Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)最新文献

{"title":"[Respiratory manifestations associated with cyclic neutropenia and innate immune deficiency (IgG3 deficiency): a case report].","authors":"Daniel Alejandro Rodríguez-Flores, María Del Pilar Ortiz-Jiménez","doi":"10.29262/ram.v72i3.1503","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1503","url":null,"abstract":"<p><strong>Background: </strong>Inborn errors of immunity are a heterogeneous group of diseases caused by a diminished or absent response of one or more components of the immune system. IgG subclass deficiency is more common in childhood, especially in boys than in girls. IgG2 deficiency is the most common, followed by IgG3 deficiency.</p><p><strong>Case report: </strong>A male pediatric patient experienced respiratory distress of viral and bacterial origin and asthma in his early years, with frequent emergency room admissions and/or hospitalizations. At age 5, he was diagnosed with cyclic neutropenia, so the Pediatric Hematology Department decided to offer conservative treatment. At age 6, he was evaluated by an Otorhinolaryngologist, who diagnosed allergic rhinitis and performed a septumplasty and turbinectomy. At age 7, he was evaluated by an Allergist, with normal laboratory results: immunoglobulin profile, lymphocyte subpopulations, and blood count. Subcutaneous allergen-specific testing was positive. Treatment with subcutaneous immunotherapy was initiated. At age 9, the patient relapsed, with symptoms of upper respiratory tract infection and asthma. Laboratory studies revealed IgG3 deficiency (7.81 mg/dL), so treatment with intravenous immunoglobulin was initiated.</p><p><strong>Conclusion: </strong>The administration of human immunoglobulin and monoclonal antibodies is associated with a reduction in respiratory symptoms in patients with inborn errors of immunity and a better quality of life.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"61-63"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ocular challenge protocol with a DPT/DF mixture for the diagnosis of local allergic conjunctivitis. Report of 2 cases (pediatric and adult)].","authors":"Rubén Waldo Reyes","doi":"10.29262/ram.v72i3.1500","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1500","url":null,"abstract":"<p><strong>Background: </strong>Ocular allergy encompasses pathologies mediated by type I hypersensitivity, affecting the ocular surface. For diagnosis, it is essential to take a clinical history, perform an examination, and verify sensitization to aeroallergens using in vivo and/or in vitro tests. There are cases of patients with negative serum IgE levels, low serum IgE levels, and persistent symptoms and clinical manifestations. In these cases, ocular challenge tests are useful to confirm local allergy.</p><p><strong>Cases report: </strong><i>Case 1</i>: A 10-year-old male diagnosed with allergic conjunctivitis. Skin prick tests were negative. Serum IgE 35 IU/ml, tear sIgE, DPT 0.37 kUA/L, DF 0.14 kUA/L. <i>Case 2</i>: A 28-year-old male diagnosed with allergic conjunctivitis. Skin tests were negative: serum IgE 1 IU/ml, tear sIgE DPT 0.12 kAU/L, DF 0.1 kAU/L. An ocular challenge was performed with a DPT/DF mixture containing a standardized ALK-abelló extract mixture-DPT/DF-10,000 AU/ml. The TOSS (Total Ocular Symptom Score) scale was used to confirm the ocular challenge. The challenge was positive in both patients for DPT/DF [100 AU/ml] in a 1:100 dilution, with a TOSS score of 8 points each. A provocation test was performed on a healthy control patient. No local ocular reaction occurred. TOSS score = 0 points. <i>Outcome</i>: Patients were receiving topical ocular drug treatment.</p><p><strong>Conclusion: </strong>Local reactions were positive in both patients, confirming local ocular allergy. A standardized allergen extract (ALK-abelló) with a DPT/DF mixture of 10,000 AU/ml was used, and the test was positive at 100 AU/ml at a 1:100 dilution. No local ocular reaction was observed in a healthy control patient at the highest concentration (10,000 AU/ml) and at a 1:1 dilution. Ocular challenge with a standardized DPT-DF extract is a safe and reproducible test that confirms local allergic conjunctivitis in both pediatric and adult patients. No adverse effects were observed with the presented protocol.