Characterization of a group of children with eosinophilic esophagitis in Cali, Colombia.

PURPOSE: Eosinophilic esophagitis (EoE) is an immunologically mediated chronic disease of the gastrointestinal tract. The objective of this study was to clinically and demographically describe a child population with EoE diagnosed in a high-complexity hospital in Cali, Colombia. METHODS: A retrospective study was carried out. The clinical histories of patients between 0 and 18 years with clinical suspicion and a histological diagnosis of EoE were analyzed. All patients underwent an allergy study, either by measurement of specific immunoglobulin (Ig) E and/or an intraepidermal skin-prick test. RESULTS: Thirty-five patients were included in the study, of which 21 (60%) women. The median age was 8 years (interquartile range [IQR] 5-12), and the age of onset of symptoms was 5 years (IQR 2-10). Thirty patients (85.7%) reported a history of allergic disease, with rhinitis being the most frequent (n = 25, 71.4%). Only one patient reported with food allergy mediated by IgE. The main symptoms in patients included abdominal pain (17 [48.6%]), refractory gastroesophageal reflux (16 [45.7%]), and choking (9 [25.7%]). Upper gastrointestinal endoscopy was normal in 10 patients (38.5%). The median number of eosinophils in the biopsy was 42 (IQR 31-92). Allergenic sensitization was verified in 25 of 35 patients (71.4%). Of these, dust mite allergy was positive in 21 patients (84%), while the most frequent food allergy was toward cow's milk, in five patients (31.3%). CONCLUSIONS: The majority of patients with EoE were females. The most frequent symptom was abdominal pain. Endoscopic abnormalities were also observed frequently, and the prevalence of other allergic diseases (especially rhinitis) and allergenic sensitization (especially to mites) was high.

Descriptive Analysis of Cross-Reactive Anaphylaxis as a Different Clinical Subtype of Nonsteroidal Anti-Inflammatory Drug (NSAID) Hypersensitivity.

INTRODUCTION: The European Network of Drug Allergy and the European Academy of Allergy and Clinical Immunology have classified hypersensitivity reactions induced by nonsteroidal anti-inflammatory drugs (NSAIDs) into 5 phenotypes according to the pathophysiology, clinical manifestations, number of drugs involved, and the presence of underlying diseases. This classification does not include anaphylaxis as part of NSAID cross-reactivity. The objective of this study was to characterize a group of patients with anaphylactic NSAID cross-reactivity. METHOD: This was a retrospective, descriptive, observational study. Patients who developed anaphylaxis to one NSAID plus another acute reaction (anaphylactic or not) to at least one other NSAID of a different chemical group were included. Demographic and clinical characteristics and the diagnostic approach were studied. RESULTS: A total of 38 patients were included, 28 (73.7%) of whom were women. The mean age was 40 ± 17.7 years. The main organs affected in the anaphylactic reaction were the skin and the respiratory system, occurring in 35 (92.1%) and 33 (86.8%) patients, respectively. Thirty-two (84.3%) patients presented with cutaneous and respiratory involvement simultaneously. The main anti-inflammatory agent involved in anaphylactic reactions was acetylsalicylic acid in 9 (23.7%) patients, followed by dipyrone in 8 (21.1%). The most frequent allergic comorbidity was rhinitis in 20 (52%) patients. Skin tests were performed in 15 (39.5%) patients, showing positivity in 12 (80%), mainly to mites. A total of 36 of 38 patients were challenged with alternative drugs, and 35 (97.2%) tolerated meloxicam and/or etoricoxib. CONCLUSION: In the present study, NSAID cross-anaphylaxis was more frequent in women, and acetylsalicylic acid and dipyrone were the main triggers. Rhinitis was the main allergic comorbidity, and there was a high incidence of atopy. The majority tolerated selective COX-2 NSAIDs.

Food allergy spectrum in the tropic: clinical and epidemiological profiles in a colombian hospital. A cross-sectional study.

Introduction: Food allergy affects 2-10% of the general population; it is more frequent among children than among adults, and it is one of the leading causes of anaphylaxis. Diagnosis of food allergy requires a detailed medical history, skin tests, specific immunoglobulin E (IgE) tests for the food involved, and an oral challenge as final confirmation. Objectives: This study aimed to describe the clinical and epidemiological characteristics of patients who underwent oral food challenges for suspected food allergies in a reference center in Colombia. Methodology: An observational, descriptive, cross-sectional and retrospective study was conducted. Data were retrospectively collected from patients who were evaluated in the allergology service and suspected of food allergy from 2011 to 2018. Quantitative variables are presented as means or medians depending on the normality of the distribution (assessed by the Shapiro-Wilk test), and categorical variables are presented as frequencies and percentages. Results: A total of 215 controlled open challenges were performed on 176 patients, most of whom were children (69%). Thirty-one patients (17%) required another oral challenge with a second food, and 11 (6.25%) required another oral challenge with three foods. Twelve oral challenges (5.58%) were positive. Of these, five challenges were positive for cow's milk, 5 were positive for shrimp, and 2 were positive for legumes (peanuts and lentils). Conclusion: The frequency of confirmed food allergies and the profile of food allergies in our population differs from that reported in other parts of the world.