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.

Efficacy and safety of mepyramine-theophylline-acetate in the treatment of asthmatic crisis in children.

Mepyramine-theophylline-acetate (MTA), a theophylline derivative combined with an antihistamine, is used to treat patients with asthma. A double-blind, randomized, prospective, parallel-group study was conducted to evaluate the efficacy and safety of MTA in the treatment of asthmatic crisis in children 2 to 6 years of age. Forty patients with mild-to-moderate asthma were admitted to the study. The MTA group received 8 mg/kg per day of MTA by mouth in three divided doses for 7 days. The other group received 50 microL/kg per day of placebo in three divided doses for 7 days. Salbutamol (albuterol) syrup was used as the rescue drug if manifestations of asthma persisted. Both the MTA group and the placebo group had similar demographic characteristics at baseline. Both groups showed improvement of the asthma symptoms (cough, dyspnea, hypoventilation, and wheezing), as evaluated by the investigators at days 3 and 7. Patient diary scores showed earlier improvements in the MTA group than in the placebo group. Both groups showed improvement in peak flow at days 3 and 7 (P = 0.005). The control group used more doses of salbutamol than the MTA group on days 2 through 6 and globally (mean +/- SD, 6.79 +/- 9.11 doses vs 1.29 +/- 2.23 doses). The improvements in the placebo group were thought to be due to salbutamol. Three MTA patients dropped out of the trial, one because the parents felt that the treatment was not effective and two because of gastrointestinal manifestations (epigastric discomfort and vomiting). In the placebo group, two patients dropped out. One patient had epigastric discomfort and the other had to be treated in the emergency department for an exacerbation of the asthma. We conclude that MTA may be a good therapeutic option for the treatment of asthmatic crisis in children 2 to 6 years of age.