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.

BackgroundIn Monterrey there are a considerable number of Ficus benjamina trees, but the awareness-related information to this plant is scarce. The objective of this study is to determine the frequency of sensitization to Ficus benjamina in patients with rhinitis who were attended the Regional Centre of Allergy and Clinical Immunology of Monterrey, Mexico.MethodsObservational, transversal and descriptive study. We included patients over 18 years old with chronic rhinitis, which completed a questionnaire to assess exposure to Ficus benjamina. Skin prick tests (SPT) to common aeroallergens in our region with extract of Ficus benjamina (Allerstand Company) had done in all subjects.ResultsA total of 177 patients were included, mean age was 38 years, 65% (115) were female, 135 (76%) reported contact with a Ficus benjamina tree in their home or neighbor. 12 (17%) patients had a positive skin test to Ficus benjamina, but up to 15% (26) had clinical manifestations when they were close to a tree of Ficus benjamina. Most patients with positive skin test to Ficus benjamina (76.9%, 9) had positive test more than one of the aeroallergen tested. The association between Ficus benjamina and sensitization to other aeroallergens, as well as the symptoms associated to the contact with the tree was not statistically significant.ConclusionsSensitization to Ficus benjamina is common and was similar to that reported in European countries. To demonstrate the association between sensitization to Ficus benjamina and symptoms should be made studies with nasal challenge test.

BackgroundThe pollens of Cupressus, Parietaria, Pinus and Morus are important causes of allergic respiratory diseases. In a study of pollen concentration in Monterrey in 2004, these pollens occupied the first places in frequency. The objective was to determine the prevalence of sensitization to Parietaria, Pinus, Cupressus and Morus in patients from CRAIC (Regional Center of allergy and clinical immunology, Monterrey, México)MethodsIs an observational, cross-comparative, double-blind study in which patients were included if they underwent prick tests to aeroallergens in CRAIC between October 2009 and February 2010. All patients underwent skin testing with allergen extracts for Parietaria, Pinus, Cupressus and Morus pollens 2 of each, a weight-volume (dilution 1:20) and other units.ResultsWe included a total of 256 patients, 140 female (53.1%), 130 (50.8%) were under 18 years. The prick test with allergenic extract of Cupressus was positive in 39 (15.2%) patients with W/V and 18 (7%) patients with PNU, the prick test to Parietaria allergenic extract was positive in 3 (1.2%) patients W/V and 4 (1.6%) patients with BAU, the prick test with Pinus allergenic extract was positive in 4 patients (1.6%) with W/V and 2 patients (0.8%) with PNU, and the prick test with Morus allergen was positive in 19 patients (7.4%) with W/V in 8 patients (3.1%) with PNU. Of the 44 aeroallergens our center applies Cupressus (1:20) ranked 7th place.ConclusionsCupressus sensitization was high in our study group (15.2%). Consideration should be the routine use of allergen extract of Cupressus for diagnosis and treatment in patients with respiratory allergy.