A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC questionnaire in Mexico City.

BACKGROUND: Asthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma. OBJECTIVE: To compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City. PATIENTS AND METHODS: We performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma. RESULTS: The asymptomatic group had a baseline FEV1 of 1.70 +/- 0.34 l/sec (mean +/- SD) and an endpoint FEV1 of 1.76 +/- 0.42 l/sec; in the symptomatic group the respective values were 1.51 +/- 0.41 l/sec and 1.57 +/- 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05). CONCLUSION: Because of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma.

Inmunodeficiencia común variable. Comunicación de un caso y revisión de la literatura / Common variable immunodeficiency presentation a case report and literature review

Paciente masculino de 10 años de edad que se refirió a la consulta de alergia debido a que su padecimiento se inició desde los seis años, con infecciones de las vías aéreas superiores de repetición: otitis media, sinusitis recurrente, además de sibilancias y tos crónica. A la exploración física sólo se advertian adenopatías cervicales; se reportaron exámenes de laboratorio con inmunoglobulinas séricas bajas en tres ocasiones; se sugirió el diagnóstico de inmunodeficiencia común variable (ICV), que es una enfermedad que cursa con una susceptibilidad incrementada a las infecciones, diarrea, mala absorción intestinal y complicaciones pulmonares como bronquiectasias, así como la formación de autoanticuerpos y enfermedades autoinmunitarias. El paciente recibió inmunoglobulina intravenosa con buena evolución

[Common variable immunodeficiency. Report of a case and review of the literature]. / Inmunodeficiencia común variable. Comunicación de un caso y revisión de la literatura.

A ten year old boy was referred to the allergy clinic due to a chronic history of upper respiratory infections, otitis media, recurrent sinusitis, wheezing and chronic cough that initiated at six years of age. He did have some very small lymph nodes in the cervical area. Serum immunoglobulins were very low which suggested the diagnosis of a common variable immuno-deficiency, a disease with features of increased susceptibility to infection, diarrhea, malabsorption and major complications that include bronchiectasis, autoantibody formation, and autoimmune disease. The patient received IVIG and has doing well.

[Potentially fatal anaphylaxis. Report of 3 cases]. / Anafilaxia potencialmente mortal. Comunicación de tres casos.

Near fatal anaphylactic reactions to food are rarely reported, we identified three such cases in the Allergy Clinic at Children's Hospital Federico Gómez in México. All had known food allergies, they received familiar training for identification and recognition of anaphylactic reaction and how to administer adrenaline rapidly. Our results are similar to those found in the literature.