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1. Profile of Sensitization to Related Animal Proteins (Crocodile, Frog, and Chicken) Among Fish-Allergic Patients

Author

Haroun-Díaz, E, primary, Blanca-López, N, additional, Martín-Pedraza, L, additional, Ruano, FJ, additional, Somoza, ML, additional, Vázquez de la Torre, M, additional, Pérez-Alzate, D, additional, López-González, P, additional, Prieto-Moreno, A, additional, Bartolomé, B, additional, Blanca, M, additional, and Canto, G, additional

Published
2022
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3. Hypersensitivity Reactions to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Selective Reactions

Author

Blanca-López N, Ja, Cornejo-García, Pérez-Alzate D, Pérez-Sánchez N, Mc, Plaza-Serón, Doña I, Mj, Torres, Canto G, Kidon M, James Richard Perkins, Blanca M, [Blanca-López,N, Pérez-Alzate,D, Canto,G] Allergy Service, Infanta Leonor Hospital, Madrid, Spain. [Cornejo-García,JA, Plaza-Serón,MC, Perkins,JR] Research Laboratory, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain. [Cornejo-García,JA, Pérez-Sánchez,N, Doña,I, Torres,MJ, Blanca, M] Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain. [Kindon,M] Pediatric Allergy Clinic, Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel. Faculty of Pediatric Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel., and The present study was supported by grants from the Carlos III National Health Institute, Spanish Ministry of Economy and Competitiveness (grants cofunded by the European Regional Development Fund), RD12/0013/0001 (Red de Investigación de Reacciones Adversas a Alérgenos y Fármacos, RIRAAF Network), FIS PI12/02247, FIS PI13/02598, and the Andalusian Public Health Service (PI-0279-2012 and PI-0463-2013).

Subjects
Drug hypersensitivity reactions, Adolescent, NSAIDs, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Sensory System Agents::Analgesics::Analgesics, Non-Narcotic::Anti-Inflammatory Agents, Non-Steroidal [Medical Subject Headings], Anti-Inflammatory Agents, Non-Steroidal, Urticaria/angioedema o anafilaxia inducidas por un único AINE, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Diagnosis, Differential, Drug Hypersensitivity, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnosis, Differential [Medical Subject Headings], Reacciones de hipersensibilidad a fármacos, Risk Factors, Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings], AINE, Humans, Diseases::Immune System Diseases::Hypersensitivity::Drug Hypersensitivity [Medical Subject Headings], Single NSAID-induced delayed reactions, Child, Reacciones selectivas, Reacciones tardías inducidas por un único AINE, Single NSAID-induced urticaria/angioedema or anaphylaxis, Named Groups::Persons::Age Groups::Child [Medical Subject Headings]
Abstract

Journal Article; Research Support, Non-U.S. Gov't; Review; Nonsteroidal anti-inflammatory drugs (NSAIDs) are used throughout the world to treat pain and inflammation; however, they can trigger several types of drug hypersensitivity reactions (DHRs) in all age groups. Although most such reactions occur through activation of the leukotriene pathway without specific immunological recognition (cross-intolerance), a significant number of DHRs to NSAIDs are due to immunological mechanisms (selective reactions [SRs]). SRs are thought to be induced by specific IgE antibodies or by T cells. In this manuscript, we focus on SRs, which are of great concern in children and adolescents and comprise a heterogeneous set of clinical pictures ranging from mild entities such as urticaria/angioedema to potentially life-threatening conditions such as Stevens-Johnson syndrome/toxic epidermal necrolysis. Paracetamol and ibuprofen are the most frequent elicitors of IgE-mediated SRs, although pyrazolones have also been implicated. T cell-mediated reactions are infrequent in children but have been associated with ibuprofen, naproxen, and dipyrone. In this review, we analyze the available literature on SRs in children and adolescents, with emphasis on epidemiological data, mechanisms, and drugs involved, as well as on diagnostic procedures. Yes A pesar de su eficacia en el tratamiento del dolor y la inflamación los antiinflamatorios no esteroideos (AINE), los medicamentos de mayor consumo mundial, también son la causa más frecuente de reacciones de hipersensibilidad a fármacos (RHFs) en cualquier tramo de edad. Aunque en muchas de estas reacciones se liberan mediadores inflamatorios en ausencia de reconocimiento inmunológico específico (intolerancia cruzada), un porcentaje considerable de las RHFs a AINE se producen a través de mecanismos inmunológicos (reacciones selectivas, SRs). En éstas participarían anticuerpos IgE específicos o células T. Las SRs son de gran interés en niños y adolescentes e incluyen un conjunto heterogéneo de entidades que comprenden desde manifestaciones clínicas de poca gravedad como la urticaria y el angioedema hasta otras como el síndrome de Stevens-Johnson y la necrolisis epidérmica tóxica, que pueden suponer una amenaza para la vida. En niños el paracetamol y el ibuprofeno son los medicamentos más frecuentemente implicados en las SRs mediadas por IgE aunque también se ha descrito la participación de las pirazolonas. Las reacciones mediadas por linfocitos T son menos frecuentes pero también se han descrito en relación con la administración de ibuprofeno, naproxeno y dipirona. En esta revisión analizaremos la literatura actual sobre las SRs en niños y adolescentes, centrándonos en los datos epidemiológicos, mecanismos y fármacos implicados, así como las pruebas disponibles para su diagnóstico.

