1
|
Villarreal-González RV, González-Díaz S, Vidal-Gutiérrez O, Cruz-de la Cruz CDL, Pérez-Ibave DC, Garza-Rodríguez ML. Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies: Safety and efficacy of desensitization. J Oncol Pharm Pract 2024; 30:811-822. [PMID: 37489025 DOI: 10.1177/10781552231189461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
BACKGROUND Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies may lead to discontinuation of first-line treatment options. Identification of these reactions can provide specific diagnosis and treatment by rapid drug desensitizations. OBJECTIVE To determine the hypersensitivity reactions involved in anticancer chemotherapy and monoclonal antibodies, and the safety and efficacy of rapid drug desensitization. METHODS We conducted an observational study of hypersensitivity reaction presented after the administration of anticancer chemotherapy and monoclonal antibodies in Mexico. We documented the symptoms of initial reaction and their severity, and the results of skin tests. We also report our experience of the administration of 12-step (mild-moderate reactions) and 16-step (severe reactions) desensitization protocols in these patients. RESULTS Overall, 93 patients received 336 rapid drug desensitization; 105 to taxanes, 115 to platinum drugs, 101 to monoclonal antibodies, and 15 other anticancer chemotherapy. Hypersensitivity reaction to taxanes occurred in the first or second administration, platinum drugs after the sixth cycle, and rituximab in the first cycle. The most common symptom in carboplatin was urticaria, paclitaxel back pain, oxaliplatin and docetaxel dyspnea, and in the monoclonal antibodies cardiovascular symptoms. Skin tests were positive in 75% of the carboplatin group, and only 16.7% in docetaxel. There was a rapid drug desensitization success rate of 99.4% and 85.7% did not present any related hypersensitivity reaction. CONCLUSION The diagnosis of hypersensitivity reaction to anticancer chemotherapy and monoclonal antibodies offers a panorama in the management of oncological diseases. Our standardized desensitization protocol is safe and effective and can be reproduced in other centers to treat patients who need to maintain first-line treatment.
Collapse
Affiliation(s)
- Rosalaura V Villarreal-González
- Faculty of Medicine, Oncology Service, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| | - Sandra González-Díaz
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Regional Center of Allergy and Clinical Immunology, Monterrey, Nuevo León, México
| | - Oscar Vidal-Gutiérrez
- Faculty of Medicine, Oncology Service, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| | - Carlos de la Cruz-de la Cruz
- Department of Internal Medicine, Universidad de Monterrey. Christus Muguerza Alta Especialidad, Monterrey, Nuevo León, México
| | - Diana C Pérez-Ibave
- Faculty of Medicine, Oncology Service, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| | - María L Garza-Rodríguez
- Faculty of Medicine, Oncology Service, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| |
Collapse
|
2
|
Rojo Gutiérrez MI, Valentín Rostan M, Latour Staffeld P, Jares EJ. [Food anaphylaxis]. REVISTA ALERGIA MÉXICO 2023; 70:300-305. [PMID: 38506876 DOI: 10.29262/ram.v70i4.1341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Anaphylaxis, a potentially life-threatening reaction, is characterized by acute symptoms affecting various systems and requires immediate medical intervention. While the overall mortality rate is low, anaphylaxis induced by foods and drugs has seen an increase. Common triggers include foods, drugs, and Hymenoptera venom. Epidemiology varies by region and age, with a global incidence of 50-112 episodes per 100,000 people annually. Implicated foods vary by age and region, with peanuts and nuts being common triggers. Two mechanisms of anaphylaxis are recognized: IgE-mediated and non-IgE-mediated. Diagnosis is based on clinical criteria and serum tryptase levels. Treatment includes epinephrine, oxygen, and intravenous fluids. Exercise-induced food-dependent anaphylaxis is addressed, where exercise, combined with certain foods, triggers anaphylactic reactions. Proper understanding and management are crucial to mitigate risks.
