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1.
Artigo em Inglês | MEDLINE | ID: mdl-28211342

RESUMO

In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis.


Assuntos
Venenos de Artrópodes/imunologia , Himenópteros/imunologia , Hipersensibilidade/imunologia , Mordeduras e Picadas de Insetos/imunologia , Animais , Venenos de Artrópodes/uso terapêutico , Hipersensibilidade/diagnóstico , Hipersensibilidade/epidemiologia , Hipersensibilidade/terapia , Testes Imunológicos , Imunoterapia/métodos , Mordeduras e Picadas de Insetos/diagnóstico , Mordeduras e Picadas de Insetos/epidemiologia , Mordeduras e Picadas de Insetos/terapia , Valor Preditivo dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologia , Resultado do Tratamento
2.
J. investig. allergol. clin. immunol ; 27(1): 19-31, 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-160494

RESUMO

In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis (AU)


En esta revisión el Comité de Alergia a Himenópteros de la SEAIC ha analizado la literatura científica más reciente sobre los principales problemas diagnósticos de la alergia a himenópteros, así como sobre las dificultades que pueden surgir durante la inmunoterapia con venenos. Se revisan especialmente las novedades relacionadas con el diagnóstico molecular y los perfiles moleculares de riesgo. También se describe la alergia a himenópteros poco habituales y los problemas diagnósticos y terapéuticos que esta conlleva. Por último, se tratan los síndromes de activación mastocitaria clonal, íntimamente relacionados con la alergia a himenópteros, que se han convertido en un nuevo reto diagnóstico para el alergólogo (AU)


Assuntos
Humanos , Masculino , Feminino , Alergia e Imunologia/instrumentação , Hipersensibilidade/diagnóstico , Comitê de Profissionais/organização & administração , Comitê de Profissionais/normas , Biologia Molecular/métodos , Imunoterapia/métodos , Mordeduras e Picadas de Insetos/imunologia , Himenópteros , Mastocitose/complicações , Mastocitose/diagnóstico , Mastocitose/imunologia , Anafilaxia/diagnóstico , Anafilaxia/imunologia , Anafilaxia/terapia , Venenos/imunologia , Venenos de Abelha/imunologia
3.
J Investig Allergol Clin Immunol ; 26(6): 366-373, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27996943

RESUMO

INTRODUCTION: Hymenoptera venom immunotherapy (VIT) is an effective treatment but not one devoid of risk, as both local and systemic adverse reactions may occur, especially in the initial phases. We compared the tolerance to 3 VIT buildup protocols and analyzed risk factors associated with adverse reactions during this phase. MATERIALS AND METHODS: We enrolled 165 patients divided into 3 groups based on the buildup protocol used (3, 4, and 9 weeks). The severity of systemic reactions was evaluated according to the World Allergy Organization model. Results were analyzed using exploratory descriptive statistics, and variables were compared using analysis of variance. RESULTS: Adverse reactions were recorded in 53 patients (32%) (43 local and 10 systemic). Local reactions were immediate in 27 patients (63%) and delayed in 16 (37%). The severity of the local reaction was slight/moderate in 15 patients and severe in 13. Systemic reactions were grade 1-2. No significant association was found between the treatment modality and the onset of local or systemic adverse reactions or the type of local reaction. We only found a statistically significant association between severity of the local reaction and female gender. As for the risk factors associated with systemic reactions during the buildup phase, we found no significant differences in values depending on the protocol used or the insect responsible. CONCLUSIONS: The buildup protocols compared proved to be safe and did not differ significantly from one another. In the population studied, patients undergoing the 9-week schedule presented no systemic reactions. Therefore, this protocol can be considered the safest approach.


Assuntos
Venenos de Artrópodes/administração & dosagem , Dessensibilização Imunológica/métodos , Himenópteros/imunologia , Hipersensibilidade/terapia , Mordeduras e Picadas de Insetos/terapia , Adolescente , Adulto , Idoso , Animais , Venenos de Artrópodes/efeitos adversos , Venenos de Artrópodes/imunologia , Criança , Dessensibilização Imunológica/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Tolerância Imunológica , Mordeduras e Picadas de Insetos/diagnóstico , Mordeduras e Picadas de Insetos/imunologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Espanha , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
J. investig. allergol. clin. immunol ; 26(6): 366-373, 2016. tab
Artigo em Inglês | IBECS | ID: ibc-159024