Published
2016

6. Immediate hypersensitivity reactions to ibuprofen and other arylpropionic acid derivatives

Author

Universitat Politècnica de València. Instituto Universitario Mixto de Tecnología Química - Institut Universitari Mixt de Tecnologia Química, Universitat Politècnica de València. Departamento de Química - Departament de Química, Ministerio de Economía y Competitividad, Junta de Andalucía, Blanca-López, Natalia, Pérez-Alzate, D., Andreu Ros, María Inmaculada, Doña, Inmaculada, Agundez, Javier A., García-Martín, Elena, Salas, M., Miranda Alonso, Miguel Ángel, Torres, M. J., Cornejo-Garcia, J.A., Blanca, M., Canto, G., Universitat Politècnica de València. Instituto Universitario Mixto de Tecnología Química - Institut Universitari Mixt de Tecnologia Química, Universitat Politècnica de València. Departamento de Química - Departament de Química, Ministerio de Economía y Competitividad, Junta de Andalucía, Blanca-López, Natalia, Pérez-Alzate, D., Andreu Ros, María Inmaculada, Doña, Inmaculada, Agundez, Javier A., García-Martín, Elena, Salas, M., Miranda Alonso, Miguel Ángel, Torres, M. J., Cornejo-Garcia, J.A., Blanca, M., and Canto, G.

Abstract

[EN] Background: Although ibuprofen and other arylpropionic acid derivatives (APs) are the most common medicines involved in hypersensitivity drug reactions (HDRs) to NSAIDs, no patient series studies have been performed regarding immediate selective reactions (SRs) to these drugs. Objective: To characterize patients with immediate selective HDRs to ibuprofen and other APs through clinical history and challenge. Methods: Subjects who developed an HDR to APs less than 1 h after drug intake were included. Tolerance to aspirin was assessed and challenge was performed with ibuprofen in all cases, and additionally with the culprit drug (if different) in those patients that tolerated ibuprofen. Serum tryptase levels and tryptase immunohistochemical staining in skin biopsies were also assessed in some patients with a positive DPT to ibuprofen. Results: From a total of 245 patients with a confirmed history of HDRs to APs, 17% were classified as selective immediate hypersensitivity reactors by both clinical history and challenge. A selective response to naproxen and dexketoprofen with tolerance to ibuprofen was found in 16 of 20 cases. Significant differences in serum tryptase levels were observed between 2 and 24 h in the 11 cases that were studied further. Conclusions: Within the group of patients with HDRs to NSAIDs, APs can induce immediate SRs. Within this group, selective responses to a single drug or responders to several APs may exist, suggesting potential immunological crossreactivit