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Update on IgA vasculitis with a focus on diagnosis and prognosis in pediatrics].","authors":"Ana Luisa Rodríguez-Lozano, Blanca Giovanna Delgado-Sánchez, Laura Berrón-Ruiz, Ruth Guadalupe Nájera-Velázquez, Chiharu Murata","doi":"10.29262/ram.v72i3.1447","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1447","url":null,"abstract":"<p><p>IgA vasculitis is the most common vasculitis in childhood, and its main feature is leukocytoclastic vasculitis, in which the capillaries are affected by the deposit of IgA immune complexes. Skin rash is the principal clinical manifestation, along with arthralgia or arthritis, digestive and renal tract involvement, and is often self-limiting. Although it occurs at any age, it prefers children between 3 and 12 years. It is common to identify a trigger, the most frequently associated with infection, with reports of up to 31% along respiratory tract infections, followed by gastrointestinal infections at 5%. Dermatological manifestations are the characteristic element of the disease; 100% of patients have purpura at some point; however, renal involvement determines the prognosis of these patients. The diagnosis is clinical, supported by laboratory and cabinet assistants and classification criteria; however, since the prognosis is mainly conditioned by renal involvement, having simple and safe alternatives, adequate follow-up, evaluation of the efficacy of the treatment, and the prognosis of the disease are some of the main objectives of biomarkers. Initial treatment consists of general measures, but in the case of gastrointestinal, renal, or other target organ involvement, such as testicles, therapy with corticosteroids and immunosuppressants is necessary. Since the end of the last century, it has been recognized that not all patients with IgA vasculitis had a benign outcome; however, recent data supports a deleterious outcome both in patients with nephritis and in pregnancy.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"45-56"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diosmin-hesperidin-induced DRESS syndrome: immune reactivation by herpesvirus].","authors":"Nataly Flores-García, Carlos Correa-Serrano, Juan Carlos Cardenas-Favela, Diana Cadenas-García, Rosalaura Villarreal-González","doi":"10.29262/ram.v72i3.1502","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1502","url":null,"abstract":"<p><strong>Background: </strong>Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse reaction. The incidence is 1-1,000,000 with a mortality rate of 3.8-10%, and it is a disease associated with reactivation of the herpes simplex virus.</p><p><strong>Case report: </strong>A 34-year-old woman with atopy and venous insufficiency presented with pruritic hives on her face and arms, which progressed to a morbilliform rash, facial edema, fever, lymphadenopathy, and scaling. A complete blood count showed no abnormalities: AST: 837 U/L, ALT: 11352 U/L. Due to the suspicion of DRESS syndrome, treatment with corticosteroids was initiated and a biopsy was obtained. Upon questioning, the patient reported having taken diosmin-hesperidin and undergone systemic sunscreen (Heliocare360°®) 21 days prior to the onset of the rash. Histopathological examination revealed atrophic epidermis, vacuolar degeneration, and inflammatory infiltrate. Systemic corticosteroids were administered for three weeks, with a satisfactory response. Two months later, the patient experienced reactivation of the dermatosis and hypertransaminasemia; the autoantibody panel and serology were positive for IgM for herpes simplex virus.</p><p><strong>Conclusion: </strong>This case underscores the need to consider severe hypersensitivity reactions, even with commonly used and apparently low-risk drugs. The importance of a comprehensive approach, including identification of the suspected medication, exclusion of differential diagnoses, prolonged clinical follow-up, and surveillance for possible viral reactivation, is emphasized.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Egg Sensitization in Pediatric and Adult Populations with Compatible Symptoms: A Prospective Study].","authors":"Gina Maribel Melendez-Diaz","doi":"10.29262/ram.v72i3.1524","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1524","url":null,"abstract":"<p><strong>Introduction: </strong>Egg allergy is a common cause of food hypersensitivity, especially in the pediatric population, with an estimated prevalence of 9%. The main proteins involved are ovomucoid (Gal d 1), the most allergenic, and ovalbumin (Gal d 2), the most abundant. Although most cases remit in childhood, certain factors are associated with persistence into adulthood, such as elevated levels of specific IgE, the presence of other food allergies, and atopic diseases.