RESUMO

Introduction: Hymenoptera venom immunotherapy (VIT) is an effective treatment but not one devoid of risk, as both local and systemic adverse reactions may occur, especially in the initial phases. We compared the tolerance to 3 VIT buildup protocols and analyzed risk factors associated with adverse reactions during this phase. Materials and Methods: We enrolled 165 patients divided into 3 groups based on the buildup protocol used (3, 4, and 9 weeks). The severity of systemic reactions was evaluated according to the World Allergy Organization model. Results were analyzed using exploratory descriptive statistics, and variables were compared using analysis of variance. Results: Adverse reactions were recorded in 53 patients (32%) (43 local and 10 systemic). Local reactions were immediate in 27 patients (63%) and delayed in 16 (37%). The severity of the local reaction was slight/moderate in 15 patients and severe in 13. Systemic reactions were grade 1-2. No significant association was found between the treatment modality and the onset of local or systemic adverse reactions or the type of local reaction. We only found a statistically significant association between severity of the local reaction and female gender. As for the risk factors associated with systemic reactions during the buildup phase, we found no significant differences in values depending on the protocol used or the insect responsible. Conclusions: The buildup protocols compared proved to be safe and did not differ significantly from one another. In the population studied, patients undergoing the 9-week schedule presented no systemic reactions. Therefore, this protocol can be considered the safest approach (AU)


Introducción: La inmunoterapia con veneno de himenópteros (ITV) es un tratamiento eficaz, pero no está desprovisto de riesgo ya que pueden ocurrir reacciones adversas locales o sistémicas, especialmente en las etapas iniciales del tratamiento. Comparamos la tolerancia de tres protocolos de inicio de ITV y analizamos los factores de riesgo asociados con las reacciones adversas que se produjeron en esta fase. Métodos: Se incluyeron 165 pacientes divididos en tres grupos según el protocolo de iniciación utilizado (3, 4 o 9 semanas). Evaluamos la gravedad de las reacciones sistémicas de acuerdo con el modelo de la Organización Mundial de Alergia. Analizamos los resultados mediante estadística descriptiva exploratoria y comparamos variables mediante el análisis de la varianza. Resultados: Cincuenta y tres pacientes (32%) experimentaron algún tipo de reacción adversa; 43 eran locales y 10 sistémicas. Las reacciones locales fueron inmediatas en 27 pacientes (63%) y tardías en 16 (37%). La gravedad de la reacción local fue leve o moderada en 15 pacientes y grave en 13. Las reacciones sistémicas fueron de grado 1 o 2. No encontramos asociación significativa entre la modalidad de tratamiento y la aparición de reacciones adversas locales o sistémicas o el tipo de reacción local. Solo encontramos una asociación estadísticamente significativa de la gravedad de la reacción local con el sexo femenino. En cuanto a los factores de riesgo asociados con las reacciones sistémicas en la fase de inicio, no se encontraron diferencias significativas en estos valores en función del protocolo utilizado o el insecto responsable. Conclusiones: Los protocolos de inicio comparados demostraron ser seguros y no difirieron significativamente entre sí. En la población estudiada, el protocolo de 9-semanas no produjo reacciones sistémicas, por lo que se puede considerar el protocolo más seguro (AU)


Assuntos
Humanos , Masculino , Feminino , Mordeduras e Picadas de Insetos/imunologia , Venenos/imunologia , Imunoterapia/métodos , Imunoterapia , Dessensibilização Imunológica/métodos , Fatores de Risco , Himenópteros/imunologia , Protocolos/métodos , Espanha/epidemiologia , Estudos Prospectivos
5.
J Investig Allergol Clin Immunol ; 25(3): 176-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26182683

RESUMO

INTRODUCTION AND OBJECTIVES: The first quality of life questionnaire for Vespula-allergic patients (Vespid Allergy Quality of Life Questionnaire [VQLQ) was developed in 2002. Our objective was to perform the cross-sectional validation of the Spanish version of this questionnaire. PATIENTS AND METHODS: Using the original English-language version of the VQLQ as a starting point, the Spanish translation and cultural adaptation were performed and the first Spanish version was backtranslated into English and discussed with the authors of the original version. The result was the Spanish Health-related Quality of Life Questionnaire for Hymenoptera Venom-Allergic Patients (HRQLHA). Cross-sectional validation was carried out in a multicenter study using a test-retest design. Patients over the age of 14 diagnosed with systemic allergic reaction to venom from Apis, Vespula, or Polistes species were included. The test-retest reliability, external validity, and internal consistency of the questionnaire were measured. RESULTS: The sample comprised 116 patients. The mean HRQLHA score was 3.48. Test-retest reliability showed an intraclass correlation coefficient of 0.85. HRQLHA showed a positive correlation (0.5) with an external questionnaire, thus demonstrating its external validity. Analysis of the internal consistency of the HRQLHA yielded a Cronbach α of 0.95, which can be considered to be excellent. CONCLUSIONS: Statistical analysis revealed the high test-retest reliability, internal consistency, and external validity of the HRQLHA. The HRQLHA is the first validated questionnaire to include patients allergic to Polistes species, which is common in our area. Our findings show that the questionnaire is also valid for these patients.