Published
2016

7. 7th Drug hypersensitivity meeting: part two

Author

Elera, J.D., Boteanu, C., Blanco, M.A.J., Gonzalez-Mendiola, R., García, I.C., Alvarez, A., Martinez, J.J.L., Garrido, J.M., Barona, C.T., Chorda, C.P., Salgueiro, R.L., Palacios, M.D., De Rojas, D.H.F., Acar, E.A., Aktas, A., Ermertcan, A.T., Temiz, C., Lin, C-Y, Hui, C-Y.R., Chang, Y-C, Yang, C-H, Chung, W-H, Carolino, F., Silva, D., De Castro, E.D., Cernadas, J.R., Ensina, L.F., Aranda, C., Nunes, I.C., Lacerda, A., Martins, A.M., Goudouris, E., Ribeiro, M., Da Silva Franco, J.F., Queiroz, L., Solé, D., Dalgiç, C.T., Sin, A.Z., Günsen, F.D., Bulut, G., Ardeniz, F.Ö., Gülbahar, O., Gökmen, E.N.M., Kokuludag, A., De Francisco, A.M.M., De Vicente Jiménez, T.M., Mendoza Parra, A.M., Burgos Pimentel, A.M., Luque, A.G., Amaral, L., Leão, L.C., Pinto, N., Belo, J., Marques, J., Carreiro-Martins, P., Leiria-Pinto, P., Chaabane, A., Romdhane, H.B., Fredj, N.B., Chadly, Z., Boughattas, N.A., Aouam, K., Uyttebroek, A.P., Bridts, C.H., Romano, A., Ebo, D.G., Sabato, V., Lopes, A., Cosme, J., Aguiar, R., Lourenço, T., Paes, M-J, Spínola-Santos, A., Pereira-Barbosa, M., Cruz, C.R., Dos Reis, R.P., Tomaz, E., Pires, A.P., Inácio, F., Benito-Garcia, F., Mota, I., Correia, M., Gaspar, Â., Chambel, M., Piedade, S., Morais-Almeida, M., Nakonechna, A., Antipkin, Y., Umanets, T., Pineda, F., Arribas, F., Lapshyn, V., Miranda, P.A., De La Cruz Hoyos, B., Blanco, A.J., Del Pozo, M., Vultaggio, A., Nencini, F., Pratesi, S., Matucci, A., Maggi, E., Cegec, I., Nahal, D.J., Turk, V.E., Aumiler, M.R., Ausperger, K.M., Kraljickovic, I., Simic, I., Yamaguchi, Y., Watanabe, T., Satoh, M., Tanegashima, T., Oda, K., Wada, H., Aihara, M., Lee, J.J., Choi, J.C., Lee, H.Y., Fernandes, R-A.R., Faria, E., Pita, J., Sousa, N., Ribeiro, C., Carrapatoso, I., Bom, A.T., Rodolfo, A., Dias-Castro, E., Voronova, M., Valle, D.K., Coronel, V.P., Chordá, C.P., Madamba, R.C.Y., Ferrer, M., Goikoetxea, M.J., D’Amelio, C., Bernad, A., Vega, O., Gastaminza, G., Bibián, B.L., Salazar, M.L., Vilà-Nadal, G., Roman, A.M.F., Ortega, J.D., Muñoz, M.G., Gancedo, S.Q., Moreno, M.R.C., Hofmeier, K.S., Barzylovych, V., Pola, B., Lluncor, M., Fiandor, A., Bellón, T., Domínguez, J., Quirce, S., Yang, M-S, Kim, S-S, Kim, S-H, Kang, H-R, Park, H-W, Cho, S-H, Min, K-U, Chang, Y-S, Delahaye, C., Flabbee, J., Waton, J., Bauvin, O., Barbaud, A., Fadhel, N.B., Gulin, S.J., Chiriac, A., Cardoso, B.K., Viseu, R., Moreira, A., Cadinha, S., Neves, A.C., Barreira, P., Malheiro, D., Da Silva, J.P., Jurakic-Toncic, R., Ljubojevic, S., Turcic, P., Gilissen, L., Huygens, S., Goossens, A., Andreu, I., Romero, A.M., Cabezas, P.G., Parejo, P.A., Del Carmen Plaza-Serón, M., Doña, I., Blanca-López, N., Flores, C., Galindo, M.L., Molina, A., Perkins, J.R., Cornejo-García, J.A., García-Agúndez, J.A., García-Martín, E., Campo, P., Canto, M.G., Blanca, M., Guéant-Rodríguez, R.M., Jurado-Escobar, R., Barrionuevo, E., Salas, M., Canto, G., Guéant, J-L, Usui, T., Tailor, A., Faulkner, L., Farrell, J., Alfirevic, A., Kevin Park, B., Naisbitt, D.J., Trelles, O., Guerrero, M.A., Upton, A., Ueta, M., Sawai, H., Sotozono, C., Tokunaga, K., Kinoshita, S., Sukasem, C., Satapornpong, P., Tempark, T., Rerknimitr, P., Pairayayutakul, K., Klaewsongkram, J., Koomdee, N., Jantararoungtong, T., Santon, S., Puangpetch, A., Intusoma, U., Tassaneeyakul, W., Theeramoke, V., Ramirez, E., Borobia, A.M., Tong, H., Castañer, J.L., De Abajo, F.J., Galvao, V.R., Pavlos, R., McKinnon, E., Williams, K., Beeghly-Fadiel, A., Phillips, E., Castells, M., Boni, E., Russello, M., Mauro, M., Ue, K.L., Rutkowski, K., Gomis, V.S., Ferre, J.F., Rodriguez, A.E., Reig, V.C., Sanchez, J.F., Breynaert, C., Van