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Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

Humoral immune deficiencies (HID) comprise a group of diseases characterized by the impossibility to develop an effective immune response mediated by immunoglobulins (Ig). Patients with HID have infections caused by capped extracellular bacteria, mainly in the respiratory and/or gastrointestinal tract, and a higher predisposition to suffer from autoimmune diseases and cancer. Some of them are caused by well-deflned genetic defects, while the cause of others is unknown. The clinical manifestations of some HID may be late and the diagnosis is supported by laboratory tests, such as serum level of the Ig, determination of lymphocyte populations, and functional studies. Gammaglobulin replacement therapy significantly decreases serious infections. In order to achieve an early diagnosis, it is necessary to maintain a high index of suspicion and evaluate the clinical and laboratory manifestations that suggest HID. Mass sequencing technologies have favored the description of mutations in various genes that lead to a clinical HID phenotype; which paves the way to a better understanding of immune pathologies in HID. [ABSTRACT FROM AUTHOR]

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Intravenous immunoglobulin (IVIG) is the treatment of choice for humoral primary immunodeficiency diseases (PIDs). A third of the patients who receive intravenous immunoglobulin have adverse reactions, such as osmotic nephrosis. Objective: To assess the presence of kidney disease in adults with humoral PIDs, in treatment with intravenous immunoglobulin. Methods: A cross-sectional, descriptive, and observational study of patients who belong to the PID Clinic of the Specialties Hospital of the National Medical Center "Siglo XXI", Mexico City, who receive treatment with intravenous immunoglobulin. A questionnaire with demographic information, 24h urine creatinine clearance, serum creatinine, urea, and BUN (Blood Urea Nitrogen) was applied. Results: 35 patients were surveyed; 65.7 % were women; the average age was 34 years; 51.4 % of the patients presented kidney damage. Those with > 5 years of treatment with intravenous immunoglobulin presented chronic kidney disease (CKD) with more frequency (55.6 %) according to the KDOQI scale. Conclusions: Chronic kidney disease occurs in 51 % of adult patients with PID who have been treated with intravenous immunoglobulin for more than 5 years; which is why these patients require periodic evaluations of their kidney function, and the use of sugar-free immunoglobulin in order to reduce the risk. [ABSTRACT FROM AUTHOR]

Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adulthood. CVID diagnosis is by exclusion and should be considered in patients of any age who have hypogammaglobulinemia of unknown origin. Numerous patients with CVID show alterations in the development of B lymphocytes, both in plasma cells and memory cells. The absence of memory B cells suggests an insufficient germinal reaction, which can be associated with a blockade of the transition of T1 cells into T2 in patients with IDCV, owing to B-cell activating factor (BAFF) receptor deficiency. In patients with IDCV, memory B cell alterations with isotype change favor the development of concomitant comorbidities such as lymphadenopathy, splenomegaly, autoimmunity and granulomatous disease, and multiple classifications that use memory B cells in common have therefore been made trying to generate a classification of patients with IDCV, as well as to establish prognostic factors. [ABSTRACT FROM AUTHOR]

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick tests with fresh foods and/or standardized allergen, or specific IgE tests. The risk of systemic reactions is of 15-23 per 100,000 skin tests performed by prick method, specifically anaphylaxis at 0.02%. This paper reports the case of four patients, who while performing prick to prick test with fresh food presented anaphylactic reaction. Implicated foods were fruits of the Rosaceae, Anacardiaceae and Caricaceae families. The severity of anaphylaxis was: two patients with grade 4, one patient grade 2 and one grade 3, all with appropriate response to drug treatment. The risk factors identified were: female sex, personal history of atopy, previous systemic reaction to Hymenoptera venom, prior anaphylaxis to prick tests to aeroallergens. We found that a history of positive skin test for Betulla v, can be a risk factor for anaphylaxis in patients with oral syndrome. During testing prick to prick with food anaphylaxis can occur, so it should be made with aerial red team on hand. The history of positivity Betulla v is an additional risk factor in these patients. [ABSTRACT FROM AUTHOR]

