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

{"title":"[Acquired angioedema associated with non-Hodgkin lymphoma: a clinical case report].","authors":"Diana Laura Alvarado-Carrillo, Itzel Yoselin Sánchez-Pérez, Andrea Velasco-Medina, Antonio Albarrán-Godinéz, Guillermo Velázquez-Sámano","doi":"10.29262/ram.v72i3.1521","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1521","url":null,"abstract":"<p><strong>Background: </strong>Acquired angioedema (AEA) is rare and usually appears after the fourth decade of life. It is characterized by recurrent episodes of nonpuriginous angioedema affecting the skin, gastrointestinal tract, and upper respiratory tract, making it difficult to distinguish from hereditary angioedema.</p><p><strong>Case report: </strong>Clinical presentation: A 44-year-old man with a history of non-Hodgkin lymphoma (NHL) in 2021, which was remitted. He presented with facial angioedema lasting 5 hours in June 2024, painless and non-puriginous. He denies recognizing any environmental factors, medications, or foods that exacerbate the condition, nor does he have a history of atopy. Laboratory/imaging studies: normal bile duct, IgE, ANA, C3, and C4. Thyroid profile was unremarkable. ESR and stool samples were normal. Autologous serum albumin (ASL) was negative. Physical urticaria tests were negative. C1 inhibitor was pending. Possible infectious processes were ruled out. Outcome: Partial improvement with antihistamines. In January 2025, the patient presented with a dry cough, which progressed to hemoptysis. A chest CT scan demonstrated a tumor in the right apex. Bronchoscopy with biopsy confirmed infiltration by NHL.</p><p><strong>Conclusion: </strong>There are two forms of AEA: type I with a recognized association with lymphoproliferative disorders, with NHL accounting for 20% of cases. It can precede the onset of NHL by an average of 2.3 years; in this case, it was the first manifestation of relapse. She has currently started chemotherapy without further episodes of angioedema. Late-onset angioedema in adulthood can be associated with a wide variety of underlying diseases, with hematologic malignancies being a significant group. A deliberate search for clinical data on malignancies leads to their timely identification.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"86"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215210","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":"[Characterization of patients with ant sting allergy: a 9 case serie and immunotherapy response].","authors":"Daniela Denisse Torreros-Lara, Itzel Yoselin Pérez-Sánchez, Guillermo Velázquez-Sámano, Andrea Velasco-Medina, Antonio Albarrán-Godinez, Diana Laura Alvarado-Carrillo","doi":"10.29262/ram.v72i3.1522","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1522","url":null,"abstract":"<p><strong>Background: </strong>Ant sting allergy can trigger from local cutaneous manifestations to fatal anaphylaxis, last one with an incidence of 23.5% in adults. Immunotherapy is effective in 9798% of cases to reducing the frequency and severity of these reactions, to reduce the risk of anaphylaxis to 5% compared to 60% in patients without immunotherapy.</p><p><strong>Objective: </strong>Describe the clinical characteristics, course, and response to specific immunotherapy in patients with ant sting allergy.</p><p><strong>Methods: </strong>A retrospective, observational, and descriptive study was conducted in nine patients with allergic reactions to ant stings from 2017 to 2025. Age, sex, history of atopy, type of reaction, skin testing, and clinical course were analyzed.</p><p><strong>Results: </strong>The mean age was 37.8 years (range 1159), with a female predominance (66.7%). Of the patients, two (22.2%) had local reactions and seven (77.8%) had systemic reactions, including two cases of anaphylaxis. Thirty-three percent (33.3%) had a history of allergic rhinitis, and 22.2% had an allergy to other insects. Five patients received immunotherapy; during follow-up, none presented systemic reactions after re-exposure, and one patient had a mild cutaneous reaction without requiring hospitalization.</p><p><strong>Conclusion: </strong>A high frequency of systemic reactions was observed in patients allergic to ant venom, exceeding that reported in the literature. Immunotherapy reduced the severity of reactions after re-exposure. Ant venom immunotherapy is effective in reducing the severity of allergic reactions and the risk of anaphylaxis during future exposures, being the only treatment shown to modify the natural history of the disease.