Hoeyveld, E., Schrijvers, R., Irigoyen, R.F., Collado, D., Vida, Y., Najera, F., Perez-Inestrosa, E., Mesa-Antunez, P., Mayorga, C., Torres, M.J., Tannert, L.K., Mortz, C.G., Skov, P.S., Bindslev-Jensen, C., Pfützner, W., Dörnbach, H., Visse, J., Rauber, M., Möbs, C., Elzagallaai, A.A., Chow, L., Abuzgaia, A.M., Rieder, M.J., Trubiano, J., Woolnough, E., Cheng, C., Kato, K., Azukizawa, H., Hanafusa, T., Katayama, I., Fujiyama, T., Hashizume, H., Umayahara, T., Ito, T., Tokura, Y., Silar, M., Zidarn, M., Rupnik, H., Korosec, P., Redwood, A.J., Strautins, K., White, K., Chopra, A., Konvinse, K., Leary, S., Mallal, S., Cabañas, R., Fiandor, A.M., Sullivan, A., Whitaker, P., Peckham, D., Haw, W.Y., Polak, M.E., Mcguire, C., Ardern-Jones, M.R., Aoyama, Y., Shiohara, T., Correia, S., Gelincik, A., Demir, S., Sen, F., Bozbey, H.U., Olgac, M., Unal, D., Coskun, R., Colakoglu, B., Buyuozturk, S., Çatin-Aktas, E., Deniz, G., Laguna, J.J., Dionicio, J., Fernandez, T., Olazabal, I., Ruiz, M.D., Lafuente, A., Núñez, J., Fernández, T.D., Palomares, F., Fernández, R., Sanchez, M.I., Ruiz, A., Ariza, A., Alonso, A.B., Garófalo, C.D., Matute, O.V., Puga, M.F., Lapresa, M.J.G., Lasarte, G.G., Thinnes, A., Merk, H.F., Baron, J.M., Leverkus, M., Balakirski, G., Gibson, A., Ogese, M., Al-Attar, Z., Yaseen, F., Meng, X., Jenkins, R., Farrel, J., Alhilali, K., Xue, Y., Illing, P., Mifsud, N., Fettke, H., Lai, J., Ho, R., Kwan, P., Purcell, A., Ogese, M.O., Betts, C., Thomson, P., Alhaidari, M., Berry, N., O’Neill, P.M., Alzahrani, A., Azoury, M.E., Fili, L., Bechara, R., Scornet, N., Nhim, C., Weaver, R., Claude, N., Joseph, D., Maillere, B., Parronchi, P., Pallardy, M., Villani, A.P., Rozières, A., Bensaïd, B., Tardieu, M., Albert, F., Mutez, V., Baysal, T., Maryanski, J., Nicolas, J-F, Kanagawa, O., Vocanson, M., Hung, S-L, Harrison, C.J., Jenkins, R.E., French, N.S., Montañez, M.I., Fernandez, T.D., Martin-Serrano, A., Molina, N., Wood, S., Pirmohamed, M., Martín-Serrano, Á., Pérez-Inestrosa, E., Pérez-Sala, D., Guzmán, A.E., Ko, T-M, Chen, Y-T, Wu, J-Y, Sánchez-Gómez, F.J., González-Morena, J.M., Arreola, A.M., Corona, J.A.B., Flores, S.M., Cherit, J.D., Figueroa, N.V.D., Flores, J.L.C., Perkins, J., Pérez-Alzate, D., Bogas, G., Marti, L.M.T., De La Losa, F.P., Poves, F.A., Lopez, J.T., Santiago, T.L., Elera, J.D., Boteanu, C., Blanco, M.A.J., Gonzalez-Mendiola, R., García, I.C., Alvarez, A., Martinez, J.J.L., Garrido, J.M., Barona, C.T., Chorda, C.P., Salgueiro, R.L., Palacios, M.D., De Rojas, D.H.F., Acar, E.A., Aktas, A., Ermertcan, A.T., Temiz, C., Lin, C-Y, Hui, C-Y.R., Chang, Y-C, Yang, C-H, Chung, W-H, Carolino, F., Silva, D., De Castro, E.D., Cernadas, J.R., Ensina, L.F., Aranda, C., Nunes, I.C., Lacerda, A., Martins, A.M., Goudouris, E., Ribeiro, M., Da Silva Franco, J.F., Queiroz, L., Solé, D., Dalgiç, C.T., Sin, A.Z., Günsen, F.D., Bulut, G., Ardeniz, F.Ö., Gülbahar, O., Gökmen, E.N.M., Kokuludag, A., De Francisco, A.M.M., De Vicente Jiménez, T.M., Mendoza Parra, A.M., Burgos Pimentel, A.M., Luque, A.G., Amaral, L., Leão, L.C., Pinto, N., Belo, J., Marques, J., Carreiro-Martins, P., Leiria-Pinto, P., Chaabane, A., Romdhane, H.B., Fredj, N.B., Chadly, Z., Boughattas, N.A., Aouam, K., Uyttebroek, A.P., Bridts, C.H., Romano, A., Ebo, D.G., Sabato, V., Lopes, A., Cosme, J., Aguiar, R., Lourenço, T., Paes, M-J, Spínola-Santos, A., Pereira-Barbosa, M., Cruz, C.R., Dos Reis, R.P., Tomaz, E., Pires, A.P., Inácio, F., Benito-Garcia, F., Mota, I., Correia, M., Gaspar, Â., Chambel, M., Piedade, S., Morais-Almeida, M., Nakonechna, A., Antipkin, Y., Umanets, T., Pineda, F., Arribas, F., Lapshyn, V., Miranda, P.A., De La Cruz Hoyos, B., Blanco, A.J., Del Pozo, M., Vultaggio, A., Nencini, F., Pratesi, S., Matucci, A., Maggi, E., Cegec, I., Nahal, D.J., Turk, V.E., Aumiler, M.R., Ausperger, K.M., Kraljickovic, I., Simic, I., Yamaguchi, Y., Watanabe, T., Satoh, M., Tanegashima, T., Oda, K., Wada, H., Aihara, M., Lee, J.J., Choi, J.C., Lee, H.Y., Fernandes, R-A.R., Faria, E., Pita, J., Sousa, N., Ribeiro, C., Carrapatoso, I., Bom, A.T., Rodolfo, A., Dias-Castro, E., Voronova, M., Valle, D.K., Coronel, V.P., Chordá, C.P., Madamba, R.C.Y., Ferrer, M., Goikoetxea, M.J., D’Amelio, C., Bernad, A., Vega, O., Gastaminza, G., Bibián, B.L., Salazar, M.L., Vilà-Nadal, G., Roman, A.M.F., Ortega, J.D., Muñoz, M.G., Gancedo, S.Q., Moreno, M.R.C., Hofmeier, K.S., Barzylovych, V., Pola, B., Lluncor, M., Fiandor, A., Bellón, T., Domínguez, J., Quirce, S., Yang, M-S, Kim, S-S, Kim, S-H, Kang, H-R, Park, H-W, Cho, S-H, Min, K-U, Chang, Y-S, Delahaye, C., Flabbee, J., Waton, J., Bauvin, O., Barbaud, A., Fadhel, N.B., Gulin, S.J., Chiriac, A., Cardoso, B.K., Viseu, R., Moreira, A., Cadinha, S., Neves, A.C., Barreira, P., Malheiro, D., Da