Tomato nsLTP as an "In Vivo" Diagnostic Tool: Sensitization in a Mediterranean Population.

BACKGROUND: Tomato allergies have been extensively studied but component-resolved in vivo diagnosis with purified allergens has yet to be performed. OBJECTIVES: To evaluate the prevalence of sensitization to Sola l 3 in a Mediterranean population, and to compare the resulting sensitization profile with that of individuals sensitized to tomato, peach, and/or purified lipid transfer protein (LTP). METHODS: Sola l 3 was purified, characterized, and used to prepare skin prick tests (SPTs). Two groups of patients were selected. Group 1 consisted of patients with at least 1 positive SPT to tomato, peach, or LTP mixture (marker extracts) who were subsequently tested with Sola l 3 (n = 280). Group 2 (prevalence study) consisted of patients who underwent simultaneous SPT with the 3 marker extracts and Sola l 3 (n = 658). Patients from either group who were positive to any of the 4 extracts were studied in detail (study group, n = 1 23). ELISA and immunoblot assays were performed in individuals with a positive SPT to Sola l 3 to detect the presence of specific IgE antibodies to this allergen. RESULTS: Prevalence of sensitization to Sola l 3 was 3.2% overall and 54.7% in tomato-positive patients. Most tomato-sensitized patients were asymptomatic. Symptoms were more common in Sola l 3-positive individuals. Sensitization to peach and the LTP mixture did not discriminate between Sola l 3-positive and Sola l 3-negative patients. CONCLUSIONS: This study confirms that LTP, not only from peach but also from other fruit and vegetables, including tomato, is an important allergen in the Mediterranean area. Sensitization to Sola l 3 is associated with more symptoms in tomato-sensitized patients.

Bilateral non-superselective embolization with particles under transient occlusion of the internal carotid artery in the management of juvenile nasopharyngeal angiofibroma: technical note.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare histologically benign tumor, highly vascularized, with usually aggressive behavior, and can extend from the nasal cavity to neighboring structures. We present the case of a 14-year-old male harboring a JNA, presenting with an active severe and persistent epistaxis. Two previous surgical attempts of removal were unsuccessful, because of profuse intraoperative bleeding. Angiography showed a highly vascularized neoplasm with multiple branches arising from both internal carotid arteries, with absence of branches from the external carotid due to previous surgical ligation. Direct puncture tumor embolization was not possible because removal of nasal packing triggered major hemorrhage. The only option for embolization was a technique of non-superselective embolization with particles under transient occlusion of the internal carotid artery. The procedure was performed uneventfully from either side, the tumor was subsequently removed, and the patient had no recurrence 2 years after the initial treatment.

Epidemiological factors on hymenoptera venom allergy in a Spanish adult population.

BACKGROUND: The prevalence and risk factors of hymenoptera venom allergy (HVA) have been studied in several countries. However, there are few studies on the general population and these have very variable results. METHODS: An observational, prospective and cross-sectional study was carried out on a sample of 1064 subjects in a total working population of 7887 subjects (Ford factory, Spain) in order to know the prevalence of HVA in this population and the influence of several risk factors in its development. RESULTS: The rate of exposure to stings was 84.1% (ci 95%: 81.8-86.3%). The prevalence of HVA was 7.6% (ci 95%: 6.1-9.4%), with local severe reactions (LSR) in 5.3% (ci 95%: 4-6.8%) and systemic reactions (SR) in 2.3% (ci 95%: 1.5-3.4%). More than 82% of individuals over 20 years had already had some exposure, a figure that did not change in the age groups of older decades. In our study, the prevalence of HVA was not dependent on either age (similar age in all groups), sex: for LSR OR 2.75 (ci 95%: 0.37-20.30), for SR OR 0.54 (ci 95%: 0.12-2.38), or atopy OR 0.96 (ci 95%: 0.50-1.83); SR being more frequent among the residents of rural habitats, with ranges approaching statistically significant levels OR 2.15 (ci 95%: 0.95-4.81). The number of stings was larger in HVA group with respect a control group. The degree of venom sensitization measure by skin test and CAP-RAST was more intensive in SR group versus LSR group. Among vespids, sensitization to Polistes was more frequent than Vespula. CONCLUSIONS: HVA in our sample has a similar prevalence to other countries located in similar geo-climatic environments. Rural habitat and the number of stings suffered along life are risk factors of HVA development.

Aluminium allergy in patients hyposensitized with aluminium-precipitated antigen extracts.

During hyposensitization therapy with aluminium-precipitated antigen solutions, a small % of patients develop persistent subcutaneous nodules at the injection site; the existence of delayed sensitivity to aluminium has been implicated in the pathogenesis of these nodules. We studied the prevalence of aluminium sensitivity (using patch, prick and intradermal tests) and common contact allergens (TRUE Test) in 20 healthy subjects, and in 40 patients treated with aluminium-containing extracts, 20 of whom had persistent subcutaneous nodules that remained for more than 2 months, the other half having no nodular reactions or nodules that remained for less than 2 months. Aluminium sensitivity was found only in those patients of the treated group who had persistent nodular reactions, 4 cases of positivity to an aluminium chloride patch test being found. All 4 cases were women, nodules remained for more than 6 months, and intracutaneous tests were negative. 3 of them also had contact sensitivity to nickel. In 2 cases, nodules were removed for histological and histochemical examination, showing non-specific inflammatory granulomas, and aluminium crystals being found in only 1 case. It is concluded that delayed sensitivity to aluminium appears to be implicated in the pathogenesis of persistent nodular reactions, but sensitivity to aluminium was not found in patients treated with aluminium-precipitated extracts without persistent nodular reactions.

[Epithelial hepatoblastomas in the adult]. / Hepatoblastomas epiteliales en el adulto.

Hepatoblastoma is the most frequent primary malignant liver neoplasm in childhood; in adults it is extremely rare and only 27 cases have been published. The prognosis of this neoplasm is poor because it is usually discovered late. Surgery, chemotherapy and liver transplantation have been tried with poor results. We present two adult patients who were diagnosed with an epithelial hepatoblastoma. The pathogenesis, histologic features and current management is reviewed.