Background: common variable immunodeficiency is a primary immunodeficiency, in which from 70 to 80% of patients have tumors and 25% of cases are associated with autoimmune diseases. Common variable immunodeficiency patients have a higher incidence of neoplasms, with a risk 12-18 times higher than the general population. There are few cases of common variable immunodeficiency patients with leukemia. Clinical case: female of 36 years old, with left upper quadrant pain, early satiety, weight loss of 8 kg in three months and splenomegaly. The complete blood count showed: leukocytosis 206 000/µL, with 8% blasts, platelets 530 000/µL and hemoglobin 8 mg/dL. Abdominal ultrasound: 19x12 cm splenomegaly. Karyotype BCR/ABL IS 64.20%, 100% Philadelphia chromosome. The diagnosis was of chronic myeloid leukemia. Given the presence of recurrent respiratory tract infection, frequent diarrheas and reduced concentrations of IgG, IgM and IgA, common variable immunodeficiency was diagnosed and human immunoglobulin was used successfully. Conclusions: the association between chronic myeloid leukemia and common variable immunodeficiency is unusual. Given the high frequency of hematological neoplasm in common variable immunodeficiency patients, we suggest that hematological patients with repeated infections and decreased concentrations of immunoglobulin be referred to an immunological evaluation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Vitamin D regulates cellular activity, also it has effects on: innate and adaptive immunity, antimicrobial, anti-inflammatory and immunomodulatory functions. It has been suggested a possible association between vitamin D deficiency and increased risk and length of respiratory infections in patients with common variable immunodeficiency (CVID). Methods: We conducted a descriptive study in patients with CVID. Vitamin D serum levels were measured in all patients. The results were analyzed using descriptive statistics by calculating measures of dispersion and central tendency. Results: We studied 20 patients, 13 women and 7 males, with an age average of 37 ± 13.43 years. The mean concentration of vitamin D in patients was 15.43 ng/mL ± 7.23. Thirty percent of all patients had severe Vitamin D deficiency, 45% had mild to moderate deficiency and 25% had insufficiency. Autoimmune diseases were associated in 35% of CVID patients, 42.8% of them had severe vitamin D deficiency. In patients with bronchiectasis, 85% were found with vitamin D deficiency, and it was severe in 35.2%. 41% of patients with bronchiectasis were classified as severe on the Bhalla score of severity, 57% of these patients had severe deficiency and 14.2% mild-moderate deficiency. Conclusions: We found deficiency of vitamin D in patients with CVID. Most of patients with CVID and bronchiectasis were detected with mild to severe vitamin D deficiency. Almost the half of patients with autoimmune diseases associated to CVID showed deficiency of vitamin D. We recommend to investigate the association of vitamin D deficiency on patients with immunodeficiencies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mites are the most common cause of respiratory allergy. Sensitization to house dust mites is estimated at 30%. Families Euroglyphus and Dermatophagoides, are the most important. Recently, storage mites, from the families Acaridae and Glyciphagidae, have become more important as a cause of allergic respiratory diseases. Objective: The aim of this study was to identify sensitization to house dust and storage mites by skin tests in adult patients with allergic respiratory diseases. Material and Methods: This is a descriptive study in patients with asthma and/or allergic rhinitis, with the approval of the local research committee 2009-3601-46. Patients underwent skin prick tests, with seven standardized extracts of mites (IPI ASACR). The results were analyzed with descriptive statistics. Results: A total of 150 patients, 109 women and 41 men, with an average age 31 years (±11) were studied. The more common allergic diseases in this group of patients were: asthma and rhinitis 72 and 26%, respectively, and asthma plus rhinitis 3.2%. Positive skin tests for Dermatophagoides pteronyssinus and Dermatophagoides farinae were 82.1% 71.5%, respectively, and for storage mites: A. siro 51.7%, Tyrophagus 47.4%, Glycyphagus 47.7%, B. tropicalis 39.7% and Lepidoglyphus 39.1%. Storage mites produced greater sensitization than house dust mites, 32% vs 10%. Conclusions: The results show that adult patients with respiratory allergy, in southern Mexico City, have a higher rate of sensitization to storage mites than the one reported in the literature. [ABSTRACT FROM AUTHOR]