Collapse
Affiliation(s)
- María Isabel Rojo Gutiérrez
- Pediatra, Alergóloga e Inmunóloga; profesora de Alergia pediátrica, Facultad de Medicina; Presidenta electa de la Sociedad Latinoamericana de Alergia, Asma e Inmunología (SLAAI) Montevideo, Uruguay
| | - Marylin Valentín Rostan
- Alergóloga e Inmunóloga clínica, Máster en Ciencias y Educación; Miembro de la Mesa Directiva de SLAAI; miembro activo del Colegio Mexicano de Inmunología Clínica y Alergia; Directora de Alergología en la Unidad Médica Zúrich, Ciudad de
| | - Patricia Latour Staffeld
- Doctora en Medicina, Inmunóloga y Alergóloga Clínica, Directora Médica del Centro Avanzado de Alergia y Asma de Santo Domingo; Profesora Asociada en la Universidad Nacional Pedro Henríquez Ureña, República Dominicana
| | - Edgardo José Jares
- Alergólogo e Inmunólogo; Jefe de sección de Alergia e inmunología, CMP Buenos Aires, Argentina
| |
Collapse
|
3
|
Rojo Gutiérrez MI, Moncayo-Coello CV. [Prevention in food allergies]. REVISTA ALERGIA MÉXICO 2023; 70:293-296. [PMID: 38506874 DOI: 10.29262/ram.v70i4.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Preventing food allergies is key to reducing the incidence of the disease. Exclusive breastfeeding is recommended during the first months of life, in addition to supplementation with vitamin D and, due to the importance of the microbiota, addition of probiotics, prebiotics and symbiotic. Currently, late exposure to foods is controversial, and it is suggested to introduce allergenic foods early, trying not to expose the cutaneous route. The application of biologics in food allergy is an evolving area of research and treatment. Biologics are indicated in diseases evaluated in various studies, such as atopic dermatitis, and are approved by the FDA for prescription; However, its potential administration in the treatment of severe allergic reactions caused by food is still debated. These therapies may change the way food allergy is addressed in the future, but they are still in experimental stages and not widely available. Food anaphylaxis is a life-threatening allergic reaction that requires quick action. Prevention involves avoiding the triggering food, awareness of symptoms, and availability of epinephrine for immediate administration in case of a reaction.
Collapse
Affiliation(s)
- María Isabel Rojo Gutiérrez
- Pediatra, Alergóloga e Inmunóloga; profesora de Alergia pediátrica, Facultad de Medicina; Presidenta electa de la Sociedad Latinoamericana de Alergia, Asma e Inmunología (SLAAI) Montevideo,
| | | |
Collapse
|
4
|
Villarreal-González RV, González-Díaz S, Vidal-Gutiérrez O, de la Cruz-de la Cruz C, Pérez-Ibave DC, Garza-Rodríguez ML. Interleukin-6 as a biomarker of hypersensitivity reactions in chemotherapeutics and monoclonal antibodies. J Oncol Pharm Pract 2023:10781552231204367. [PMID: 37817577 DOI: 10.1177/10781552231204367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
BACKGROUND In recent years, a new type of immediate hypersensitivity reaction known as cytokine release began to emerge, and within this phenotype of reactions, interleukin-6 is the most frequently associated with the presence during drug administration. Chemotherapeutic agents (QT) and monoclonal antibodies. OBJECTIVE Determine interleukin-6 levels in hypersensitivity reactions to QT and monoclonal antibodies. METHODS Observational and prospective study that was carried out from March 1, 2021 to March 1, 2022 in a university hospital in northeastern Mexico. Symptoms, severity, interleukin-6 levels, and skin tests of hypersensitivity reaction were evaluated at QT and monoclonal antibodies. RESULTS A total of 41 patients with oncological disease were included, the most frequent being ovarian cancer. Symptoms as initial hypersensitivity reaction were neuromuscular in taxanes and cutaneous in Platinums.41.5% presented elevation of interleukin-6, and it was found more frequently in presence of metastases. Positive skin tests were found more frequently in the carboplatin and doxorubicin groups. The most frequently presented phenotype was type I in paclitaxel, carboplatin, and doxorubicin, and mixed-reaction (type I and cytokine release) in oxaliplatin. CONCLUSION With the increasing prevalence of hypersensitivity reactions to biologic and antineoplastic therapies, interleukin-6 should be recognized as a biomarker in immediate hypersensitivity reactions to QT and monoclonal antibodies.