Silva, J.P., Jurakic-Toncic, R., Ljubojevic, S., Turcic, P., Gilissen, L., Huygens, S., Goossens, A., Andreu, I., Romero, A.M., Cabezas, P.G., Parejo, P.A., Del Carmen Plaza-Serón, M., Doña, I., Blanca-López, N., Flores, C., Galindo, M.L., Molina, A., Perkins, J.R., Cornejo-García, J.A., García-Agúndez, J.A., García-Martín, E., Campo, P., Canto, M.G., Blanca, M., Guéant-Rodríguez, R.M., Jurado-Escobar, R., Barrionuevo, E., Salas, M., Canto, G., Guéant, J-L, Usui, T., Tailor, A., Faulkner, L., Farrell, J., Alfirevic, A., Kevin Park, B., Naisbitt, D.J., Trelles, O., Guerrero, M.A., Upton, A., Ueta, M., Sawai, H., Sotozono, C., Tokunaga, K., Kinoshita, S., Sukasem, C., Satapornpong, P., Tempark, T., Rerknimitr, P., Pairayayutakul, K., Klaewsongkram, J., Koomdee, N., Jantararoungtong, T., Santon, S., Puangpetch, A., Intusoma, U., Tassaneeyakul, W., Theeramoke, V., Ramirez, E., Borobia, A.M., Tong, H., Castañer, J.L., De Abajo, F.J., Galvao, V.R., Pavlos, R., McKinnon, E., Williams, K., Beeghly-Fadiel, A., Phillips, E., Castells, M., Boni, E., Russello, M., Mauro, M., Ue, K.L., Rutkowski, K., Gomis, V.S., Ferre, J.F., Rodriguez, A.E., Reig, V.C., Sanchez, J.F., Breynaert, C., Van Hoeyveld, E., Schrijvers, R., Irigoyen, R.F., Collado, D., Vida, Y., Najera, F., Perez-Inestrosa, E., Mesa-Antunez, P., Mayorga, C., Torres, M.J., Tannert, L.K., Mortz, C.G., Skov, P.S., Bindslev-Jensen, C., Pfützner, W., Dörnbach, H., Visse, J., Rauber, M., Möbs, C., Elzagallaai, A.A., Chow, L., Abuzgaia, A.M., Rieder, M.J., Trubiano, J., Woolnough, E., Cheng, C., Kato, K., Azukizawa, H., Hanafusa, T., Katayama, I., Fujiyama, T., Hashizume, H., Umayahara, T., Ito, T., Tokura, Y., Silar, M., Zidarn, M., Rupnik, H., Korosec, P., Redwood, A.J., Strautins, K., White, K., Chopra, A., Konvinse, K., Leary, S., Mallal, S., Cabañas, R., Fiandor, A.M., Sullivan, A., Whitaker, P., Peckham, D., Haw, W.Y., Polak, M.E., Mcguire, C., Ardern-Jones, M.R., Aoyama, Y., Shiohara, T., Correia, S., Gelincik, A., Demir, S., Sen, F., Bozbey, H.U., Olgac, M., Unal, D., Coskun, R., Colakoglu, B., Buyuozturk, S., Çatin-Aktas, E., Deniz, G., Laguna, J.J., Dionicio, J., Fernandez, T., Olazabal, I., Ruiz, M.D., Lafuente, A., Núñez, J., Fernández, T.D., Palomares, F., Fernández, R., Sanchez, M.I., Ruiz, A., Ariza, A., Alonso, A.B., Garófalo, C.D., Matute, O.V., Puga, M.F., Lapresa, M.J.G., Lasarte, G.G., Thinnes, A., Merk, H.F., Baron, J.M., Leverkus, M., Balakirski, G., Gibson, A., Ogese, M., Al-Attar, Z., Yaseen, F., Meng, X., Jenkins, R., Farrel, J., Alhilali, K., Xue, Y., Illing, P., Mifsud, N., Fettke, H., Lai, J., Ho, R., Kwan, P., Purcell, A., Ogese, M.O., Betts, C., Thomson, P., Alhaidari, M., Berry, N., O’Neill, P.M., Alzahrani, A., Azoury, M.E., Fili, L., Bechara, R., Scornet, N., Nhim, C., Weaver, R., Claude, N., Joseph, D., Maillere, B., Parronchi, P., Pallardy, M., Villani, A.P., Rozières, A., Bensaïd, B., Tardieu, M., Albert, F., Mutez, V., Baysal, T., Maryanski, J., Nicolas, J-F, Kanagawa, O., Vocanson, M., Hung, S-L, Harrison, C.J., Jenkins, R.E., French, N.S., Montañez, M.I., Fernandez, T.D., Martin-Serrano, A., Molina, N., Wood, S., Pirmohamed, M., Martín-Serrano, Á., Pérez-Inestrosa, E., Pérez-Sala, D., Guzmán, A.E., Ko, T-M, Chen, Y-T, Wu, J-Y, Sánchez-Gómez, F.J., González-Morena, J.M., Arreola, A.M., Corona, J.A.B., Flores, S.M., Cherit, J.D., Figueroa, N.V.D., Flores, J.L.C., Perkins, J., Pérez-Alzate, D., Bogas, G., Marti, L.M.T., De La Losa, F.P., Poves, F.A., Lopez, J.T., and Santiago, T.L.

