Alergia alimentaria a maní: conceptos clínicos, diagnósticos y terapéuticos / Food allergy to peanuts: clinical, diagnostic and therapeutic concepts

The prevalence of food allergy (FA) is about 2-8 percent, with clinical manifestations ranging from localized symptoms, to severe anaphylactic reactions. FA is generally caused by milk, eggs, soybeans, tree nuts, peanuts, wheat, fish and crustacean; being peanut one of the main foods involved in Western countries. Although in other parts of the world peanut allergy (PA) is not a problem, probably due to timing of introduction into the diet, form and preparation, genetics, and the hygiene hypothesis. Unfortunately, in Chile there are no epidemiological data about FA or PA. A number of food allergens have been identified, which has improved patient diagnosis and treatment assessment. Regarding peanut, 9 allergens have been identified, Ara h 1 to Ara h 9 (Arachis hypogaea). The diagnosis of IgE-mediated PA is based on a consistent history and evidence of peanut-specific IgE sensitization, carried out by skin-prick testing or in vitro determination. PA treatment consists of peanuts avoidance, which often becomes difficult due to inadvertent consumption. Today promising treatments are under development, including oral induction tolerance or sublingual immunotherapy. These treatments offer the possibility of at least raising the threshold of the amount of peanut that would be necessary to cause a life-threatening allergic reaction.

Inmunoterapia con veneno de himenópteros: presentación de diez casos clínicos / Immunotherapy against hymenoptera venom: Report of ten patients

Background: Immunotherapy can be used to treat allergic reactions to insect stings, specially bees and wasps. Aim: To report the experience with immunotherapy with aqueous extracts of hymenoptera venoms (bees and wasps). Material and methods: Ten patients aged 6 to 58 years were treated in an allergy center of a University Clinical Hospital. The medical indication for this treatment was, in all patients, anaphylactic reactions after hymenoptera stings. Immunotherapy was carried out using standardized vaccines (Aqueous extracts Venomvac LETI, Spain), applied in a traditional protocol, with subcutaneous injections. This protocol had two phases: a buildup phase (between weeks 1 and 13) and a monthly maintenance phase, from the 13th week. The monthly maintenance dose was 100 fig of hymenoptera specific venom extract. Results: Six patients had adverse reactions of different severity, during the treatment protocols and all had a good response to immediate therapeutic measures. After these events, they followed the protocol without problems. Two patients, treated with bee vaccines, suffered an accidental bee sting during the maintenance phase and they developed only local reactions. Conclusions: The lack of adverse reactions to bee stings in these two patients indicates the acquisition of clinical tolerance.

Alergia al látex: avances en el desarrollo de inmunoterapias hipoalergénicas especificas / Latex allergy: advances in the development of specific hypoallergenic immunotherapies

This review provides a brief update about the strategies that have been developed for the hipoallergenic immunotherapy against latex allergens. Thus, recombinant mutants, chemically modified molecules, anti IgE monoclonal antibodies and T-cell epitope-based peptides have been used. Additionally, recent finds that show the importance of dendritic cells and their potential applicability to latex allergens are included.

Prevalencia y factores de riesgo de sensibilización al látex en personal del Hospital del Trabajador Santiago / Prevalence and risk factors of latex hypersensitivity in workers hospital personnel in Santiago

Los trabajadores de la salud (TS) tienen riesgo de desarrollar alergia al látex, lo que está respaldado por múltiples publicaciones. OBJETIVOS: Establecer prevalencia de sensibilización y alergia a látex en TS del Hospital del Trabajador Santiago (HTS) y determinar factores de riesgo asociados. MATERIALES Y MÉTODOS: Se estudiaron 157 TS con encuesta sobre atopia, tiempo y Los trabajadores de la salud (TS) tienen riesgo de desarrollar alergia al látex, lo que está respaldado por múltiples publicaciones. OBJETIVOS: Establecer prevalencia de sensibilización y alergia a látex en TS del Hospital del Trabajador Santiago (HTS) y determinar factores de riesgo asociados. MATERIALES Y MÉTODOS: Se estudiaron 157 TS con encuesta sobre atopia, tiempo y síntomas con exposición a látex. Se efectuaron prick test con aeroalergenos, látex y frutas (Leti, España), látex amoniacado, prick in prick con guantes de látex y test de parche con látex y aditivos (Trolab, Alemania). RESULTADOS: La sensibilización a látex fue de 13,4por ciento (n=21). Hubo diferencia significativa entre sensibilizados y no sensibilizados en: presencia de atopia (p<0,001), sensibilización a frutas (p<0,001) y presencia de urticaria de contacto (p<0,001). Tres TS de los 19 examinados presentaron test de parche positivo. CONCLUSIONES: La prevalencia de sensibilización a látex es menor a la encontrada en otro estudio nacional realizado por nuestro grupo. La atopia y la sensibilización a frutas tropicales parecen importantes factores para el desarrollo de alergia al látex en la población estudiada.

Neurosífilis e infección por el virus de inmunodeficiencia humana (VIH-1): experiencia en 6 casos / Neurosyphilis and infection by immunodeficiency human virus (HIV-1): experience in 6 cases

HIV infected population has a higher incidence of syphilis, being this an independent risk factor for HIV infection. We report 88 HIV infected patients seen during the last three years. Fourteen (16 percent) had reactive serum VDRL and FTA-ABS and neurosyphilis was diagnosed in six (6,8 percent). Three had a treponemal uveitis-retinitis, one a meningovascular syphilis and one a secondary syphilis with meningeal and otological involvement. Patients were treated with penicillin 20 million UI/day for 14 days with good clinical and laboratory response and CFS normalization in those subjected to a second lumbar puncture. It is concluded that neurosyphilis must be considered in the differential diagnosis of neurological complications of HIV infections