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"91"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215278","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":"[Economic Burden of Hereditary Angioedema from the Perspective of the Public Health System in Mexico].","authors":"Mauricio Mijail Rodríguez-Mendoza, Eduardo Enrique Piñeyro-Beltrán, Francisco Alberto Contreras-Verduzco, Ulises García U","doi":"10.29262/ram.v72i3.1507","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1507","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the economic burden of hereditary angioedema (HAE) and compares the impact of on-demand treatment versus longterm prophylaxis (LTP) with Lanadelumab, from the perspective of the public health system in Mexico.</p><p><strong>Method: </strong>A systematic literature review and modified Delphi Panel were conducted to understand the resource use of public sector institutions in the diagnosis and treatment of HAE. Costs were obtained from institutional sources such as the IMSS contracting portal and the Diagnosis Related Groups (DRG-2017). The economic burden considered direct medical costs. The results express the annual cost per patient with and without long-term prophylaxis.</p><p><strong>Results: </strong>With a correct diagnosis, the cost is $5,154.78 MXN (250.20 USD). Without long-term prophylaxis, the annual cost per patient is $3,446,790.56 MXN (167,229.63 USD), with 70% peripheral attacks, 28% abdominal attacks, and 1% laryngeal attacks. Medical expenses are divided into 38% treatment, 36% complications, and 20% hospitalizations. With LTP, the annual cost is $2,641,682.18 MXN (128,221.44 USD), with 8% for attack treatment and 92% for prophylaxis. Prophylactic treatment reduces the economic burden of HAE attacks by 94.2% compared to on-demand treatment and decreases the economic burden by 23% from an institutional perspective.</p><p><strong>Conclusions: </strong>HAE represents a high economic burden, affecting hospitalizations and productivity. LTP with Lanadelumab reduces the burden on the Mexican healthcare system.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214885","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":"[Patient with severe congenital neutropenia associated with ELANE gene mutation: c.684C>G, p.Tyr228Ter].","authors":"Sabrina Dinorah Sotelo-de Jesús, Alonso Gutiérrez-Hernández","doi":"10.29262/ram.v72i3.1501","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1501","url":null,"abstract":"<p><strong>Introduction: </strong>Severe congenital neutropenia type 1 (SCN1) is a rare inherited disorder caused by arrested granulocyte maturation, frequently associated with mutations in the ELANE gene, which encodes neutrophil elastase.</p><p><strong>Case report: </strong>A 3-year-5-month-old female patient with a history of recurrent perianal infections and necrotizing fasciitis secondary to appendicitis complicated by septic shock. She required laparotomy, appendectomy, ileostomy, debridement, and vasoactive amine support. During her hospitalization, persistent severe neutropenia, lymphopenia, and eosinophilia were identified. Bone marrow aspirate showed arrested myeloid leukemia with an absence of neutrophils. Among the infectious isolates, the following were isolated: P. aeruginosa and Stenotrophomonas maltophilia, as well as rhinovirus/enterovirus. The neutrophil count remained persistently low (100-530/μL), responding to G-CSF (5 mcg/kg/dose). Genetic sequencing revealed a heterozygous missense mutation in ELANE (c.684C>G, p.Tyr228Ter).</p><p><strong>Conclusion: </strong>The diagnosis of NCG1 was clinically supported by severe infections, persistent neutropenia, absence of mature granulocytes in the bone marrow, and genetic confirmation. This mutation generates a premature stop codon. Other relevant variants include GFI1, HAX1, VPS45, JAGN1, CSF3R, and WAS. NCG1 should be suspected in pediatric patients with recurrent severe infections and persistent neutropenia. Early identification and the use of G-CSF can improve clinical outcome and reduce infectious complications.