Abstract

No abstract available

Published
2016

9. Clavulanic Acid Is a Leading Culprit Beta-Lactam in Immediate Allergic Reactions to Penicillins.

Author

Torres-Rojas I, Pérez-Alzate D, Somoza ML, Pfeifer AP, Diaz EH, Jimenez-Rodriguez TW, Sánchez JF, Ruano FJ, Blanca M, and Blanca-López N

Abstract

Purpose: Clavulanate, a beta-lactam associated with amoxicillin, is frequently prescribed in patients at all ages. Recent data implicate amoxicillin-clavulanate in up to 80% of beta-lactam allergy cases. We assessed clavulanate's role in inducing allergic reactions to this combination treatment, with a focus on selective immediate reactions., Methods: Adults (≥ 16 years) reporting a history of immediate reactions to amoxicillin-clavulanate were evaluated through a beta-lactam allergological workup, using modified European Academy of Allergy and Clinical Immunology guidelines. Patients first underwent skin testing, and if negative, drug provocation tests. Expected outcomes were: Group A, subjects with immediate reaction to classical penicillin group determinants (penicilloyl polylysine, minor determinants mixture, and/or penicillin G); Group B, subjects with selective immediate reaction to amoxicillin; Group C, subjects with selective immediate reaction to clavulanate and Group D, those immediate reactions with co-sensitization to clavulanate plus penicillin group determinants or amoxicillin., Results: Of 1,170 included patients, 104 had immediate reactions: 36.5% to penicillin group determinants (Group A), 26.9% to amoxicillin (Group B), 32.7% to clavulanate (Group C), and 3.8% to clavulanate plus penicillin determinants or amoxicillin (Group D). Diagnosis was made by skin testing in 79%, 75% and 47% of the patients, respectively, in the first 3 groups ( P < 0.001). Drug provocation tests were necessary to establish most other diagnoses. Anaphylaxis predominated over urticaria/angioedema in all groups., Conclusions: Selective immediate reactions to clavulanate accounted for over a third of cases with confirmed reactions after amoxicillin-clavulanate intake, with more than half experiencing anaphylaxis. Within this group, skin test sensitivity was below 50%. People taking amoxicillin-clavulanate may also be co-sensitized to both drugs., Competing Interests: There are no financial or other issues that might lead to conflict of interest., (Copyright © 2023 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease.)