Collapse
Affiliation(s)
- Rosalaura V Villarreal-González
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Sandra González-Díaz
- Faculty of Medicine, Regional Center of Allergy and Clinical Immunology, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Oscar Vidal-Gutiérrez
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - Carlos de la Cruz-de la Cruz
- Department of Internal Medicine, Universidad de Monterrey, Christus Muguerza Alta Especialidad, Monterrey, Nuevo León, Mexico
| | - Diana C Pérez-Ibave
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| | - María L Garza-Rodríguez
- Faculty of Medicine, Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Universidad Autónoma de Nuevo León, Hospital Universitario "Dr José Eleuterio González", Monterrey, Nuevo León, Mexico
| |
Collapse
|
5
|
Tanno LK, Worm M, Ebisawa M, Ansotegui IJ, Senna G, Fineman S, Geller M, Gonzalez-Estrada A, Campbell DE, Leung A, Muraro A, Levin M, Ortega Martell JA, Caminati M, Kolkhir P, Le Pham D, Darlenski R, Esteban-Gorgojo I, Rial M, Filipovic I, Chiarella SE, Cuervo-Pardo L, Kwong C, Pozo-Beltran CF, Trinh THK, Greenberger PA, Turner PJ, Thong BYH, Martin B, Cardona V. Global disparities in availability of epinephrine auto-injectors. World Allergy Organ J 2023; 16:100821. [PMID: 37915955 PMCID: PMC10616381 DOI: 10.1016/j.waojou.2023.100821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023] Open
Abstract
Background Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions and can cause death. Given the prevalence of anaphylaxis within healthcare systems, it is a high priority public health issue. However, management of anaphylaxis - both acute and preventative - varies by region. Methods The World Allergy Organization (WAO) Anaphylaxis Committee and the WAO Junior Members Steering Group undertook a global online survey to evaluate local practice in the diagnosis and management of anaphylaxis across regions. Results Responses were received from WAO members in 66 countries. While intramuscular epinephrine (adrenaline) is first-line treatment for anaphylaxis, some countries continue to recommend alternative routes in contrast to guidelines. Epinephrine auto-injector (EAI) devices, prescribed to individuals at ongoing risk of anaphylaxis in the community setting, are only available in 60% of countries surveyed, mainly in high-income countries. Many countries in South America, Africa/Middle-East and Asian-Pacific regions do not have EAI available, or depend on individual importation. In countries where EAIs are commercially available, national policies regarding the availability of EAIs in public settings are limited to few countries (16%). There is no consensus regarding the time patients should be observed following emergency treatment of anaphylaxis. Conclusion This survey provides a global snapshot view of the current management of anaphylaxis, and highlights key unmet needs including the global availability of epinephrine for self-injection as a key component of anaphylaxis management.