Assuntos
Himenópteros/imunologia , Hipersensibilidade/psicologia , Mordeduras e Picadas de Insetos/imunologia , Qualidade de Vida , Inquéritos e Questionários , Peçonhas/imunologia , Adolescente , Adulto , Idoso , Animais , Estudos Transversais , Características Culturais , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Espanha , Tradução , Adulto Jovem
6.
J Investig Allergol Clin Immunol ; 25(6): 426-30, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26817139

RESUMO

BACKGROUND AND OBJECTIVE: The Spanish version of the health-related quality of life questionnaire for allergy to hymenoptera venom (HRQLHA) has been shown to be reliable, internally consistent, and externally valid. The aim of this study was to complete the validation of the HRQLHA by analyzing its sensitivity to changes (longitudinal validity) using the sting challenge test (SCT) as the variable of change. PATIENTS AND METHODS: Patients over the age of 17 years with a systemic allergic reaction to Apis, Vespula, or Polistes venom were included during their first year of venom-specific immunotherapy. Patients were assigned to either a group that underwent the SCT or a control group that did not. All patients completed the HRQLHA at baseline and after a period of 2 to 4 months, during which time the SCT was performed in the active group, with no intervention in the control group. RESULTS: Fifty patients were included in the study: 25 in the SCT group and 25 in the control group. The patients in the SCT group showed a significant improvement in mean HRQLHA score (+0.35, P=.03) after the SCT, while those in the control group showed no significant changes in questionnaire scores. CONCLUSIONS: Our results demonstrate the sensitivity of the HRQLHA to changes and thus complete the longitudinal validation of the questionnaire. A well-tolerated SCT improves the quality of life of venom-allergic patients as it reduces anxiety associated with the fear of being stung.


Assuntos
Venenos de Artrópodes/imunologia , Himenópteros/imunologia , Hipersensibilidade/psicologia , Mordeduras e Picadas de Insetos/psicologia , Qualidade de Vida , Animais , Dessensibilização Imunológica , Humanos , Hipersensibilidade/terapia , Mordeduras e Picadas de Insetos/terapia , Estudos Longitudinais , Espanha , Inquéritos e Questionários
7.
J. investig. allergol. clin. immunol ; 25(3): 176-182, 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-136422

RESUMO

Introducción: En 2002 se desarrolló el primer cuestionario de calidad de vida para alérgicos a veneno de Vespula (VQLQ). El objetivo de este trabajo es desarrollar y validar una versión en español de este cuestionario. Métodos y Pacientes: Partiendo del VQLQ en inglés se realizó la traducción al español y adaptación cultural del cuestionario con una posterior retraducción consensuada con los autores de la versión original. Así se desarrolló el cuestionario de calidad de vida en español para pacientes alérgicos a veneno de himenópteros (HRQLHA). La validación transversal se realizó mediante un estudio multicéntrico, con diseño test-retest en el que se incluyeron pacientes mayores de 14 años con reacción sistémica por alergia a veneno de Apis, Vespula o Polistes . Se analizó la fiabilidad test-retest, la validez externa y la consistencia interna del cuestionario. Resultados: Se incluyeron 116 pacientes alérgicos a venenos de Apis, Vespula o Polistes . La puntuación media del HRQLHA fue 3.48. El estudio de fiabilidad test-retest mostró un coeficiente de correlación intraclase de 0.85. El HRQLHA mostró una correlación positiva (0.5) con el cuestionario de referencia externa, confirmando su validez. En el análisis de la consistencia interna se encontró una Alpha de Cronbach de 0.95 Conclusiones: El análisis estadístico muestra una elevada fiabilidad test-retest y consistencia interna del HRQLHA, además de su validez externa. En la validación del HRQLHA se han incluido por primera vez pacientes alérgicos a veneno de Polistes, muy prevalente en nuestra área, demostrando la utilidad del cuestionario también en estos pacientes (AU)


Introduction and Objectives: The first quality of life questionnaire for Vespula-allergic patients (Vespid Allergy Quality of Life Questionnaire [VQLQ]) was developed in 2002. Our objective was to perform the cross-sectional validation of the Spanish version of this questionnaire. Patients and Methods: Using the original English-language version of the VQLQ as a starting point, the Spanish translation and cultural adaptation were performed and the first Spanish version was backtranslated into English and discussed with the authors of the original version. The result was the Spanish Health-related Quality of Life Questionnaire for Hymenoptera Venom–Allergic Patients (HRQLHA). Cross-sectional validation was carried out in a multicenter study using a test-retest design. Patients over the age of 14 diagnosed with systemic allergic reaction to venom from Apis, Vespula, or Polistes species were included. The test-retest reliability, external validity, and internal consistency of the questionnaire were measured. Results: The sample comprised 116 patients. The mean HRQLHA score was 3.48. Test-retest reliability showed an intraclass correlation coefficient of 0.85. HRQLHA showed a positive correlation (0.5) with an external questionnaire, thus demonstrating its external validity. Analysis of the internal consistency of the HRQLHA yielded a Cronbach a of 0.95, which can be considered to be excellent. Conclusions: Statistical analysis revealed the high test-retest reliability, internal consistency, and external validity of the HRQLHA.The HRQLHA is the first validated questionnaire to include patients allergic to Polistes species, which is common in our area. Our findings show that the questionnaire is also valid for these patients (AU)


