ABSTRACT
BACKGROUND: Oral mite anaphylaxis (OMA), or pancake syndrome, occurs in atopic individuals when eating starchy foods contaminated by mites, which induce moderate or severe, even fatal, allergic reactions. This syndrome is usually seen in tropical and subtropical environments,where conditions for the growth of domestic mites are given. Oral mite anaphylaxis has been associated with hypersensitivity to acetylsalicylic acid (ASA)-non-steroidal anti-inflammatory drugs (NSAID) and physical exercise. OBJECTIVE: To document the clinical and descriptive study of cases of OMA attended in City of Panama from 2011 to 2014. MATERIAL AND METHOD: A clinical descriptive and retrospective study was performed, including skin prick test to five species of domestic mites. Taxonomic identification of the mites was performed under microscope and its density per gram of food was calculated for three cases. RESULTS: Ten cases with clinical history compatible with OMA were studied, being the pancakes the most incriminated food. The onset of symptoms occurred between 25 and 60 minutes after ingestion of the food. All patients were atopic young adults. Four of the ten patients had hypersensitivity to ASA-NSAID. The patients were positive to Prick test mites: Blomia tropicalis, Dermatophagoides pteronyssinus and Suidasia pontifica. The three samples of wheat flour studied presented high densities of mites per gram. CONCLUSIONS: The pancakes were the most incriminated food in the cases of OMA in our study. Suidasia pontifica and Blomia tropicalis seem to be the mites species of greater relevance related with this syndrome in our country.
Antecedentes: la anafilaxia oral por ácaros, o síndrome de las panquecas, ocurre cuando individuos atópicos ingieren alimentos elaborados con harina de trigo contaminada con ácaros, lo que induce reacciones alérgicas moderadas o severas, incluso fatales. Los reportes provienen de ambientes tropicales y subtropicales, donde las condiciones para la proliferación de ácaros domésticos son favorables. Se ha encontrado una asociación importante con la hipersensibilidad a ácido acetilsalicílico (AAS)-antiinflamatorios no esteroides (AINES) y el ejercicio físico. Objetivo: documentar el estudio clínico y descriptivo de casos de anafilaxia oral por ácaros atendidos en Ciudad de Panamá durante los años 2011 a 2014. Material y método: estudio clínico descriptivo y retrospectivo, que incluyó pruebas cutáneas de punción para cinco especies de ácaros domésticos. La identificación taxonómica de los ácaros se realizó bajo microscopio y se calculó la densidad de ácaros por gramo de alimento en tres casos. Resultados: se estudiaron 10 casos compatibles con anafilaxia oral por ácaros, la panqueca fue el alimento implicado con más frecuencia. Los primeros síntomas aparecieron entre 25 y 60 minutos después de la ingestión del alimento. Todos los pacientes fueron adultos jóvenes atópicos, cuatro con hipersensibilidad a AAS-AINES. Los pacientes resultaron positivos a las pruebas cutáneas de punción para los ácaros: Blomia tropicalis, Dermatophagoides pteronyssinus y Suidasia pontifica. Tres muestras de harina de trigo estudiadas motraron altas densidades de ácaros. Conclusiones: la panqueca fue el alimento implicado con más frecuencia en los casos de anafilaxia oral por ácaros. Suidasia pontifica y Blomia tropicalis parecen ser los ácaros más importantes relacionados con este síndrome en nuestro país.
ABSTRACT
The genus Amblyomma is the most diverse and relevant among the Neotropical ticks. In Panama, this genus contains 19 species, including Amblyomma ovale. There is a lack of knowledge of the ecology of A. ovale in Panama, and thus the aim of this work is to report on its geographical distribution and its spectrum of vertebrate hosts. We reviewed data of ticks collected in different areas of Panama from 2007 to 2012 and found parasitism of A. ovale in 625 vertebrates, corresponding to 21 species (2 species of birds and 19 mammal species). A. ovale is present in different environments of Panama, from lowlands to places with 800m altitude, including rural towns, disturbed forests, and wilderness areas.