Background: Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by defective immunoglobulin production. Twenty percent of patients may also have associated autoimmune diseases, especially hematologic, whose prevalence is estimated at 5 to 8%. Objective: To report the occurrence of autoimmune haematological disorders in CVID adults. Methods: We included 18 patients with CVID, who underwent hematologic evaluation, which included: CBC, serum folate or vitamin B complex and bone marrow aspirate. Results: Of a total of 18 patients, 11 women (61%), mean age 38 ± 13.5, six patients (33.3%) had autoimmune diseases, five of them had blood diseases (4 with PTI and one with Evans syndrome). Three patients had more than one autoimmune disease and one presented three autoimmune diseases (Evans syndrome, hypoparathyroidism and celiac disease with a history of autoimmune hemolytic anemia). Conclusions: The prevalence of autoimmune diseases in this group of patients with CVID was higher than the 20% reported in the literature. Hematological diseases should be suspected in CVID patients, since half of our cases presented them. [ABSTRACT FROM AUTHOR]

Introduction: Up to 25% of patients with common variable immunodeficiency (CVID) debut with autoimmunity, which is related to the Freiburg classification, which is based on flow cytometry., Objective: to determine the frequency and type of autoimmune diseases and their association with the Freiburg classification in adults with CVID., Methods: A cross-sectional, analytical and observational study was carried out with 33 patients belonging to the Primary Immunodeficiency Clinic of a third level hospital, with a diagnosis of CVID. They were divided into 3 phenotypes according to the Freiburg classification., Results: Of the 33 patients studied, 66.6% presented autoimmune diseases, 19 of them (86.3%) had cytopenia; 42.1% belonged to Freiburg group Ia, 36.8% to Ib and 21% to phenotype II. In 36.6% of the patients, autoimmune cytopenia were the first manifestation of CVID; and up to 70% of them belong to the Freiburg phenotype Ia (p = 0.086). Patients with autoimmune cytopenia had a lower percentage of isotype-switched memory B cells (p = 0.018), no higher percentage of CD21low B cells (p = 0.226)., Conclusions: Classification by CVID phenotypes allows the identification of the patient's profile according to the percentage of memory B cells with isotype change, which is useful to intentionally search for non-infectious complications of the disease., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Asthma has a global prevalence of 18%. In work-related asthma, there is an association between asthma and the exposure to dust, vapors, or fumes only at the workplace, in patients with or without a previous asthma diagnosis; it represents approximately 5-25% of the cases of adult onset asthma. In Mexico, the information about this topic is scarce., Case Report: A series of 17 patients with an asthma diagnosis and occupational exposure to dust, vapors, or fumes is reported; occupational asthma was determined by the Allergy and Clinical Immunology Service at Centro Médico Nacional Siglo XXI., Conclusion: Occupational health is essential for the proper performance of the staff, the optimal performance of the work unit, and for avoiding health damages, economic losses, and social implications. The role of the physician in charge of occupational health in terms of prevention, diagnosis, and timely management of frequent pathologies according to the work sector, represents a great area of opportunity that is important to fulfill in many work centers.

Background: Common variable immunodeficiency (CVID) is the most common primary symptomatic humoral immunodeficiency in adults. Antibody deficiency entails higher susceptibility to sinopulmonary infections and bronchiectasis formation, which is related to increased mortality. Scales have been established to assess the degree of severity of bronchiectasis in order to predict outcomes such as mortality, exacerbations and hospitalizations., Objective: To determine bronchiectasis severity in adult patients with common variable immunodeficiency using the Brief Symptom Inventory scale., Method: Cross-sectional study in adult population diagnosed with common variable immunodeficiency and attended to at the Mexican Institute of Social Security National Medical Center Siglo XXI Specialty Hospital., Results: Bronchiectasis severity according to the Brief Symptom Inventory was mild in 60% of patients and moderate in 40%. Statistically significant differences were found for body mass index, number of affected lobes and type of bronchiectasis (p < 0.001)., Conclusions: Using bronchiectasis severity scales in patients with common variable immunodeficiency is indispensable for clinical and therapeutic decision making; however, determining the most appropriate instrument to assess bronchiectasis severity in this population is necessary.

Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adulthood. CVID diagnosis is by exclusion and should be considered in patients of any age who have hypogammaglobulinemia of unknown origin. Numerous patients with CVID show alterations in the development of B lymphocytes, both in plasma cells and memory cells. The absence of memory B cells suggests an insufficient germinal reaction, which can be associated with a blockade of the transition of T1 cells into T2 in patients with IDCV, owing to B-cell activating factor (BAFF) receptor deficiency. In patients with IDCV, memory B cell alterations with isotype change favor the development of concomitant comorbidities such as lymphadenopathy, splenomegaly, autoimmunity and granulomatous disease, and multiple classifications that use memory B cells in common have therefore been made trying to generate a classification of patients with IDCV, as well as to establish prognostic factors.

Primary immunodeficiencies (PIDs) are low-incidence diseases caused by defects in genes involved in the development, maintenance, and regulation of the immune system. Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency of adulthood. It has an approximate prevalence of 1 in 25 000-50 000 in the general population, with a delay in diagnosis between 6-7 years. The clinical manifestations of CVID constitute six main categories: infections, pulmonary complications, granulomatous or polyclonal lymphocytic disease, autoimmunity, gastrointestinal diseases and malignancy Most patients must have at least one of the following clinical manifestations (infection, autoimmunity, lymphoproliferation). However, the diagnosis of CVID can be conferred in asymptomatic patients, especially in familial cases. Secondary causes of hypogammaglobulinemia should be ruled out in any patient meeting the diagnostic criteria for CVID, as the treatment may be totally different from that required for CVID. Because CVID comprises a heterogeneous group of syndromes with poor primary antibody production, the potential number of entities within this group is unknown. Patients with CVID suffer from various complications that are considered prognostic. In the absence of clear guidelines for their search, it is recommended that lymphoproliferative disease, lung disease, liver disease and autoimmunity be investigated intentionally during the initial evaluation. The intervals in which they should be performed are not clear, but several evaluations may be required per year, according to the clinical evolution of the patient.

Background: Common variable immunodeficiency is a primary immunodeficiency, in which from 70 to 80 % of patients have tumors and 25 % of cases are associated with autoimmune diseases. Common variable immunodeficiency patients have a higher incidence of neoplasms, with a risk 12-18 times higher than the general population. There are few cases of common variable immunodeficiency patients with leukemia., Clinical Case: Female of 36 years old, with left upper quadrant pain, early satiety, weight loss of 8 kg in three months and splenomegaly. The complete blood count showed: leukocytosis 206 000/mL, with 8 % blasts, platelets 530 000/mL and hemoglobin 8 mg/dL. Abdominal ultrasound: 19??12 cm splenomegaly. Karyotype BCR/ABL IS 64.20 %, 100 % Philadelphia chromosome. The diagnosis was of chronic myeloid leukemia. Given the presence of recurrent respiratory tract infection, frequent diarrheas and reduced concentrations of IgG, IgM and IgA, common variable immunodeficiency was diagnosed and human immunoglobulin was used successfully., Conclusions: The association between chronic myeloid leukemia and common variable immunodefficiency is unusual. Given the high frequency of hematological neoplasm in common variable immunodeficiency patients, we suggest that hematological patients with repeated infections and decreased concentrations of immunoglobulin be referred to an immunological evaluation.

The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick tests with fresh foods and/or standardized allergen, or specific IgE tests. The risk of systemic reactions is of 15-23 per 100,000 skin tests performed by prick method, specifically anaphylaxis at 0.02%. This paper reports the case of four patients, who while performing prick to prick test with fresh food presented anaphylactic reaction. Implicated foods were fruits of the Rosaceae, Anacardiaceae and Caricaceae families. The severity of anaphylaxis was: two patients with grade 4, one patient grade 2 and one grade 3, all with appropriate response to drug treatment. The risk factors identified were: female sex, personal history of atopy, previous systemic reaction to Hymenoptera venom, prior anaphylaxis to prick tests to aeroallergens. We found that a history of positive skin test for Betulla v, can be a risk factor for anaphylaxis in patients with oral syndrome. During testing prick to prick with food anaphylaxis can occur, so it should be made with aerial red team on hand. The history of positivity Betulla v is an additional risk factor in these patients.

