies evaluation. Twenty five healthy controls sex and age matched with hematic biometry (BH) and AA. All subjects were negative to HIV and HBV. Viral activity was demonstrated in eight patients; vascular purpura (5), Takayasu disease (1), polyarteritis nodosa (1), erythema nodosum (1). None subject of control group had IgM activity. Antibodies response of IgG in patients were of lesser intensity than in control group. 14 abnormalities in BH were found in patients and 4 in control group. Immune response in patients, measured by lymphocyte subpopulations and circulating immune complexes was abnormal. In conclusion 47% showed viral activity, but the dominant feature was abnormal immune response in 82%.

[Hyperprolactinemia and autoimmunity]. / Hiperprolactinemia y autoinmunidad.

Prolactin is a pituitary hormone with several functions, one of them, immunoregulatory. Patients with prolactinoma develop hyperprolactinemia. In the next two cases, patients with microprolactinoma, both autoimmune disease associated. First patient, male, with multiple sclerosis; the other one patient, female, with systemic lupus erythematosus. Treatment of hyperprolactinemia with bromocriptine was associated with satisfactory clinical evolution, and a reduction of dosage of immunosuppressor treatment. The patients with multiple sclerosis had neurological functions recovery and the patients with systemic lupus erythematosus had severe relapse of disease each time she dropped bromocriptine treatment. Pituitary function must be evaluated in autoimmune disease, to search alterations like hyperprolactinemia who influenced immune function.