Assuntos
Humanos , Masculino , Feminino , Himenópteros/imunologia , Himenópteros/patogenicidade , Hipersensibilidade/complicações , Hipersensibilidade/imunologia , Qualidade de Vida , Imunoterapia/métodos , Imunoterapia , Inquéritos e Questionários , Estudos Transversais/métodos , Estudos Transversais/tendências , Estudos Transversais , Venenos/efeitos adversos , Venenos/imunologia , Venenos/isolamento & purificação , Reprodutibilidade dos Testes , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/imunologia
8.
J. investig. allergol. clin. immunol ; 25(6): 426-430, 2015. tab, graf, mapas
Artigo em Inglês | IBECS | ID: ibc-146914

RESUMO

Background and Objective: The Spanish version of the health-related quality of life questionnaire for allergy to hymenoptera venom (HRQLHA) has been shown to be reliable, internally consistent, and externally valid. The aim of this study was to complete the validation of the HRQLHA by analyzing its sensitivity to changes (longitudinal validity) using the sting challenge test (SCT) as the variable of change. Patients and Methods: Patients over the age of 17 years with a systemic allergic reaction to Apis, Vespula, or Polistes venom were included during their first year of venom-specific immunotherapy. Patients were assigned to either a group that underwent the SCT or a control group that did not. All patients completed the HRQLHA at baseline and after a period of 2 to 4 months, during which time the SCT was performed in the active group, with no intervention in the control group. Results: Fifty patients were included in the study: 25 in the SCT group and 25 in the control group. The patients in the SCT group showed a significant improvement in mean HRQLHA score (+0.35, P=.03) after the SCT, while those in the control group showed no significant changes in questionnaire scores. Conclusions: Our results demonstrate the sensitivity of the HRQLHA to changes and thus complete the longitudinal validation of the questionnaire. A well-tolerated SCT improves the quality of life of venom-allergic patients as it reduces anxiety associated with the fear of being stung (AU)


Introducción y objetivo: El cuestionario de calidad de vida en español para alérgicos a veneno de himenópteros (HRQLHA) ha demostrado su fiabilidad, consistencia interna y validez externa. El objetivo de este estudio era completar la validación del HRQLHA mediante el análisis de su sensibilidad al cambio o validación longitudinal, considerando como variable de cambio la prueba de repicadura controlada intrahospitalaria (RIH). Pacientes y Métodos: Se incluyeron pacientes mayores de 17 años con reacción sistémica por alergia a veneno de Apis, Vespula o Polistes, en el primer año de tratamiento con inmunoterapia. Los pacientes se distribuyeron en un grupo sometido a RIH y un grupo control no sometido a esta prueba. Los pacientes cumplimentaron el HRQLHA basal y después de la repicadura o después de un periodo de 2-4 meses si pertenecían al grupo control. Resultados: Se incluyeron 50 pacientes en el estudio. 25 en el grupo de RIH y 25 en el grupo control. Los pacientes del grupo RIH presentaron una mejoría significativa en la puntuación del cuestionario HRQLHA después de la repicadura de + 0,35 (p=0,03), mientras que los pacientes del grupo control no mostraron cambios significativos en la puntuación del cuestionario. Conclusiones: Los resultados obtenidos demuestran la sensibilidad al cambio del HRQLHA y permiten completar la validación longitudinal del cuestionario. La prueba de repicadura controlada intrahospitalaria bien tolerada mejora la calidad de vida de los pacientes alérgicos a venenos ya que disminuye su ansiedad ante una nueva picadura (AU)


Assuntos
Humanos , Venenos de Abelha/efeitos adversos , Hipersensibilidade/psicologia , Psicometria/instrumentação , Himenópteros/patogenicidade , Qualidade de Vida/psicologia , Perfil de Impacto da Doença , Estudos de Casos e Controles
11.
Allergy ; 67(4): 528-36, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22229815

RESUMO

BACKGROUND: Cross-reactivity between hymenoptera species varies according to the different allergenic components of the venom. The true source of sensitization must therefore be established to ensure the efficacy of venom immunotherapy. OBJECTIVE: In the Mediterranean region, Polistes dominulus and Vespula spp. are clinically relevant cohabitating wasps. A panel of major vespid venom allergens was used to investigate whether serum-specific IgE (sIgE) could be used to distinguish sensitization to either vespid. METHODS: Fifty-nine individuals with allergic reactions to vespid stings and positive ImmunoCAP and/or intradermal tests to vespid venoms were studied. sIgE against recombinant and natural venom components from each wasp species was determined using the ADVIA Centaur(®) system. RESULTS: sIgE against recombinant antigen 5s sensitization to be detected in 52% of the patients tested (13/25). The sensitivity increased to 80% (20/25), when using natural antigen 5s, and to 100% with the complete panel of purified natural components, because the sIgE was positive to either the antigen 5s (Pol d 5/Ves v 5) or to the phospholipases (Pol d 1/Ves v 1) of the two vespids, or to both components at the same time. In 69% of cases, it was possible to define the most probable sensitizing insect, and in the rest, possible double sensitization could not be excluded. Vespula hyaluronidase was shown to have no additional value as regards the specificity of the assay. CONCLUSIONS: The major allergens of P. dominulus' and Vespula vulgaris' venom, namely phoshpholipases and antigen 5s, are required to discriminate the probable sensitizing species in vespid-allergic patients.