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"90"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215119","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":"[Biblio-informatic analysis of allergens contained in the milpa diet].","authors":"Gandhi Fernando Pavón-Romero, Regina Manzanilla-Bello, Daniela Galindo-Castañeda, Ximena Cabrera-González, Josaphat Miguel Montero, Fernando Ramírez-Juárez, Luis Manuel Terán-Juárez","doi":"10.29262/ram.v72i3.1533","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1533","url":null,"abstract":"<p><strong>Introdution: </strong>The milpa diet (MD) is a balanced and accessible nutritional model based on the biodiversity of Mexico. Currently, research on allergens involved in food allergy (FA) has focused on foods with high global consumption, without analyzing foods included in MD.</p><p><strong>Objective: </strong>To describe the allergens contained in MD.</p><p><strong>Methods: </strong>A specific search was performed using the PUBMED-NCBIwebsite for MD and their respective allergens implicated in FA. Of the articles identified, those that had at least one allergen reported in the WHO/IUISsoftware were evaluated, as well as their UniProt code, necessary to access protein sequencing by BLAST software. We then conducted identification analysis using the AllerCatPro 2.0 software, setting a threshold of above 60% correlation of identity among proteins included in MD.</p><p><strong>Results: </strong>Only 11 (16.9%) MD foods have reported associations with FA (pineapple, chili pepper, tomato, amaranth, sapodilla, peanut, avocado, squash, corn, green beans, and papaya). Likewise, 19 protein families were associated; profilins and nsLTP1 were the most frequent, presented in four and six foods, respectively. Five proteins (PR-10, TLP, cyclophilin, class IV chitinase, and nsLTP2) were identified in two foods, while twelve proteins (oleosins, conglutins, defensins, polygalacturonase, cupin, chymopapain, bromelain, L-ascorbate oxidase, 11S and 2S globulins, beta-fructofuranosidase, and ole-1-like protein) were identified in at least one food. The highest identity was found between profilins from chili pepper (cap*a*2.0201) and tomato (Sola*l*1.0101) at 94.7%.</p><p><strong>Conlusion: </strong>Among 1080 molecules implicated in allergic responses, the bioinformatic analysis identified only ~5% in MD. However, in vitro confirmation of these findings is necessary. Foods in the MD contain a higher proportion of nsLTP1 and profilins.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215306","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":"[Asthma: A preventable cause of hospital mortality. what has been the trend in Mexico in Recent Years?]","authors":"Erick Damián García-González, Diana Berenice García-Gómez, Elis Lara-Lona","doi":"10.29262/ram.v72i3.1496","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1496","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma has a significant global impact, affecting approximately 260 million people worldwide. Although mortality has decreased in recent years, it still causes around 420,000 deaths annually. This study aims to describe hospital mortality due to asthma in Mexico during the period 20202024.</p><p><strong>Methods: </strong>A descriptive, observational, cross-sectional, and retrospective analysis was conducted using public records from the General Directorate of Health Information. Deaths with a diagnosis of asthma (ICD-10 codes J45, J46) were analyzed. Hospital mortality, averages, frequencies, and proportions were calculated. The variables included: year, age, sex, and federal entity.</p><p><strong>Results: </strong>In Mexico, between 2020 and 2024, a total of 188 hospital deaths due to asthma were recorded, with an overall hospital mortality rate of 0.09% and an annual average of 0.1%. Mexico City reported the highest number of deaths (n=21), while Hidalgo registered the highest mortality rate (0.42%). The year with the most deaths was 2023 (n=46), and 2021 had the highest mortality rate (0.14%). Of all deaths, 56.45% were in women and 43.55% in men, with mortality rates of 0.1% and 0.08%, respectively. Adults aged 60 years and older accounted for the highest number of deaths (n=64) and the highest mortality rate (0.31%). The 10 to 14-year-old age group had the highest number of discharges but only 7 deaths, with a low mortality rate (0.01%).</p><p><strong>Conclusions: </strong>Although asthma mortality has shown a decreasing trend in recent years, it remains a public health problem in Mexico. Between 2011 and 2021, an estimated 36,009 Years of Life Lost due to Premature Death occurred annually due to asthma, highlighting its ongoing epidemiological burden. Since most asthma-related complications and deaths are largely preventable, more effective strategies must be implemented to support its prevention.