</p><p><strong>Objective: </strong>To determine the frequency of egg sensitization in patients with symptoms reported after egg consumption and to describe the clinical characteristics of the sensitized population.</p><p><strong>Methodology: </strong>A prospective study was conducted between August 2024 and February 2025. 57 patients (pediatric and adult) with symptoms suggestive of egg allergy were included. Skin tests to ovalbumin, ovomucoid, and egg yolk were performed. In pediatric patients, serum-specific IgE was determined.</p><p><strong>Results: </strong>Sensitization was positive in 37.5% of children and 14% of adults. Reactivity to ovomucoid was observed in 66% of sensitized children and 85% of sensitized adults, to ovalbumin in 100% of children and 57% of adults, and to egg yolk in 33.3% and 42%, respectively. The most common comorbidities were allergic rhinitis (60%), allergy to other foods (40%), and atopic dermatitis (10%). 57% of adults had a history of anaphylaxis.</p><p><strong>Conclusions: </strong>Sensitization to egg was more frequent in the pediatric population. Ovomucoid was the most frequently implicated allergen. The presence of atopic diseases was common, especially in adults. Although skin prick tests do not confirm the diagnosis of allergy, their high negative predictive value makes them useful as an exclusion tool.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sensitization to aeroallergens in adults with allergic rhinitis in a tertiary care hospital in Mexico City].","authors":"María Elizabeth Loredo Colunga, María de Guadalupe López Rivera, Luis Moisés Silva Goytia, Verónica Arroyo Martínez, Patricia María O Farrill Romanillos, Diana Andrea Herrera Sánchez","doi":"10.29262/ram.v72i3.1510","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1510","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis is the most common allergic disease in the world. Asthma and conjunctivitis are highly associated comorbidities, with dust mites being one of the main sources of involved allergens. The primary objective was to identify the most frequent aeroallergens in patients with allergic rhinitis, as well as to evaluate demographic factors and determine the most prevalent comorbidities.</p><p><strong>Method: </strong>This was a cross-sectional, descriptive, observational, and retrospective study through the review of clinical records of patients diagnosed with allergic rhinitis treated in the Immunotherapy Clinic of the Allergy and Clinical Immunology Service.</p><p><strong>Results: </strong>A total of 200 patients were studied, 74% of whom were women, with a median age of 38 years. The majority of the population evaluated were from the southern areas of Mexico City, mainly from the Iztapalapa delegation (22.50%), Álvaro Obregón (14%), and Coyoacán (12.50%). The most frequent comorbidities were asthma (61%) and conjunctivitis (60%). 88% of the patients showed polysensitization. Fraxinus excelsior was the most frequent aeroallergen (47.50%), followed by dust mites, Dermatophagoides Pteronyssinus (42%) and Dermatophagoides Farinae (40%).</p><p><strong>Conclusions: </strong>Although dust mites are typically considered the most frequent allergens, in this study, Fraxinus was the most prevalent. The comorbidities correspond exactly as described in the literature. The study successfully achieved its primary objective of identifying the most common comorbidities and demographic factors, providing better insight into the characteristics of our current population.