Antecedentes: Se conoce poco sobre la sensibilización a camarón en pacientes con alergias respiratorias sensibilizados a ácaros y la importancia clínica de dicha sensibilización en el trópico.Objetivos: Determinar la prevalencia de sensibilización a camarón en pacientes con rinitis o asma sensibilizados a ácaros, explorar la ruta de sensibilización, su relevancia y el papel de la sensibilización a tropomiosina.Métodos: Estudio de corte transversal en pacientes con asma y rinitis sensibilizados a ácaros. Mediante encuesta se indagó consumo de camarón y control del asma o rinitis. Se realizaron pruebas de provocación oral con camarón a los individuos sensibilizados a ácaros y camarón sin consumo, o con consumo mayor a seis meses, sin historia de reacción. En un subgrupo se midió la sIgE para camarón, Der p y Lit v 1. Se compararon los pacientes sensibilizados a ácaro y camarón (casos) y los sensibilizados solo a ácaros (controles).Resultados: De 229 pacientes, 48 (21 %) se encontraban sensibilizados a camarón. No hubo diferencia estadísticamente significativa en la ingesta de camarón entre casos (54.2 %) y controles (49.7 %); ocho casos presentaron síntomas al contacto con camarón. No se encontraron diferencias estadísticamente significativas en la sIgE para Der p, Lit v1 y camarón entre casos y controles. Se observó cambio mediano en la magnitud de efecto: 0.45, 0.44 y 0.41, respectivamente.Conclusiones: La sensibilización a camarón en pacientes con asma o rinitis alérgica por ácaros es alta, en 25 % parece ser clínicamente relevante, principalmente en aquellos con asma. La ingesta no es la principal vía de exposición a la tropomiosina; la reactividad cruzada puede explicar la frecuencia de sensibilización.

Background: Skin prick test is the most widely used test for the diagnosis of IgE-mediated conditions. Commercial extracts are used for its performance, but in the case of fruits and vegetables it is preferable using fresh food. Although both tests possess a good safety profile, hypersensitivity reactions have been recorded. Clinical case: Forty-seven-year old woman with a history of persistent allergic rhinitis, sensitized to the pollen of grasses, olive and salsola; she was referred to an allergology department due to anaphylaxis triggered by the consumption of avocado, cantaloupe, carrots and watermelon. Minutes after skin prick test with standardized extract and skin prick with fresh foods, she developed dyspnea, pruritus, erythema, dizziness and sibilance; she was administered 0.5 mg of intramuscular adrenalin and 4 salbutamol inhalations and placed in the Trendelemburg position. Dyspnea persisted, and vital signs monitoring showed heart and respiratory rates increase and, hence, salbutamol was applied again, together with 2 L/min of oxygen delivered by nasal cannula, intravenous fluids and 100 mg intravenous hydrocortisone; improvement was observed at 40 minutes. The patient was hospitalized for 48 hours. Conclusions: Although skin tests are safe, the risk of hypersensitivity and anaphylactic reactions should not be ruled out, especially in susceptible patients.

Aspirin-exacerbated respiratory disease comprises a series of signs and symptoms mainly involving the upper and lower posterior airway after the consumption of cyclooxygenase enzyme inhibitors. Adverse reactions that occur are not considered to be an allergy and are common to all non-steroidal anti-inflammatory drugs, and cross-reactivity between these agents is therefore common. The description of 3 clinical cases serves to review key aspects of this condition, such as epidemiology, pathophysiology, clinical manifestations, diagnosis and management. Adequate diagnosis and education on the use or elimination of all different NSAIDs is essential, as well as availability of different analgesic options, verified with challenge tests. Aspirin-exacerbated respiratory disease management includes surgical procedures for nasal polyp control, pharmacological treatment for asthma control and desensitization with aspirin in selected individuals.