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"71"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215318","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":"[The challenge of delabeling antibiotic allergy in Colombian children: do parents trust the negative result of the drug provocation test with the implicated antibiotic?]","authors":"Ana María Rincón-González, Diana Carolina Galeano-Tamayo, Libia Susana Díez Zuluaga","doi":"10.29262/ram.v72i3.1465","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1465","url":null,"abstract":"<p><strong>Objective: </strong>To explore the factors associated with the use of the antibiotic implicated in an adverse reaction following a negative challenge test in pediatric patients in a clinical allergology service of a health institution in Medellin.</p><p><strong>Methods: </strong>Observational cross-sectional study with analytical intent, in pediatric patients with a history of adverse reaction to an antibiotic, who underwent a provocation test and obtained a negative result. Sociodemographic and clinical data were obtained from medical records and parents or caregivers of patients who met the inclusion criteria were surveyed.</p><p><strong>Results: </strong>Between January 2016 and December 2021, 571 antibiotic provocations were performed. Only 19.2% of patients received the implicated antibiotic or antibiotics of the same class after a negative challenge test, without experiencing adverse reactions related to the new use. However, 53% of those who did not receive the antibiotic, despite needing it, mainly because their parents or caregivers continued to report the allergy label. Additionally, 26.9% of parents or caregivers did not recall the negative test result, and 44.2% would refuse future administration of the antibiotic to their children, identifying failure to recall the negative challenge test result as a factor associated with this behavior.</p><p><strong>Conclusions: </strong>Local strategies (providing individualized forms for parents and healthcare providers) should be designed to explain the meaning of a negative test result, as well as follow-up visits to verify adherence to recommendations, thus increasing the effectiveness of antibiotic allergy delabeling.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"11-26"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215076","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":"[Relationship between FeNO levels and asthma severity: a cross-sectional study at the University Hospital of Puebla].","authors":"Jorge Andres Naranjo-Vallejo, Juan Jesús Ríos-López, Aida Inés López-García, Daniela Rivero-Yeverino, Chrystopherson Gengyny Caballero-López, José Sergio Papaqui-Tapia","doi":"10.29262/ram.v72i3.1517","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1517","url":null,"abstract":"<p><strong>Introduction: </strong>The evaluation of patients with asthma uses clinical tools such as the Asthma Control Test (ACT), pulmonary function tests, and biomarkers. Among these, an elevated fractional exhaled nitric oxide (FeNO) level can predict a higher risk of exacerbations and response to corticosteroids and/or biological therapies, although it does not always reflect poor clinical control. Our objective was to determine the relationship between asthma severity and FeNO levels in patients attending our service.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in patients over 12 years of age with controlled asthma assessed by ACT. FeNO was measured using the NIOX-VERO^® device. Descriptive analysis and Spearmans correlation coefficient were applied.</p><p><strong>Results: </strong>Thirty-six patients (66.7% women) with a mean age of 36.3 years (SD ± 14.4) were included. According to GINA, 63.9% had mild asthma and 36.1% had moderate asthma. 22.2% had low FeNO levels (<25 ppb) and 52.8% had high levels (>50 ppb). The mean FeNO level in mild asthma was 62.7 ppb (SD ± 62.7) and in moderate asthma, 54.8 ppb (SD ± 36.2). No significant correlation was found between asthma severity and FeNO levels (rs = 0.150, p = 0.306).</p><p><strong>Conclusions: </strong>Although more than half of the patients had elevated FeNO levels, no significant association was observed with asthma severity. This finding is consistent with previous studies and suggests that FeNO, although useful as a biomarker of type 2 inflammation, should not be used in isolation to assess clinical severity.