Assuntos
Alérgenos , Hipersensibilidade/diagnóstico , Proteínas de Insetos , Venenos de Vespas/imunologia , Vespas/imunologia , Adolescente , Adulto , Idoso , Alérgenos/imunologia , Animais , Criança , Reações Cruzadas , Humanos , Hipersensibilidade/sangue , Hipersensibilidade/imunologia , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Proteínas de Insetos/imunologia , Pessoa de Meia-Idade , Fosfolipases/imunologia , Proteínas Recombinantes/imunologia , Adulto Jovem
12.
J Investig Allergol Clin Immunol ; 19 Suppl 2: 56-60, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19530420

RESUMO

BACKGROUND: There are infrequent or unspecific diseases that occupy an important part of time in the job of the allergists. OBJECTIVE: We sought to evaluate the frequency and to determine the characteristics of uncommon or unspecific diseases seen by allergists in Spain, and to compare these data with findings obtained in a similar study undertaken in 1992. MATERIAL AND METHODS: An observational, prospective and cross-sectional study named "Alergológica 2005" was carried out in Spain. A part of this study analyzed the demographic, healthcare and clinical aspects of infrequent or unspecific diseases categorized as "Other allergic diseases" (OAD) or "Other non-allergic diseases" (ONAD). RESULTS: The survey comprised 4991 patients. In OAD, 45 patients were included. In ONAD, 290 patients were included. Significant diagnoses were gastroallergic anisakiasis (10 patients), idiopathic anaphylaxis (7 patients), and hypersensitivity pneumonitis (2 patients). In the ONAD group, non allergic respiratory diseases were the most frequent diagnosis. Mean time spent to reach a diagnosis was 14.2 days. However, the median of this time was only 1 day. Main diagnostic methods employed were a clinical history/physical examination in 86% of patients and skin tests in 73.7%. CONCLUSION: Several unspecific diseases affected more than 60% of patients in the two groups together. Findings show the current knowledge of allergic disorders due to Anisakis simplex. Diagnoses of hypersensitivity pneumonitis seem to be as frequent as previously published. Idiopathic anaphylaxis seems to be less frequent. The wide-range of times needed to reach a diagnosis was in agreement with the mixture of diseases included in both groups.


Assuntos
Hipersensibilidade/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/terapia , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Espanha/epidemiologia
13.
Allergol Immunopathol (Madr) ; 33(5): 288-90, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16287550

RESUMO

BACKGROUND: Few previous reports of carrot-induced asthma have been confirmed by objective tests. Hypersensitivity to carrot is frequently associated with allergy to Apiaceae spices and sensitization to birch and mugwort pollens. CLINICAL CASE: A 40-year-old cook woman was seen with sneezing, rhinorrhea, contact urticaria and wheezing within few minutes of handling or cutting raw carrots. She needed to leave out of the kitchen while the other cooks cut raw carrots. METHODS AND RESULTS: Skin tests were positive to carrot, celery, aniseed and fennel. Rubbing test with fresh carrot was positive. Specific IgE to carrot was 4.44 kU/L. Determinations of specific IgE to mugwort, grass and birch pollens were negative. Inhalative provocation test, performed as a handling test, was positive. The IgE-immunoblotting showed two bands in carrot extract: a band with apparent molecular weight of 30 kd and other band of 18 kd. This band of 18 kd was Dau c 1. The band of 30 kd could correspond a phenylcoumaran benzylic ether reductase. Dau c 1 did not appear to be the unique allergen in this case. Additional allergens may induce the sensitization. Primary sensitization due to airborne allergens of foods and the lack of pollen allergy in this patient are notorious events.


Assuntos
Asma/etiologia , Daucus carota/efeitos adversos , Manipulação de Alimentos , Doenças Profissionais/etiologia , Adulto , Apium/efeitos adversos , Tosse/etiologia , Feminino , Humanos , Prurido/etiologia , Testes Cutâneos , Urticária/etiologia
14.
Allergol. immunopatol ; 33(5): 288-290, sept. 2005. ilus
Artigo em Inglês | IBECS | ID: ibc-042141

