BackgroundAllergic reactions to insects are a global problem. The objective of this study was to assess the efficacy of immunotherapy with allergenic extract of Aedes aegypti for the treatment of large local reactions (LLR) to mosquito bites in children.MethodsExperimental, comparative, prospective, longitudinal and randomized none blinded study was conducted. We included 2 to 15 year old children with a history of large local reactions to mosquito bites. Sensitization was confirmed by a positive prick test. One group was treated with subcutaneous immunotherapy with extract of Aedes aegypti during 5 months and a second group received only antihistamine as needed. Diary symptoms and medication use were recorded in each case. The presence of adverse reactions to immunotherapy was also documented.ResultsA total of 35 patients from August 2009 to September 2010. Twenty-eight patients completed the study (16 male were included, with mean 7 ± 2.5 years) 15 in the immunotherapy group and 13 in the control group. The immunotherapy group showed a decrease in the diameter of the wheal and flare as well as the duration of the reaction and the use of drugs, from the third month of treatment, compared with the control group (P < 0.001).ConclusionsOur results suggest that immunotherapy with extract of Aedes aegypti, could modify the natural history of LLR to mosquito bites in children. Additional studies are needed to determine the optimal length treatment of the scheme and its long-term effects.

Las reacciones por picaduras de mosquito son reacciones inmunológicas con afectación de la hipersensibilidad mediada por IgE, IgG y linfocitos T. Éstas son frecuentes y van desde reacciones locales pequeñas o grandes, hasta reacciones alérgicas sistémicas. El síndrome de Skeeter es una reacción inflamatoria local grande inducida por la picadura de mosquito, en ocasiones acompañada de síntomas sistémicos como fiebre y vómito. El diagnóstico se basa en la historia clínica y la exploración física, con el apoyo de la identificación de IgE específica mediante pruebas cutáneas. El tratamiento consiste en la prevención de picaduras, administración de antihistamínicos y, en algunos casos, de esteroides. La inmunoterapia específica aún requiere mayor estudio. Comunicamos dos casos de pacientes que manifestaron reacciones de hipersensibilidad a la picadura de mosquito, que fueron evaluados en nuestro centro con pruebas cutáneas positivas.

BackgroundRhinitis is characterized clinical by chronic runny nose, sneezing, nasal itching, congestion and postnasal discharge, among other symptoms. It´s classified as allergic and non allergic. Skin prick testing is the principal diagnosis method for allergic rhinits. However, there is a group of patients with chronic rhinopathy that have negative skin tests, the objective of this study was to determine the cutaneous response to patch tests with Dermatophagoides farinae and Dermatophagoides pteronyssinus in patients with chronic rhinitis.MethodsIt was a cross-sectional, observational and descriptive study. We included patients over 18 years old. They were divided into 3 groups; Group A patients who came for the first time with a history of chronic rhinopathy over 18 months of evolution and positive skin tests for aeroallergens; group B patients with chronic rhinitis with at least one year of evolution and negative skin tests; group C healthy volunteers. Patch test with farinae and pteronisyinnus were done in the subjects of all 3 groups, with readings at 48 and 72 hours.ResultsA total of 37 patients were studied, mean age 26.1 years. Twenty two were male subjects (60%). The mean lenghtof chronic rhinophaty was 10.8 years. Six patients had positive patch test to any of the mites tested; 2 (33%) in group A, 2 (33%) in group B and 2 (33%) of the control group, but it was not statistically significant (P > 0.05).ConclusionsAlthough the results were not statistically significant, there were patients with chronic rhinitis wich had positive patch test for mites. This sensitization could be clinically significant for those patients.

BackgroundFood allergy occurs between 2 and 8% of the population and sensitization to food allergens be detected by skin prick test (SPT). To assess the frequency of sensitization to food allergens in patients attended in an allergy service of Northeast of Mexico.MethodsWe reviewed the records of patients in whom SPT were performed with food allergens extracts, from January 2008 to December 2010. The extracts were applied on the back surface with multitest in patients under 8 years old and with duotip in those over 8 years. According to age, patients were divided into 4 groups: I ≤ 2 years, II 3 to 5 years, III 6 to 18 years, IV > 18.Results565 records were reviewed 56.8% of patients were female. 73.3% had at least one positive SPT. The most common diagnoses were allergic rhinitis (74.4%) and urticaria (10.4%). The most common positive SPTs in total group were: shrimp 61 (10.8%), cheese 58 (10.2%), beans 58 (10.3%), almond 57 (10.1%), Chile 53 (9.2%). According to the age groups, the most common positive SPTs were: I egg yolk in 12 patients (12.1%) and tuna 11 patients (11.1%), II peach 9 patients (11.4%) and tomatoes 8 patients (10.1%), III cheese 16 patients (13.4%), shrimp 15 patients (12.6%), almond 15 patients (12.6%), and IV shrimp 40 patients (14.9%), almond 34 patients (12.7%), beans 33 patients (12.3%).ConclusionsSensitization to food allergens were very common in our allergic patients. The most common sensitizing foods were shrimp, cheese, beans, and oats, although food sensitization varies among the different age groups.

BackgroundAmong the more than 150 different forms of Primary Immunodeficiency Diseases (PID) the CVID is the most common symptomatic primary immunodeficiency, present mainly in adults. There is a failure of B cells to develop and differentiate into plasma cells; at consequent a reduction of the production of one or more isotypes of antibody can also affected Cell-mediated immunity. Common manifestations included recurrent bacterial infections, that typically involve the upper and lower respiratory tract. Some patients are highly prone to autoimmune manifestations, lymphoid hyperplasia, and tumors.MethodsWe presented 3 cases of CVID with a variety of clinical presentation, evolution and complications related to delayed diagnosis.ResultsA 34 year old male presented chronic diarrhea, weight loss, malnutrition and recurrent upper respiratory infections; digestive tract endoscopy and biopsy was reported with villous atrophy, chronic inflammation and low grade non-Hodgkin's lymphoma B cell. Unfortunately this patient refused the use of gamma globulin treatment, had a high morbidity, and finally the patient died. The case of a nurse with clinical manifestation of recurrent rinosinusitis and pneumonia, which was diagnosed as IDCV 17 years later, after she developed pulmonary bronchiectasis. Fortunately the disease is under control and she is actually under treatment with intravenous immunoglobulin. Finally, the case of a 44 year old female, who suffered from recurrent upper respiratory infections, additionally had a thyroid gland tumor associated which affecting the thyroid function.ConclusionsIn the 3 cases had low levels of all immunoglobulin as a hallmark. The clinician must be suspecting this condition in all adults with recurrent infectious disease who have gastrointestinal symptoms or who are detected a malignant disease. Early diagnosis and correct treatment are critical in preventing tissue damage, long-term sequelae and death. Replacement with intravenous gamma globulin and antibiotics are the mainstays in the management of these patients.