Fixed drug eruption due to atorvastatin

No disponible

Tomato nsLTP as an 'In Vivo' diagnostic tool: sensitization in a mediterranean population

Antecedentes: La alergia a tomate ha sido ampliamente estudiada; sin embargo, todavía no se ha realizado diagnóstico basado en componentes in vivo con alérgenos purificados. Objetivos: Evaluar la prevalencia de sensibilización a Sola l3 en una población mediterránea y comparar su perfil de sensibilización con el de individuos sensibilizados a piel de tomate, piel de melocotón y/o nsLTP (proteínas de transferencia de lípidos) purificadas. Métodos: Se purificó Sola l3, se caracterizó y se utilizó para preparar pruebas cutáneas (SPT). Se seleccionaron dos grupos de pacientes. Grupo 1: a estos pacientes se les realizaron pruebas cutáneas con tomate, melocotón y una mezcla de LTPs (extractos marcadores); a los pacientes que fueron positivos al menos a uno ellos se les realizó una prueba cutánea con Sola l3 (n=280). Grupo 2 (estudio de prevalencia): a los pacientes se les realizó una prueba cutánea simultáneamente con los tres extractos marcadores y Sola l3 (n=658). Los pacientes de los dos grupos que fueron positivos a cualquiera de los cuatros extractos se analizaron con más detalle (grupo de estudio, n=123). Se realizaron ensayos de ELISA e inmunoblot con los individuos positivos a Sola l3 para detectar la presencia de anticuerpos IgE específicos para este alérgeno. Resultados: La prevalencia de sensibilización a Sola l3 fue del 3,2%, pero incrementó hasta un 54,7% en pacientes positivos a tomate. La mayoría de los pacientes sensibilizados a tomate fueron asintomáticos. El número de pacientes sintomáticos aumentó en los individuos positivos a Sola l3. La sensibilización a melocotón y mezcla de LTP no discriminó entre pacientes positivos y negativos a Sola l3. Conclusiones: Este estudio confirma que las nsLTP son alérgenos importantes en el área mediterránea, no solo relacionados con melocotón, sino también con otros vegetales, como el tomate. La sensibilización a Sola l3 está relacionada con más síntomas en pacientes sensibilizados a tomate (AU)

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 l3 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 l3 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 l3 (n=280). Group 2 (prevalence study) consisted of patients who underwent simultaneous SPT with the 3 marker extracts and Sola l3 (n=658). Patients from either group who were positive to any of the 4 extracts were studied in detail (study group, n=123). ELISA and immunoblot assays were performed in individuals with a positive SPT to Sola l3 to detect the presence of specific IgE antibodies to this allergen. Results: Prevalence of sensitization to Sola l3 was 3.2% overall and 54.7% in tomato-positive patients. Most tomato-sensitized patients were asymptomatic. Symptoms were more common in Sola l3–positive individuals. Sensitization to peach and the LTP mixture did not discriminate between Sola l3–positive and Sola l3–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 l3 is associated with more symptoms in tomato-sensitized patients (AU)

Occupational asthma and dermatitis induced by eugenol in a cleaner

No disponible

Profilin sensitisation in a Mediterranean population

BACKGROUND: Sensitisation to pan-allergens has become an interesting tool for the study of the allergenic profile of different populations. Profilins are one of the most common pan-allergens to be studied because they are responsible for a large number of sensitisations and are clearly related to cross-reactivity and co-sensitisation. OBJECTIVES: The objective of this study was to investigate the profile of sensitisation to profilins and to correlate it with sensitisation to foods and pollens. METHODS: Six hundred and fifty-four consecutive patients were skin-prick tested with a battery of common allergens including pollens, epithelia, mites and moulds and profilin and divided into three groups depending on their sensitisation profile (non-atopic, atopic with pollinosis and atopic without pollinosis). Patients with symptoms were challenged and diagnosed with the offending food extracts. Profilin sensitisation was identified and analysed in detail. RESULTS: According to the classification of the population, the prevalence of profilin sensitisation was estimated at 2.9% in patients suffering respiratory allergy, 4.2% in atopic patients, and 5.9% in pollen-sensitised individuals. Positive association was observed between pollen (except Cupressus and olive) and profilin but not with moulds, mites or epithelia. With respect to foods, positive association was only observed between profilin and melon sensitisation. Lastly, in terms of symptoms, positive association was only observed between profilin sensitisation and OAS. CONCLUSION: Profilin sensitisation seems to be a marker of pollen-related poly-sensitisation in our area. Pan-allergen diagnosis seems to be an essential tool for developing and improving selection of the correct treatment for allergic patients