RESUMO

Background: Few previous reports of carrot-induced asthma have been confirmed by objective tests. Hypersensitivity to carrot is frequently associated with allergy to Apiaceae spices and sensitization to birch and mugwort pollens. Clinical case: A 40-year-old cook woman was seen with sneezing, rhinorrhea, contact urticaria and wheezing within few minutes of handling or cutting raw carrots. She needed to leave out of the kitchen while the other cooks cut raw carrots. Methods and results: Skin tests were positive to carrot, celery, aniseed and fennel. Rubbing test with fresh carrot was positive. Specific IgE to carrot was 4.44 kU/L. Determinations of specific IgE to mugwort, grass and birch pollens were negative. Inhalative provocation test, performed as a handling test, was positive. The IgE-immunoblotting showed two bands in carrot extract: a band with apparent molecular weight of 30 kd and other band of 18 kd. This band of 18 kd was Dau c 1. The band of 30 kd could correspond a phenylcoumaran benzylic ether reductase. Dau c 1 did not appear to be the unique allergen in this case. Additional allergens may induce the sensitization. Primary sensitization due to airborne allergens of foods and the lack of pollen allergy in this patient are notorious events


No disponible


Assuntos
Feminino , Adulto , Humanos , Asma/etiologia , Daucus carota/efeitos adversos , Manipulação de Alimentos , Prurido/etiologia , Urticária/etiologia , Apium/efeitos adversos , Tosse/etiologia , Testes Cutâneos
15.
Allergol Immunopathol (Madr) ; 33(3): 145-50, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-15946627

RESUMO

BACKGROUND: Castanea sativa pollen allergy has generally been considered to be uncommon and clinically insignificant. In our geographical area (Plasencia, Cáceres, Spain) Castanea sativa pollen is a major pollen. OBJECTIVE: To determine the atmospheric fluctuations and prevalence of patients sensitized to Castanea pollen in our region and to compare this sensitization with sensitizations to other pollens. METHODS: Patients with respiratory symptoms attending our outpatient clinic for the first time in 2003 were studied. The patients underwent skin prick tests with commercial extracts of a battery of inhalants including Castanea sativa pollen. Serologic specific IgE to Castanea sativa pollen was determined using the CAP system (Pharmacia and Upjohn, Uppsala, Sweden). Airborne pollen counts in our city were obtained using Cour collection apparatus over a 4-year period (2000 to 2003). RESULTS: The most predominant pollens detected were (mean of the maximal weekly concentrations over 4 years in pollen grains/m3): Quercus 968, Poacea 660, Olea 325, Platanus 229, Pinus 126, Cupresaceae 117, Plantago 109, Alnus 41, Populus 40, Castanea 32. We studied 346 patients (mean age: 24.1 years). In 210 patients with a diagnosis of pollinosis, the percentages of sensitization were: Dactylis glomerata 80.4%, Olea europea 71.9%, Fraxinus excelsior 68%, Plantago lanceolata 62.8%, Chenopodium album 60.9%, Robinia pseudoacacia 49%, Artemisia vulgaris 43.8%, Platanus acerifolia 36.6%, Parietaria judaica 36.1%, Populus nigra 32.3%, Betula alba 27.6%, Quercus ilex 21.4%, Alnus glutinosa 20.9%, Cupressus arizonica 7.6% and Castanea sativa 7.1%. Fifteen patients were sensitized to Castanea sativa and 14 had seasonal rhinoconjunctivitis and asthma. Ten patients had serum specific IgE to Castanea pollen (maximum value: 17.4 Ku/l). Castanea pollen is present in our area in large amounts from the 23rd to the 28th weeks of the year, with a peak pollen count in the 25th week. CONCLUSIONS: The most important allergenic pollens in northern Extremadura were Poaceae, Olea europaea and Plantago sp. The prevalence of sensitization to Castanea sativa pollen was very low (7.1%). Most sensitized patients had asthma and polysensitization. Castanea sativa pollen is not a major cause of pollinosis in our area.


Assuntos
Rinite Alérgica Sazonal/epidemiologia , Árvores/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ar/análise , Alérgenos , Artemisia/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Olea/imunologia , Plantago/imunologia , Poaceae/imunologia , Pólen/efeitos adversos , Pólen/imunologia , Prevalência , Estudos Prospectivos , Rinite Alérgica Sazonal/etiologia , Espanha/epidemiologia
16.
Allergol. immunopatol ; 33(3): 145-150, mayo 2005. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-037706