Corticosteroid hypersensitivity is a complex phenomenon in which many factors interact, such as idiosyncrasy, intolerance or allergic reactions. The prevalence of immediate hypersensitivity reactions to corticosteroids is 0.2%-0.5%. Corticosteroids have major therapeutic implications; thus, when hypersensitivity is suspected, in-vitro and/or in-vivo testing can be performed to confirm diagnosis, being the drug challenge the gold standard. After definitive diagnosis, cross-reactivity among the different corticosteroid groups should be considered, to choose wisely if corticosteroid therapy is still required. In Coopman classification, steroids belonging to groups A, B and D2 have high cross-reactivity, however, more studies are needed to determine the degree of cross-reaction among these drugs. This paper presents the case of a woman, in who hypersensitivity to hydrocortisone succinate was confirmed by drug challenge test.

Background: Vitamin D regulates cellular activity, also it has effects on: innate and adaptive immunity, antimicrobial, anti-inflammatory and immunomodulatory functions. It has been suggested a possible association between vitamin D deficiency and increased risk and length of respiratory infections in patients with common variable immunodeficiency (CVID)., Methods: We conducted a descriptive study in patients with CVID. Vitamin D serum levels were measured in all patients. The results were analyzed using descriptive statistics by calculating measures of dispersion and central tendency., Results: We studied 20 patients, 13 women and 7 males, with an age average of 37 ± 13.43 years. The mean concentration of vitamin D in patients was 15.43 ng/mL ± 7.23. Thirty percent of all patients had severe Vitamin D deficiency, 45% had mild to moderate deficiency and 25% had insufficiency. Autoimmune diseases were associated in 35% of CVID patients, 42.8% of them had severe vitamin D deficiency. In patients with bronchiectasis, 85% were found with vitamin D deficiency, and it was severe in 35.2%. 41% of patients with bronchiectasis were classified as severe on the Bhalla score of severity, 57% of these patients had severe deficiency and 14.2% mild-moderate deficiency., Conclusions: : We found deficiency of vitamin D in patients with CVID patients. Most of patients with CVID and bronchiectasis were detected with mild to severe vitamin D deficiency. Almost the half of patients with autoimmune diseases associated to CVID showed deficiency of vitamin D. We recommend to investigate the association of vitamin D deficiency on patients with immunodeficiencies.

Background: Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia. Its prevalence is 1:10000 to 1:50000 with the highest incidence in children, 6 to 10 years, and in adults around age 29. The association of CVID and bronchiectasis has a prevalence of 17-90%. The quality of life in these patients can be assessed through instruments such as the Saint George Respiratory Questionnaire (SGRQ), which is designed for patients with chronic lung diseases and validated for the Mexican population., Objective: [corrected] To evaluate the quality of life in adult patients with CVID and bronchiectasis using the SGRQ., Methods: We applied CRSG to all the patients of the Immunodeficiencies Clinic from Hospital Especialidades CMN SXXI diagnosed with CVID and bronchiectasis for assessing quality of life which was evaluated in the three areas of application 1)Symptoms, 2)Activities and 3)Impact and the overall quality of life. We also analyzed its relationship with the severity of bronchiectasis confirmed by HRCT., Results: 19 patients were included, (5 males, 14 women) in whom it was found affected the overall quality of life in 84.2%. Women showed higher scores for all areas of the SGRQ (♀ 28.3 ± 25.18 vs. ♂ 9.89 ± 8.14). The most affected area by both sexes was the Symptoms in 92% of women and 80% men. About the severity of bronchiectasis patients with mild bronquietasias presented scores 0-22.2 (x= 11.1 ± 15.6), those with moderate bronchiectasis 3.24-56.9 (x=25.5 ± 21.76) and severe with scores of 0-74.8 (x= 24.1 ± 28.5.)., Conclusions: Patients with CVID and bronchiectasis have impaired quality of life, mainly associated with respiratory symptoms, with less involvement of and impact areas. Females were most affected in intensity to show higher scores.