No disponible

Mite exposure in a Spanish Mediterranean region

Background: Knowledge of the domestic mite fauna and allergen levels is important for a correct diagnosis and treatment of mite allergy. Our objectives were to describe the domestic mite fauna in the region of Murcia, Spain, to quantify mite allergens in dust samples obtained from mattresses of this area and to assess the influence of geographical, climatic and dwelling factors. Methods: Dust samples were collected in a transversal descriptive study from mattresses of 51 patients who went to the Allergology Service, and from mattress of 81 neighbours or family members of these patients. A questionnaire about home environment was filled in and obtained by all participants. Mite identification was done by light microscopy and allergen determinations (Der p 1 and Der f 1) by monoclonal antibodies. Results: Sixteen mite species were identified in the 132 dust samples collected. The most frequent species were Dermatophagoides farinae (36% of the samples), Dermatophagoides pteronyssinus (32%) and Tyrophagus putrescentiae (5.3%). There were significant differences among climatic regions. The coastal sector had greater mite abundance, being D. pteronyssinus more frequent and abundant than D. farinae. In inland areas D. farinae was the predominant mite species. Allergen levels correlated with the concentration of Dermatophagoides, with higher levels detected in coastal regions. Average annual temperature was the main outdoor factor that correlated with higher mite concentrations. Indoor main predictor of higher levels of mites was the presence of obvious signs of humidity in the home. Conclusion: This study demonstrates the existence of a mite fauna dominated by D. pteronyssinus and D. farinae with a strong influence of climatic factors and residential characteristics(AU)

Clinical profile of a Mediterranean population sensitised to date palm pollen (Phoenix dactylifera). A retrospective study

Background: Date palm pollen allergy is frequently associated with polysensitisation. Observational studies have suggested that date-palm-sensitised individuals could be included in a distinct group of polysensitised patients. The objectives of the study were to analyse the clinical characteristics of a group of patients diagnosed of date-palm pollen allergy and to compare them with pollen allergic patients without date-palm sensitisation. Methods: Forty-eight palm-pollen sensitised individuals were classified as Group A. A control group of 48 patients sensitised to pollens but without palm-pollen allergy were included as Group B. All individuals were skin prick tested with a common battery of aeroallergens. Information about age, sex, family history of atopy, respiratory symptoms, food allergy and sensitisation to other pollens were considered variables of the study. Specific IgE and the allergogram todate-palm pollen were determined in a subgroup of Group A. Results: Significant differences in the family history of atopy and number of sensitisations were observed. Both parameters were significantly higher in Group A. Group A showed high prevalence of asthma and higher level of sensitisation to foods (p < 0.05). Significant differences were obtained for sensitisation to epithelia and pollens. Pho d 2 was the most commonly recognised allergen (83.3%) in the palm-pollen allergic group. Conclusions: Date-palm pollen allergic patients constitute a homogeneous group characterised for showing bronchial asthma, sensitisation to food allergens and polysensitisation. These results suggest that the reasons for sensitisation to date-palm pollen remain to be elucidated, but could relate to the existence of as yet non-identified pan-allergens (AU)

Sensibilización a piel y pulpa de tomate en pacientes residentes en la costa mediterranea remitidos a consultas de alergia / Direct costs derived from healthcare assistance of a patient in an ambulatory allergology service of an University Hospital

Introducción: El consumo de tomate es muy frecuente en España, tanto ensaladas y sopas frías, como en productos elaborados. Objetivos: Estudiar la prevalencia de sensibilización cutánea al tomate en pacientes con clínica respiratoria, cutánea o de ambos tipos (rinitis,a sma, urticaria, dermatitis...). Material y Métodos: Se evaluaron todos los pacientes estudiados por primera vez en las consultas de alergia de varios hospitales del Mediterráneo: dos comarcas de Alicante (Vega Baja, Marina Baixa), una de Murcia (Campo de Cartagena) y otra de Gerona entre septiembre de 2004 y julio de 2005. Se incluyeron todos aquéllos que referían síntomas respiratorios, cutáneos o de ambos tipos independientemente del motivo de consulta. En todos se realizaron pruebas cutáneas mediante técnicas prick con una batería habitual de aeroalergenos estandarizados (Laboratorios LETI, SL) y con extractos (10 mg/ml) de piel y pulpa de tomate canario preparados mediante extracción en PBS/PVPP, centrifugado, recogida de sobresaliente, diálisis con punto de corte en 3,5 kDa, filtrado, centrifugado y liofilizado. Resultados: Se incluyeron 1.498 pacientes (675 varones y 823 mujeres, edad estudiada 31,4 +/-17,8). La prevalencia de sensibilización al tomate en la población estudiada fue del 5,94% (89 pacientes); respecto al extracto de piel fue del 5,81% y al de pulpa del 2,2%. Se observaron pruebas cutáneas positivas a aeroalérgenos en el 63,6% de la población estudiada y en el 95,5% (p<0,001) de los pacientes sensibilizados al tomate. Referían clínica con la ingestión o contacto con el tomate el 1,4% de la población (21 pacientes). Nueve de ellos tuvieron una prueba cutánea positiva con el extracto del tomate (0,6%). De los 89 pacientes sensibilizados al tomate, 77 (86,5%) presentarion sensibilización a los pólenes, 52 (58,4%) a los ácaros, 33 (37,1%) a los epitelios y 16 (18%) a los hongos (p<0,001 en todos los casos). Conclusiones: La prevalencia de pruebas cutáneas positivas frente al tomate en la población estudiada es alta, pero la relevancia clínica de esta sensibilización parece baja. El extracto de piel de tomate ha sido más sensible que el extracto de pulpa. La mayoría de los pacientes sensibilizados al tomate es atópica y está sensibilizada a los pólenes