Collapse
Affiliation(s)
- Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
- Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Cedex 5, Montpellier, France
| | - Margitta Worm
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Campus Charité Mitte, Universitätsmedizin Berlin, Germany
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Gianenrico Senna
- Department of Medicine, Allergy Asthma and Clinical Immunology Section, University of Verona, Verona, Italy
| | - Stanley Fineman
- Atlanta Allergy & Asthma, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mario Geller
- Section of Medicine of the Brazilian Academy of Medicine of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexei Gonzalez-Estrada
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Agnes Leung
- The Chinese University of Hong Kong, Department of Pediatrics, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
| | - Antonella Muraro
- Department of Mother and Child Health University of Padua Padua, Italy
| | - Michael Levin
- Division of Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | | | - Marco Caminati
- Department of Medicine, University of Verona, Verona, Italy
| | - Pavel Kolkhir
- Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Duy Le Pham
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet nam
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital Sofia, 51B Nikola Vaptsarov Blvd., 1407, Sofia, Bulgaria
- Department of Dermatology and Venereology, Trakia University-Stara Zagora, Stara Zagora, Bulgaria
| | | | - Manuel Rial
- Allergology Section, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | | | - Lyda Cuervo-Pardo
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Medicine, University of Florida, USA
| | | | | | - Tu HK. Trinh
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet nam
| | - Paul A. Greenberger
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | - Paul J. Turner
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Bryan Martin
- Medicine and Pediatrics, The Ohio State University in Columbus, Ohio, USA
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, and ARADyAL Research Network, Spain
| | - the WAO Anaphylaxis Committee and the WAO Junior Members Steering Group
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
- Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Cedex 5, Montpellier, France
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Campus Charité Mitte, Universitätsmedizin Berlin, Germany
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
- Department of Medicine, Allergy Asthma and Clinical Immunology Section, University of Verona, Verona, Italy
- Atlanta Allergy & Asthma, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Section of Medicine of the Brazilian Academy of Medicine of Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA
- The University of Sydney, New South Wales, Australia
- The Chinese University of Hong Kong, Department of Pediatrics, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Department of Mother and Child Health University of Padua Padua, Italy
- Division of Paediatric Allergology, University of Cape Town, Cape Town, South Africa
- Department of Immunology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
- Department of Medicine, University of Verona, Verona, Italy
- Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet nam
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital Sofia, 51B Nikola Vaptsarov Blvd., 1407, Sofia, Bulgaria
- Department of Dermatology and Venereology, Trakia University-Stara Zagora, Stara Zagora, Bulgaria
- Department of Allergy, Hospital General de Villalba, Madrid, Spain
- Allergology Section, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
- University Hospital Dr Dragisa Misovic, Serbia
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN, USA
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Medicine, University of Florida, USA
- Phoenix Children's Hospital, Phoenix, AZ, USA
- Hospital Infantil de México Federico Gómez, Mexico
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet nam
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- National Heart & Lung Institute, Imperial College London, London, UK
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
- Medicine and Pediatrics, The Ohio State University in Columbus, Ohio, USA
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, and ARADyAL Research Network, Spain
| |
Collapse
|
6
|
Arámburo-Gálvez JG, Figueroa-Salcido OG, Ramírez-Torres GI, Terán-Cabanillas E, Gracia-Valenzuela MH, Arvizu-Flores AA, Sánchez-Cárdenas CA, Mora-Melgem JA, Valdez-Zavala L, Cárdenas-Torres FI, Ontiveros N. Prevalence of Parent-Reported Food Allergy in a Mexican Pre-School Population. J Clin Med 2023; 12:5095. [PMID: 37568497 PMCID: PMC10420166 DOI: 10.3390/jcm12155095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical diagnosis and presentation. A cross-sectional survey was conducted in Culiacán City. A validated questionnaire was utilized. A total of 810 parents responded to the questionnaire (valid response rate, 40.7%). The estimated prevalence rates (95% CI) were: "physician-diagnosed Food Allergy (FA), ever" 5.30% (3.86-7.08); "immediate-type FA, ever" 2.96% (1.91-4.38); "immediate-type FA, current" 1.60% (0.86-2.73); and food-dependent anaphylaxis 1.11% (0.51-2.01). The main food allergens were milk (0.49%), strawberries (0.37%), egg, and soy (0.25% each). Atopic diseases and a family history of allergies were significantly associated with immediate-type FA. Among "immediate-type FA, current" cases, 76.9% required emergency room visits, but the prescription of epinephrine autoinjectors was reported in one case only. The food reactions occurred at home (92.35%), in a relative's house (38.5), and at restaurants (23%). Immediate-type FA reactions requiring emergency room visits are not uncommon among the studied population. Actions like proper anaphylaxis management and the prevention of cross-contamination of foods should be encouraged.