RESUMO

Introducción: La alergia al polen de castaño (Castanea sativa) ha sido considerada rara y clínicamente insignificante. En nuestra área geográfica (Plasencia, Cáceres, España) es un polen predominante. Objetivo: Este trabajo pretende determinar las fluctuaciones atmosféricas y la existencia de individuos sensibilizados al polen de castaño y su comparación con otras especies. Métodos: Pacientes que acudieron en el año 2003 por primera vez a nuestra consulta por síntomas respiratorios. Se les realizó prueba del prick con extractos comerciales de una batería de aeroalérgenos que incluía polen de castaño. Se determinó la IgE específica a polen de Castanea sativa por CAP system (Pharmacia & Upjohn, Uppsala, Suecia). El estudio aerobiológico se realizó con un captador Cour, durante los años 2000-2003. Resultados: Los taxones más abundantes fueron (media de la concentración semanal máxima de los 4 años, en granos de polen/m 3 de aire): Quercus 968, gramíneas 660, olivo 325, plátano de sombra 229, pino 126, cupresáceas 117, llantén 109, aliso 41, chopo 40, castaño 32... Se estudiaron 346 pacientes. En los 210 diagnosticados de polinosis, los porcentajes de sensibilización fueron: Dactylis glomerata 80,4 %, Olea europea 71,9 %, Fraxinus excelsior 68 %, Plantago lanceolata 62,8 %, Chenopodium album 60,9 %, Robinia pseudoacacia 49 %, Artemisia vulgaris 43,8 %, Platanus acerifolia 36,6 %, Parietaria judaica 36,1 %, Populus nigra 32,3 %, Betula alba 27,6 %, Quercus ilex 21,4 %, Alnus glutinosa 20,9 %, Cupressus arizonica 7,6 % y Castanea sativa 7,1 %. Hubo quince pacientes sensibilizados al polen de castaño, catorce con rinoconjuntivitis y asma. Diez tuvieron IgE específica sérica a polen de castaño, aunque el valor mayor encontrado fue de 17,4 ku/L. El castaño polinizó en las semanas 23 a 28, con pico en la 25. Conclusiones: Los pólenes alergénicos más importantes en el norte de Extremadura fueron gramíneas, Olea europea y Plantago sp. La prevalencia de sensibilización al polen de Castanea sativa fue del 7,1 %, cifra muy baja. La mayoría de los pacientes eran asmáticos y estuvieron polisensibilizados. El polen de castaño no es un alérgeno importante en nuestra zona como causa de polinosis


Background: Castanea sativa pollen allergy has generally been considered to be uncommon and clinically insignificant. In our geographical area (Plasencia, Cáceres, Spain) Castanea sativa pollen is a major pollen. Objective: To determine the atmospheric fluctuations and prevalence of patients sensitized to Castanea pollen in our region and to compare this sensitization with sensitizations to other pollens. Methods: Patients with respiratory symptoms attending our outpatient clinic for the first time in 2003 were studied. The patients underwent skin prick tests with commercial extracts of a battery of inhalants including Castanea sativa pollen. Serologic specific IgE to Castanea sativa pollen was determined using the CAP system (Pharmacia & Upjohn, Uppsala, Sweden). Airborne pollen counts in our city were obtained using Cour collection apparatus over a 4-year period (2000 to 2003). Results: The most predominant pollens detected were (mean of the maximal weekly concentrations over 4 years in pollen grains/m 3): Quercus 968, Poacea 660, Olea 325, Platanus 229, Pinus 126, Cupresaceae 117, Plantago 109, Alnus 41, Populus 40, Castanea 32. We studied 346 patients (mean age: 24.1 years). In 210 patients with a diagnosis of pollinosis, the percentages of sensitization were: Dactylis glomerata 80.4 %, Olea europea 71.9 %, Fraxinus excelsior 68 %, Plantago lanceolata 62.8 %, Chenopodium album 60.9 %, Robinia pseudoacacia 49 %, Artemisia vulgaris 43.8 %, Platanus acerifolia 36.6 %, Parietaria judaica 36.1 %, Populus nigra 32.3 %, Betula alba 27.6 %, Quercus ilex 21.4 %, Alnus glutinosa 20.9 %, Cupressus arizonica 7.6 % and Castanea sativa 7.1 %. Fifteen patients were sensitized to Castanea sativa and 14 had seasonal rhinoconjunctivitis and asthma. Ten patients had serum specific IgE to Castanea pollen (maximum value: 17.4 Ku/l). Castanea pollen is present in our area in large amounts from the 23rd to the 28th weeks of the year, with a peak pollen count in the 25th week. Conclusions: The most important allergenic pollens in northern Extremadura were Poaceae, Olea europaea and Plantago sp. The prevalence of sensitization to Castanea sativa pollen was very low (7.1 %). Most sensitized patients had asthma and polysensitization. Castanea sativa pollen is not a major cause of pollinosis in our area


Assuntos
Humanos , Hipersensibilidade Respiratória/etiologia , Pólen/efeitos adversos , Castanea vesca/efeitos adversos , Hipersensibilidade Respiratória/epidemiologia , Espanha/epidemiologia , Alérgenos , Imunoglobulina E/análise , Conjuntivite Alérgica/imunologia , Asma/imunologia , Testes Cutâneos/métodos , Rinite Alérgica Sazonal/imunologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-15301309

RESUMO

Hypersensitivity pneumonitis or extrinsic allergic alveolitis can be defined as a lung disease caused by a wide group of antigens that reach the lung by inhalation of organic and/or inorganic dust of various sources. The dust of the stored maize corn has been reported as cause of respiratory symptoms. During the storage process, maize corn dust can be contaminated by moulds and thermophilic actinomycetes, which have not been described until now as the causing antigens of these symptoms. We present a case of occupational hypersensitivity pneumonitis in an agricultural worker who cultured and stored maize corn. Clinical findings, precipitating antibodies, and evolution after having removed him from his work, confirmed the diagnosis. In our case, Aspergillus species contaminating the maize corn dust are probably the antigens that caused the disease.


