Quality of life in adult patients using dialyzable leukocyte extract for allergic rhinitis.

Allergic rhinitis (AR) has considerable impact on the general health of individuals. Therefore, treatment trials should include an evaluation of quality of life. We aimed to determine changes in the quality of life of moderate/severe AR patients treated with standard treatment in addition to dialyzable leukocyte extract (DLE), a peptide-based immunomodulator. In a prospective, non-controlled trial, DLE was added to the standard treatment regimen for patients with moderate/severe AR. DLE was administered orally at 2 mg per day for 5 days, followed by 4 mg per week for 5 weeks, and then 2 mg per week for 5 weeks. The primary endpoints were overall improved Standardized Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores, domain scores, and individual item scores of 0.5 points or higher. Statistical significance was defined as P < .05. Thirty patients (50% female) aged 14 to 60 years old (33.4 ± 11.9) were enrolled in this study. The mean overall basal quality of life score was 3.41 ± 1.22. After 11 weeks, the mean RQLQ score was 1.74 ± 1.09 ( P < .0001; 95% confidence interval [CI], 1.05-2.33), and all the domain scores improved (daily activities P < .001, 95% CI 0.91-2.15, sleep P < .001, 95% CI 0.9-2.26, non-hay fever symptoms P = .001, 95% CI 0.51-1.82, practical problems P < .001, 95% CI 1.55-2.85, nasal symptoms P < .001, 95% CI 1.36-2.67, ocular symptoms P < .001, 95% CI 1.05-2.17, emotional P < .001, 95% CI 1.23-2.55). Each of the 28 individual item scores on the RQLQ showed clinical (minimal important difference [MID] ≥ 0.5) and statistical ( P < .05) improvements. DLE might be a beneficial adjuvant treatment for AR. Our results provide preliminary data for future research. Clinical trials registration ID: NCT02506998.

Imaging diagnosis of subclavian steal syndrome secondary to Takayasu arteritis affecting a left-side subclavian artery.

Takayasu arteritis (TA) is a rare form of large-vessel, chronic, occlusive vasculitis. It involves mainly aorta and its main branches, causing stenosis and/or obstruction. Its frequency has been estimated at 2.9 cases per 1 million people. Epidemiologically, it is found principally in young female patients and is more prevalent in Asia and Latin America. When there is severe stenosis or occlusion in subclavian artery, the phenomenon of subclavian steal syndrome (SSS) occurs, which usually causes symptoms of the vertebrobasilar territory because blood supply to the arm is sustained by reversal of flow in ipsilateral vertebral artery. We describe a case of SSS thought to be due to TA in a Mexican woman. Doppler ultrasound of neck vessels showed retrograde flow in left vertebral artery during systole. Digital subtraction angiography confirmed 30% stenosis of left subclavian artery with filling of left vertebral artery in retrograde direction. In presenting this case, we carried out a brief review of TA, main features in imaging diagnosis of SSS, and the infrequently reported association of TA with SSS.