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"87"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hypocomplementemic urticarial vasculitis in SLE: between urticaria and autoimmunity].","authors":"Jacqueline Edith Mut Quej, Paula Isabel Ramirez Molina, Maria Isabel Saad Manzanera, Patricia Maria O Farrill Romanillos, Mariana Guadalupe Jimenez Fonseca, Salmahk Karen Aviles Tenorio, Diana Andrea Herrera Sánchez","doi":"10.29262/ram.v72i3.1526","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1526","url":null,"abstract":"<p><strong>Background: </strong>Urticarial vasculitis (UV) is a rare entity affecting small blood vessels, characterized by persistent (>24 hours) urticarial lesions with histopathological findings of leukocytoclastic vasculitis. It is classified as normocomplementemic (NUV) and hypocomplementemic (HUV), the latter associated with systemic diseases such as systemic lupus erythematosus (SLE). Its incidence is 0.5 per 100,000 person-years.</p><p><strong>Case report: </strong><i>Clinical presentation</i>: A 66-year-old female with a history of SLE, hypothyroidism, and osteoarthritis developed in 2022. In 2022, she developed a dermatosis disseminated to all four body segments with pruritic wheals lasting up to 72 hours, persisting for more than six weeks, and followed by post-inflammatory hyperpigmentation. No triggering factors were identified. She also presented episodes of palpebral and labial angioedema. Given the clinical features, a skin biopsy and complement measurement were performed. <i>Imaging/laboratory studies</i>: <i>Skin biopsy</i>: Superficial neutrophilic vasculitis (venulitis) with erythrocyte extravasation. <i>Lab results 2023</i>: C3: 79.7 mg/dL. C4: 10.8 mg/dL.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering hypocomplementemic urticarial vasculitis in patients with SLE and persistent urticarial lesions, as well as conducting a targeted history. Given the risk of systemic involvement, close follow-up and a multidisciplinary approach are essential. The diagnosis of UV requires clinical-histopathological correlation, with biopsy recommended for persistent lesions (>24 h), residual bruising, or systemic manifestations. Early identification and appropriate management are essential to prevent systemic complications. Treatment focuses on addressing underlying autoimmune diseases and managing symptoms with antihistamines, corticosteroids, or immunosuppressants, depending on the severity and systemic involvement.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"88"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Adverse reactions to biotechnological agents targeting IL-5].","authors":"Guillermo Pérez-Dimas, Citlali Ramírez-Casillas, Itzel Yoselin Sánchez-Pérez, Andrea Velasco-Medina, Antonio Albarrán-Godínez, Guillermo Velázquez-Samano","doi":"10.29262/ram.v72i3.1518","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1518","url":null,"abstract":"<p><strong>Case report: </strong>A 24-year-old woman with asthma (2013) and allergic rhinitis (2014) was treated for 3 years with subcutaneous immunotherapy, inhaled salmeterol/fluticasone, and external antihistamines. She presented to our department (2019). Upon admission, her asthma persisted with uncontrolled asthma, daily use of a rescue inhaler, and persistent moderate-severe rhinitis. Asthma treatment was adjusted according to guidelines, reaching step 4 of treatment, with persistent lack of control (ACT 16 points), meeting criteria for starting Benralizumab 30 mg (July 26, 2024). Two doses were completed with clinical improvement (ACT). However, during two doses, the patient presented with fever, headache, myalgia, and arthralgia, so treatment was discontinued. Symptoms worsened. A decision was made to switch from the biotechnological agent to mepolizumab (February 4, 2025), with adverse effects after the third dose.</p><p><strong>Conclusion: </strong>A percentage of patients with asthma presented with severe symptoms, 80% with an eosinophilic phenotype, associated with difficult control and increased exacerbations. Monoclonal antibodies are indicated in these patients. Benralizumab, which targets IL-5Rα, induces eosinophil depletion through antibody-mediated cytotoxicity. Several studies (MELTEMI) have been conducted to evaluate the safety of long-term use. The most common non-serious adverse effects include upper respiratory tract viral infections (47.3%), while less common adverse effects are headache and arthralgia, which account for 20.9% and 6.4%. Biotechnological agents reduce exacerbations, reduce corticosteroid use, and improve control and quality of life. However, they are not exempt from adverse effects, and even the less common ones should be identified to assess continued treatment.