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"79"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215091","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":"[Omalizumab Withdrawal Protocol for Chronic Spontaneous Urticaria: Clinical Case].","authors":"Daniela Ramírez-Vázquez, Chrystopherson Gengyny Caballero-López, Aida Inés López-García, Daniela Rivero-Yeverino D, Juan Jesus Ríos-López, José Sergio Papaqui-Tapia, Jahnisi Riley-Pérez","doi":"10.29262/ram.v72i3.1520","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1520","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria is characterized by the daily appearance of hives and/or angioedema (Fig. 1) without a specific trigger, lasting more than 6 weeks. Treatment is based on second-generation H1 antihistamines, and in patients with an insufficient response, therapy with omalizumab has been effective; however, it is a costly and long-term treatment. The WAO (World Allergy Organization) has proposed a tapering regimen upon achieving complete remission.</p><p><strong>Case report: </strong>A 66-year-old female was referred for evaluation due to generalized hives of 6 years duration under treatment with fexofenadine 180 mg, with a partial response. Triple doses of H1 antihistamines were started, with no improvement, maintaining the UCT (Urticaria Control Test) at 5 points, and omalizumab 300 mg was added every 4 weeks, with an adequate clinical response. After complete remission, omalizumab tapering began in November 2023 according to the WAO protocol (Fig. 2). The final dose was administered in March 2025.</p><p><strong>Conclusion: </strong>We present the case of a patient with chronic spontaneous urticaria. After achieving complete remission with omalizumab, the tapering protocol proposed by the WAO was implemented. During this period, our patient remained asymptomatic, with UCT scores greater than 13, allowing for progressive reduction of antihistamine use. The omalizumab tapering protocol for the treatment of chronic spontaneous urticaria is safe and effective, reduces the risk of disease reactivation, and prevents prolonged treatment.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215104","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":"[Non-allergic immediate hypersensitivity to Brentuximab vedotin in pediatrics: usefulness of skin testing to guide provocation testing].","authors":"Karla Daniela González-Silva, Pablo Perea-Valle, José Alonso Gutiérrez-Hernández","doi":"10.29262/ram.v72i3.1534","DOIUrl":"https://doi.org/10.29262/ram.v72i3.1534","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reactions to monoclonal antibodies represent a clinical challenge, especially when there are no equivalent therapeutic alternatives. Brentuximab vedotin (BV), an anti-CD30 monoclonal antibody indicated for relapsed Hodgkin lymphoma, has been associated with immediate hypersensitivity in 1.2% of cases.</p><p><strong>Case report: </strong>An 11-year-old patient with relapsed Hodgkin lymphoma presented with grade 3 anaphylaxis (Brown scale) with hypotension, dyspnea, cough, wheezing, bipalpebral edema, conjunctival injection, nausea, and altered consciousness during the fifth cycle of chemotherapy with AVD (doxorubicin, vinblastine, and dacarbazine) + BV. Intramuscular epinephrine and fluid therapy were administered, with resolution of the condition. Laboratory Studies: BV skin tests performed 2 weeks after the event were negative. Outcome: Given the immediacy and severity of the event, and the need to continue treatment, a successful pharmacological challenge with AVD agents was performed. Subsequently, two cycles of BV desensitization were performed (cycles 6 and 7), using different protocols, without adverse reactions.</p><p><strong>Conclusion: </strong>Although skin tests were negative, the clinical presentation was consistent with immediate non-allergic hypersensitivity. Desensitization allowed treatment to continue with adequate tolerance and without recurrence. Repeat skin tests are currently being considered 4 to 6 weeks after the index event; if negative, a BV challenge test is considered. Skin tests support safety prior to a controlled challenge. Desensitization is an effective strategy for continuing essential treatments in pediatric oncology.</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"72 3","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215144","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}