Published
2023
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10. Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children.

Author

Torres-Rojas I, Pérez-Alzate D, Somoza ML, Haroun Diaz E, Ruano Pérez FJ, Prieto-Moreno Pfeifer A, Jimenez-Rodriguez TW, Fernandez Sánchez J, Blanca M, Canto Diez G, and Blanca-López N

Subjects
Anti-Bacterial Agents adverse effects, Child, Humans, Prospective Studies, Skin Tests, beta-Lactams adverse effects, Drug Hypersensitivity diagnosis, Drug Hypersensitivity epidemiology, Hypersensitivity, Immediate, Pharmaceutical Preparations
Abstract

Background: Beta-lactams generate different allergenic determinants that induce selective or cross-reactive drug hypersensitivity reactions (DHRs). We aimed to identify the drugs involved, the selectivity of the response, the mechanism, and the value of the different diagnostic tests for establishing a diagnosis in children evaluated for DHRs to beta-lactams., Methods: Prospective study evaluating children aged under 16 years reporting DHRs to beta-lactams. Reactions were classified as immediate and non-immediate reactions. The workup included sIgE, skin testing, and drug provocation tests (DPTs) for immediate reactions and patch testing and DPTs for non-immediate ones., Results: Of the 510 children included, 133 were evaluated for immediate reactions and confirmed in 8.3%. Skin test/in vitro IgE contributed to diagnosing half of the cases. Selective reactions occurred with amoxicillin (63%), followed by common penicillin determinants (27%) and cephalosporins (0.9%). Among non-immediate reactions (11.4% of the 377 children evaluated), most required DPTs, 52.7% of which were positive at 6-7 days of drug challenge. Selective reactions were identified with amoxicillin (80%), penicillin G (7.5%), cephalosporins (7.5%), and clavulanic acid (5%). Urticaria and maculopapular exanthema were the most frequent entities., Conclusions: There were few confirmed cases of either type of reaction. Skin testing proved less valuable in non-immediate reactions, over half of which would also have been lost in a short DPT protocol. Selective responders to amoxicillin were more likely to have non-immediate reactions, while clavulanic acid selectivity was exclusive to the non-immediate typology. Over half the cases with DPTs required 6-7 days of treatment for DHR confirmation., (© 2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)

Published
2021
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12. Impact of the COVID-19 pandemic in children with allergic asthma.

Author

Ruano FJ, Somoza Álvarez ML, Haroun-Díaz E, Vázquez de la Torre M, López González P, Prieto-Moreno A, Torres Rojas I, Cervera García MD, Pérez Alzate D, Blanca-López N, and Canto Díez G

Subjects
Acetaminophen therapeutic use, Adolescent, Adrenal Cortex Hormones therapeutic use, Adrenergic beta-2 Receptor Agonists therapeutic use, Analgesics, Non-Narcotic therapeutic use, Anti-Asthmatic Agents therapeutic use, COVID-19, Child, Child, Preschool, Coronavirus Infections diagnosis, Female, Humans, Male, Pandemics, Pneumonia, Viral diagnosis, SARS-CoV-2, Spain epidemiology, Asthma drug therapy, Asthma epidemiology, Betacoronavirus, Coronavirus Infections drug therapy, Coronavirus Infections epidemiology, Pneumonia, Viral drug therapy, Pneumonia, Viral epidemiology
Published
2020
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13. Acetyl Salicylic Acid Challenge in Children with Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs Differentiates Between Cross-Intolerant and Selective Responders.

Author

Blanca-López N, Haroun-Diaz E, Ruano FJ, Pérez-Alzate D, Somoza ML, Vázquez de la Torre Gaspar M, Rivas-Ruiz F, García-Martin E, Blanca M, and Canto G

Subjects
Acetaminophen adverse effects, Administration, Oral, Adolescent, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Child, Child, Preschool, Drug Hypersensitivity etiology, Female, Humans, Ibuprofen adverse effects, Immune Tolerance, Infant, Male, Single-Blind Method, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Aspirin adverse effects, Drug Hypersensitivity diagnosis
Abstract

Background: Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in children are becoming a great concern. Most studies have focused on adults, with noted discrepancies observed in the classification of hypersensitivity reactions to NSAIDs in children when compared with adults., Objective: To phenotype a group of children with hypersensitivity reactions to NSAIDs, including paracetamol, and analyze the degree of agreement with the entities reported in adults and how they fit the proposed classifications., Methods: The study comprised 116 children aged 0.5 to 14 years, with a clinical history indicative of hypersensitivity reactions to NSAIDs. They all underwent a single-blind oral provocation test with acetyl salicylic acid, except in those cases when this was the suspected drug, in which case the challenge was done first with ibuprofen. If positive, cross-intolerance was established and if negative, an oral provocation test with the culprit drug was performed to establish a selective response or exclude allergy., Results: Of the 26% diagnosed as hypersensitive to NSAIDs, 83% were cross-intolerant and 17% selective reactors. The highest significant differences between reactors and nonreactors were observed in the time to reaction after drug intake and the clinical entity (P < .0001), followed by drug involved and age (P < .01)., Conclusions: From the total number of cases confirmed with NSAID hypersensitivity, 83% were cross-intolerant. In cross-intolerant reactions, both cutaneous and respiratory manifestations are common. Acetyl salicylic acid challenge as the first approach proved to be safe and useful to establish the diagnosis., (Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Published
2018
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14. Anaphylaxis and severe immune hemolytic anemia during the course of desensitization with carboplatin.