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[<i>Staphylococcus aureus</i> sepsis as an initial manifestation of common variable immunodeficiency].","authors":"Saira Marlene Cabrera-Arias, A Díaz Terríquez, Z A López Morales, L Berrón Ruiz, B Bayardo Gutiérrez, M Núñez Núñez","doi":"10.29262/ram.v72i3.1497","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1497","url":null,"abstract":"<p><strong>Introduction: </strong>Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults, diagnosed by exclusion in cases of hypogammaglobulinemia without an identifiable cause. Its manifestations range from recurrent infections to autoimmunity and risk of malignancy.</p><p><strong>Case report: </strong>A previously healthy 11-year-old female patient was originally from and resides at Rancho El Nogal in Arandas, Jalisco, a community of approximately 250 inhabitants. There was no significant family history; there was no known consanguinity or presence of genetic diseases in the family. <i>Outcome</i>: After trauma to the left leg, she developed osteomyelitis. Upon admission, pancytopenia, enlarged lymph nodes, hepatosplenomegaly, and abscesses with positive cultures for Staphylococcus aureus were detected. An approach to detecting inborn errors of immunity was initiated, revealing decreased immunoglobulin G and A levels. Due to the severe systemic infection, intravenous immunoglobulin was administered at 1 gram/kilogram, and the immunosuppression study was expanded. Abnormalities in the lymphocyte subpopulation were detected, with decreased CD19+ counts: 71 mm³, CD3+ counts: 915 mm³, CD4+ CD45RA+ T cells (naive): 92 mm³, total memory B cells (3%), non-isotype-switched (2.5%), isotype-switched (0.5%), plasmablasts (0.3%), and decreased CD21 counts (9%). The patient was classified as Freiburg 1B common variable immunodeficiency. Monthly intravenous immunoglobulin was started at a dose of 400 milligrams/kilogram. The patient responded favorably to immunoglobulin treatment, with no subsequent serious infections. She remains stable and is being monitored by immunologists.</p><p><strong>Conclusion: </strong>CVID, although more common in adults, can present in children. S. aureus sepsis as an initial manifestation, as in this patients case, should raise concerns about possible underlying immunodeficiencies. This case highlights the importance of suspecting primary immunodeficiencies in patients with severe infections, underscoring the need for early diagnosis and treatment to optimize prognosis.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Successful benralizumab therapy for severe asthma secondary to EGPA refractory to mepolizumab].","authors":"Andrea Ofelia García-Vaca, Claudine Isela Nava-Ramírez","doi":"10.29262/ram.v72i3.1490","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1490","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem inflammatory disease. It presents a type 2 inflammatory profile and IL-5 overexpression which stimulates eosinophil production and contributes to the development of severe and late-onset asthma.</p><p><strong>Case report: </strong>We present the case of a female in her sixth decade of life, diagnosed with EGPA 37 years ago and currently with severe asthma. Despite being on triple inhaled therapy, she exhibited persistent severe airflow obstruction (ACT: 13; ACQ- 5: 2; blood eosinophils: 545 cells/μL). Mepolizumab 100 mg monthly (institutionally approved dosage) was initiated for over a year, with poor clinical response and multiple exacerbations. A switch to benralizumab 30 mg every two months was made, achieving sustained clinical control within four months: normalized spirometry, ACT: 22, ACQ-5: 0.2, undetectable serum eosinophils, and no exacerbations. This allowed discontinuation of the second controller inhaler and reduction to a low dose of inhaled corticosteroid, without adverse events attributable to treatment.</p><p><strong>Conclusion: </strong>A significant challenge in institutional clinical practice is that both biologics are approved only at doses indicated for severe eosinophilic asthma, resulting in suboptimal dosing according to international guidelines for EGPA. In institutional practice, benralizumab at 30 mg every two months may be a viable therapeutic option for patients with severe asthma secondary to EGPA, aiming to reduce corticosteroid dependence and improve respiratory function.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}