Introduction: Tomatoes (Lycopersicon esculentum) are widely consumed in Spain, either in salads, cold soups (gazpacho), or cooked. Objective: To study the prevalence of skin sensitisation to tomato in patients with respiratory or cutaneous symptoms. The objective of this study was to determine the prevalence of skin test reactivity to tomato allergens in this group of patients living in the Mediterranean coast of Spain. Methods: All the patients evaluated for respiratory and/or cutaneous symptoms (independently of the reason for submission) at the allergy units of 4 hospitals located in the Mediterranean coast in Spain between September 2004 and July 2005 were included in the study. All patients were skin prick tested with a battery of standardized common inhalant allergens and with extracts of peel and pulp of ripe Canary Islands tomatoes at 10 mg/ml. After tomatoes were peeled, homogenisation in PBS/PVPP, extraction under continuous magnetic stirring, centrifugation, dialysis, filtration and freeze-drying were performed separately with the peel and pulp to elaborate the extracts used. The X2, Fisher exact test and OR were used to evaluate the results. Results: One thousand and four hundred ninety-eight consecutive individuals (675 males and 823 females; mean age, 31.4 +/- 17.8 years-old) were included in the study. The prevalence of sensization to tomato was 5.94% (89 patiens; 51 males and 38 females; mean age, 30.2+/-12.9 years). The tomato peel extract was positive in 87 patients (5.81%) and the pulp extract in 33 patients (2.2%); 2 patients were positive exclusively to pulp. In the totalpopulation, skin prick tests to inhalants were positive in 953 subjects (63.6%), whereas 85 (95.5%) of the tomato sensitised patients were positive to at least one inhalant allergen (p<0.001): 77 (86.5%) to pollens; 52 (58.4%) to mites, 33 (37.1%) to epithelia, and 16 (18.0%) to moulds (p<0.01 in all cases compared with the non-sensitized population). Most of the sensitised subjects (91.1%) were asymptomatic and did not refer symptoms after tomato contact or ingestion. Twenty one subjects, 9 positive and 12 negative to both tomato extracts, referred mild symptoms with tomato ingestion or contact (1.4%, o.6%, and 0.8%, respectively of the total population). Conclusions: The prevalence of sensitisation to tomato in this population is high. However, most sensitised subjects are asymptomatic. Peel extract has been more sensitive than pulp extract. Sensitisation to tomato is more prevalent among atopic and pollen sensitised individuals, suggesting allergen cross-reactivity

Tolerance of a Salsola kali extract standardized in biological units administered by subcutaneous route. Multicenter study

Background: Sensitivity to Salsola kali is a frequent cause of allergic respiratory disease in various regions of Spain. However, there are very few articles in which this allergen has been studied. Methods and Results: In order to evaluate the tolerance of this extract, a prospective study has been performed. This study was observational, multi-centred and open, involving 88 patients with allergic respiratory disease due to sensitivity to Salsola, aged between 5 and 52 years. The administration of the extract was performed subcutaneously, through one of two treatment schedules: cluster (8 doses in 4 visits) or conventional (13 doses in 12 visits). A total of 42 adverse reactions were registered, in 26 patients (35 local reactions in 21 patients and 7 systemic reactions in 6 patients). Among the 7 systemic reactions, 4 were registered with the cluster protocol and 2 with the conventional protocol (p = 0.329). In no patients were serious adverse reactions registered. Conclusion: The subcutaneous administration of a Salsola extract is safe and well tolerated, both when administered using a conventional schedule and when using a cluster schedule

Antecedentes: La sensibilización a Salsola kali es una causa frecuente de enfermedad alérgica respiratoria en varias zonas de España. Sin embargo, apenas existen publicaciones en las que se estudie este alergeno. Métodos y resultados: Para valorar la tolerancia de este extracto, se ha realizado un estudio prospectivo, observacional, multicéntrico y abierto, en el que se han incluido 88 pacientes, de edad entre 5 y 52 años, con enfermedad alérgica respiratoria por sensibilización a Salsola. La administración del extracto se ha realizado por vía subcutánea, mediante dos esquemas de tratamiento: agrupada (8 dosis en 4 visitas) o convencional (13 dosis en 12 visitas). Se han registrado un total de 42 reacciones adversas en 26 pacientes (35 locales en 21 pacientes y 7 sistémicas en 6 pacientes). De las 7 reacciones sistémicas, 4 se registraron con la pauta agrupada y 2 con la convencional (p = 0,329). No se registró ninguna reacción adversa grave. Conclusión: La administración subcutánea de un extracto de Salsola es segura y bien tolerada, tanto cuando se administra con una pauta convencional como con una pauta agrupada