Author

Pérez-Alzate D, Blanca-López N, Somoza ML, Ruano FJ, Montero GS, Penalva MJ, Gimeno C, Blanca M, and Canto G

Subjects
Aged, Anaphylaxis prevention & control, Female, Humans, Ovarian Neoplasms drug therapy, Anaphylaxis etiology, Anemia, Hemolytic etiology, Antineoplastic Agents adverse effects, Carboplatin adverse effects, Desensitization, Immunologic adverse effects
Published
2018
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15. Asthma and Rhinitis Induced by Selective Immediate Reactions to Paracetamol and Non-steroidal Anti-inflammatory Drugs in Aspirin Tolerant Subjects.

Author

Pérez-Alzate D, Blanca-López N, Doña I, Agúndez JA, García-Martín E, Cornejo-García JA, Perkins JR, Blanca M, and Canto G

Abstract

In subjects with non-steroidal anti-inflammatory drugs (NSAIDs)- exacerbated respiratory disease (NERD) symptoms are triggered by acetyl salicylic acid (ASA) and other strong COX-1 inhibitors, and in some cases by weak COX-1 or by selective COX-2 inhibitors. The mechanism involved is related to prostaglandin pathway inhibition and leukotriene release. Subjects who react to a single NSAID and tolerate others are considered selective responders, and often present urticaria and/or angioedema and anaphylaxis (SNIUAA). An immunological mechanism is implicated in these reactions. However, anecdotal evidence suggests that selective responders who present respiratory airway symptoms may also exist. Our objective was to determine if subjects might develop selective responses to NSAIDs/paracetamol that manifest as upper/lower airways respiratory symptoms. For this purpose, we studied patients reporting asthma and/or rhinitis induced by paracetamol or a single NSAID that tolerated ASA. An allergological evaluation plus controlled challenge with ASA was carried out. If ASA tolerance was found, we proceeded with an oral challenge with the culprit drug. The appearance of symptoms was monitored by a clinical questionnaire and by measuring FEV1 and/or nasal airways volume changes pre and post challenge. From a total of 21 initial cases, we confirmed the appearance of nasal and/or bronchial manifestations in ten, characterized by a significant decrease in FEV1% and/or a decrease in nasal volume cavity after drug administration. All cases tolerated ASA. This shows that ASA tolerant subjects with asthma and/or rhinitis induced by paracetamol or a single NSAID without skin/systemic manifestations exist. Whether these patients represent a new clinical phenotype to be included within the current classification of hypersensitivity reactions to NSAIDs requires further investigation.

Published
2016
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16. Hypersensitivity Reactions to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Selective Reactions.

Author

Blanca-López N, Cornejo-García JA, Pérez-Alzate D, Pérez-Sánchez N, Plaza-Serón MC, Doña I, Torres MJ, Canto G, Kidon M, Perkins JR, and Blanca M

Subjects
Adolescent, Child, Diagnosis, Differential, Drug Hypersensitivity diagnosis, Drug Hypersensitivity therapy, Humans, Risk Factors, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Drug Hypersensitivity etiology
Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used throughout the world to treat pain and inflammation; however, they can trigger several types of drug hypersensitivity reactions (DHRs) in all age groups. Although most such reactions occur through activation of the leukotriene pathway without specific immunological recognition (cross-intolerance), a significant number of DHRs to NSAIDs are due to immunological mechanisms (selective reactions [SRs]). SRs are thought to be induced by specific IgE antibodies or by T cells. In this manuscript, we focus on SRs, which are of great concern in children and adolescents and comprise a heterogeneous set of clinical pictures ranging from mild entities such as urticaria/angioedema to potentially life-threatening conditions such as Stevens-Johnson syndrome/toxic epidermal necrolysis. Paracetamol and ibuprofen are the most frequent elicitors of IgE-mediated SRs, although pyrazolones have also been implicated. T cell-mediated reactions are infrequent in children but have been associated with ibuprofen, naproxen, and dipyrone. In this review, we analyze the available literature on SRs in children and adolescents, with emphasis on epidemiological data, mechanisms, and drugs involved, as well as on diagnostic procedures.

Published
2015

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