RESUMO
Kawasaki disease (KD) is a medium-vessel vasculitis that is typically presented during childhood; fewer than 100 cases of KD have been reported worldwide in adult patients who met the criteria according to the American College of Rheumatology. This study presents the case of an 18-year-old patient with no previous history of any disease, who presented atypical KD with liver and kidney dysfunction, with a good response to intravenous immunoglobulin therapy. The symptoms began 22 days after the application of the COVID-19 vaccine (nonreplicating viral vector Vaxzevria), and other conditions were ruled out. The term Adverse Events Following Immunization (AEFI)encompasses all the reactions that follow the application of any vaccine with no necessary causal relationship and can be due to the vaccine product, quality of the vaccine, immunization errors, or anxiety or just happen to be coincident events. These reactions should be reported so that clinicians can identify compatible cases and consider that the presentation of this disease, despite being atypical, can be manifested in adult patients. Likewise, case reports are an important basis for the pharmacovigilance of vaccines.
RESUMO
Pollen-food syndrome (PFS) is characterized by allergic sensitization to proteins of pollens of grasses, weeds, and trees, which produce a type I hypersensitivity reaction that is associated with the intake of plant-derived foods that are usually in raw form. The most frequently-associated protein families are: profilins, PR-10, and ns LTP; however, others such as thaumatins, isoflavones, reductases, and B1,2 glucanases have been documented. The prototype syndrome is birch-fruit-vegetables, and of these, the most common is birch-apple due to the fact that more than 70 % of patients who are sensitized to birch present symptoms associated with the intake of plant-derived foods. The symptoms are restricted to the oral cavity; however, some patients may present systemic symptoms, including anaphylaxis, so it is important to identify the type of protein that is involved since the type of reaction that the patient may present depends on that. In spite of everything, it is considered an entity that may be under diagnosed due to its complex diagnosis and treatment, since the procedure, in most cases, is an elimination diet, because treatment with immunotherapy is not yet available. The purpose of this review is to describe the pathophysiology, as well as the most common pollen-food syndromes.
El síndrome polen-alimento (SPA) se caracteriza por la sensibilización alérgica a proteínas de pólenes de pastos, malezas y árboles, que producen una reacción de hipersensibilidad de tipo I, asociada a la ingesta de alimentos derivados de plantas, usualmente en forma cruda. Las familias de proteínas que más frecuentemente están asociadas son las profilinas, las PR-10 y las ns LTP; sin embargo, se ha documentado otras, como las taumatinas, isoflavonas reductasas y las B1,2 gluconasas. El síndrome prototipo es el abedul-frutas-vegetales, y de ellos el más común es el abedul-manzana, debido a que más de 70 % de los pacientes sensibilizados al abedul presentan síntomas asociados a la ingesta de alimentos derivados de plantas. Los síntomas están restringidos a la cavidad oral; sin embargo, algunos pacientes pueden presentar síntomas sistémicos, incluso anafilaxia, por lo que es importante identificar el tipo de proteína implicada, ya que de eso depende el tipo de reacción que puede presentar el paciente. Pese a todo, se considera una entidad que puede estar subdiagnosticada debido a su valoración y tratamiento complejos, debido a que el procedimiento en la mayor parte de los casos es dieta de eliminación, ya que aún no está disponible el tratamiento con inmunoterapia. El objetivo de esta revisión es describir la fisiopatología, así como los síndromes polen-alimento más comunes.