Assuntos
Doenças dos Trabalhadores Agrícolas/microbiologia , Alveolite Alérgica Extrínseca/microbiologia , Aspergilose/imunologia , Aspergillus/imunologia , Zea mays/microbiologia , Doenças dos Trabalhadores Agrícolas/imunologia , Agricultura , Alveolite Alérgica Extrínseca/imunologia , Aspergilose/microbiologia , Poeira/imunologia , Humanos , Exposição por Inalação/efeitos adversos , Masculino , Pessoa de Meia-Idade , Zea mays/imunologia
18.
Allergol Immunopathol (Madr) ; 32(2): 86-8, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15087096

RESUMO

Immune abnormalities have been found in many patients receiving anti-epileptic drugs. However, the effects of carbamazepine are still conflicting. We report the case of a 31-year-old woman who began carbamazepine treatment because of idiopathic epilepsy of adulthood. After three years of treatment she developed arthralgias and malaise. Complete immunologic evaluation showed a total absence of immunoglobulin M with decreased levels of immunoglobulin A, positive antinuclear antibodies and monoclonal paraproteinemia type IgG-kappa. The possibility of B cell lymphoma or myeloma was ruled out. Skin testing was negative. Bone marrow examination was normal. After carbamazepine discontinuation, levels of IgA and IgM increased until reaching normal values over 3 years. The monoclonal gammopathy of undetermined significance also disappeared over this period. During this period of immunodeficiency, the patient did not complain of any infectious complications.


Assuntos
Agamaglobulinemia/induzido quimicamente , Anticonvulsivantes/efeitos adversos , Carbamazepina/efeitos adversos , Deficiência de IgA/induzido quimicamente , Imunoglobulina M/deficiência , Síndromes de Imunodeficiência/induzido quimicamente , Gamopatia Monoclonal de Significância Indeterminada/induzido quimicamente , Adulto , Medula Óssea/patologia , Diagnóstico Diferencial , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Feminino , Humanos , Cadeias kappa de Imunoglobulina/sangue , Linfoma de Células B/diagnóstico , Gamopatia Monoclonal de Significância Indeterminada/diagnóstico , Mieloma Múltiplo/diagnóstico
20.
Allergol. immunopatol ; 32(2): 86-88, mar. 2004.
Artigo em Inglês | IBECS | ID: ibc-31310

RESUMO

Immune abnormalities have been found in many patients receiving anti-epileptic drugs. However, the effects of carbamazepine are still conflicting. We report the case of a 31-year-old woman who began carbamazepine treatment because of idiopathic epilepsy of adulthood. After three years of treatment she developed arthralgias and malaise. Complete immunologic evaluation showed a total absence of immunoglobulin M with decreased levels of immunoglobulin A, positive antinuclear antibodies and monoclonal paraproteinemia type IgG-kappa. The possibility of B cell lymphoma or myeloma was ruled out. Skin testing was negative. Bone marrow examination was normal. After carbamazepine discontinuation, levels of IgA and IgM increased until reaching normal values over 3 years. The monoclonal gammopathy of undetermined significance also disappeared over this period. During this period of immunodeficiency, the patient did not complain of any infectious complications (AU)


Se han detectado alteraciones inmunitarias en muchos pacientes que reciben antiepilépticos; sin embargo, los efectos de carbamacepina siguen siendo contradictorios. Describimos el caso de una mujer de 31 años que empezó a tomar carbamacepina por epilepsia idiopática en adultos. Después de tres años de tratamiento, experimentó artralgias y malestar. Una evaluación inmunológica completa reveló la ausencia total de inmunoglobulina M y disminución de la concentración de inmunoglobulina A, anticuerpos antinucleares positivos y una paraproteinemia monoclonal de tipo IgG-kappa. Se descartó la posibilidad de linfoma de los linfocitos B o mieloma. Las pruebas cutáneas fueron negativas. La exploración de la médula ósea fue normal. Después de suspender la carbamacepina, las concentraciones de IgA e IgM aumentaron hasta alcanzar sus valores normales a lo largo de 3 años. La gammapatía monoclonal de significación indeterminada también desapareció a lo largo de ese período. Durante ese período de inmunodeficiencia, la paciente no experimentó ninguna complicación infecciosa (AU)


Assuntos
Feminino , Adulto , Humanos , Imunoglobulina M , Anticonvulsivantes , Síndromes de Imunodeficiência , Linfoma de Células B , Deficiência de IgA , Mieloma Múltiplo , Epilepsia , Diagnóstico Diferencial , Carbamazepina , Agamaglobulinemia , Cadeias kappa de Imunoglobulina , Gamopatia Monoclonal de Significância Indeterminada , Medula Óssea
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