Aspergilosis broncopulmonar alérgica y mepolizumab, ¿una unión fructífera? / Allergic bronchopulmonary aspergillosis and mepolizumab, a fruitful union?

La aspergilosis broncopulmonar alérgica (ABPA) es un trastorno pulmonar tipo reacción de hipersensibilidad contra las distintas especies de Aspergillus, que se produce principalmente en pacientes con asma. Mediante distintas respuestas inmunitarias frente a los antígenos de Aspergillus, se llega a causar daño sobre las vías aéreas, produciéndose a largo plazo bronquiectasias y fibrosis pulmonar. Los signos y síntomas más frecuentes son disnea, sumándose tos productiva y, en ocasiones, fiebre y anorexia. Mediante técnicas radiológicas como la tomografía computarizada (TC) de tórax podemos ayudarnos a realizar un correcto diagnóstico. Con la aparición de nuevas terapias biológicas, anti-IgE o anti-IL-5, y el uso de otros tratamientos más consolidados, como corticoides sistémicos o antifúngicos, se puede llegar a controlar esta enfermedad. Presentamos el caso de un paciente con diagnóstico de ABPA en tratamiento con mepolizumab, con presencia de IgE total y específica elevada pese a dicho tratamiento

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder type hypersensitivity reaction against the different species of Aspergillus, occurring mainly in patients with asthma. Through different immune responses to Aspergillus antigens, damage to the airways is caused, producing long-term bronchiectasis and pulmonary fibrosis. The most frequent signs and symptoms are dyspnea, in addition to a productive cough and, occasionally, fever and anorexia. Using radiological techniques such as computerized tomography (CT) we can help ourselves to make a correct diagnosis. With the appearance of new biological therapies, anti-IgE or anti-IL-5, and the use of other more consolidated treatments, such as systemic corticosteroids or antifungal agents, this disease can be controlled. We present the case of a patient diagnosed with ABPA in treatment with mepolizumab, with the presence of high total and specific IgE despite said treatment

Incidence of anaphylaxis in the city of Alcorcon (Spain): a population-based study.

BACKGROUND: Relatively few studies have examined the incidence of anaphylaxis in the general population. OBJECTIVE: To report the incidence of anaphylaxis among the general population of the city of Alcorcon, Spain, using various public health care databases. METHODS: Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon. RESULTS: The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person-years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0-4 years age group and a different distribution of incidence rates (although non-significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%). CONCLUSION AND CLINICAL RELEVANCE: This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.

Síndrome de enfermedad del suero. A propósito de un caso / Serum disease syndrome. Based on one case

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