Collapse
Affiliation(s)
- Jesús Gilberto Arámburo-Gálvez
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Oscar Gerardo Figueroa-Salcido
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
- Integral Postgraduate Program in Biotechnology, Faculty of Chemical and Biological Sciences, Autonomous University of Sinaloa, Ciudad Universitaria, Culiacan 80010, Mexico
| | | | - Elí Terán-Cabanillas
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Martina Hilda Gracia-Valenzuela
- Department of Engineering, Technological National of Mexico, Technological Institute of the Yaqui Valley, Bacum 85276, Mexico;
| | - Aldo Alejandro Arvizu-Flores
- Postgraduate Program in Health Sciences, Faculty of Biological and Health Sciences, University of Sonora, Hermosillo 83000, Mexico;
| | - Cesar Antonio Sánchez-Cárdenas
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - José Antonio Mora-Melgem
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Luisamaria Valdez-Zavala
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Feliznando Isidro Cárdenas-Torres
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, U.N.), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Faculty of Biological and Health Sciences, University of Sonora, Navojoa 85880, Mexico
| |
Collapse
|
7
|
Aguirre-Morales N, Zapata-Marín V, Calvo VD, Ramirez-Giraldo RH, Cardona-Villa R. [Characterization of patients with anaphylaxis in a tertiary hospital in Medellin, Colombia (2009-2019)]. REVISTA ALERGIA MÉXICO 2023; 70:8-14. [PMID: 37566751 DOI: 10.29262/ram.v70i1.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/02/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE To characterize demographically and clinically the patients with anaphylaxis treated in a third level health institution in Medellin, Colombia. METHODS A cross-sectional descriptive observational study was carried out, which includedpatients were diagnosed with anaphylaxis between 2009 and 2019. Information was retrieved from medical records through a collection instrument. Subsequently, a descriptive statistical analysis of proportions and measures of central tendency of the variables of interest was performed. RESULTS A total of 1820 records were reviewed and data from 253 patients were included. Among the reported comorbidities, drug allergy was the most prevalent (28%). The most frequent manifestations of anaphylaxis were cutaneous and respiratory. Most of the cases presented basal tryptase values ≤ 11.4 ng/mL (94.7%). Different etiological agents (food, drugs, insects and latex) were reported, and their frequency varied according to age. Adrenaline, steroids, and antihistamines were the treatments of choice in 39.9, 34.3, and 39.9% of cases, respectively. CONCLUSIONS The characteristics of anaphylaxis in a medical center in Colombia coincide with those reported in Latin American. The treatment of anaphylaxis is not standardized, which makes it necessary to educate the health personnel and develop national guidelines.
Collapse
Affiliation(s)
| | - Valeria Zapata-Marín
- Grupo de Alergología Clínica y Experimental (GACE), Hospital Alma Mater, Medellín, Colombia.
| | - Victor Daniel Calvo
- Grupo de Alergología Clínica y Experimental (GACE), Hospital Alma Mater, Medellín, Colombia
| | | | - Ricardo Cardona-Villa
- Grupo de Alergología Clínica y Experimental (GACE), Hospital Alma Mater, Medellín, Colombia
| |
Collapse
|
8
|
Beltrán-Cárdenas CE, Granda-Restrepo DM, Franco-Aguilar A, Lopez-Teros V, Arvizu-Flores AA, Cárdenas-Torres FI, Ontiveros N, Cabrera-Chávez F, Arámburo-Gálvez JG. Prevalence of Food-Hypersensitivity and Food-Dependent Anaphylaxis in Colombian Schoolchildren by Parent-Report. ACTA ACUST UNITED AC 2021; 57:medicina57020146. [PMID: 33562800 PMCID: PMC7915673 DOI: 10.3390/medicina57020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: The epidemiology of food allergy (FA) and food-dependent anaphylaxis remains unknown in Colombia. Our aim was to estimate by parent-report the prevalence of FA and food-dependent anaphylaxis in a Colombian population of schoolchildren. Materials and methods: A printed questionnaire was sent to parents of schoolchildren aged 5–12 years old from Medellín, Colombia in order to collect FA-related data. Results: Nine hundred and sixty-nine (969) parents returned the questionnaire with valid responses (response rate, 52.5%). The estimated prevalence rates (95% CI) were: adverse food reactions 12.79% (10.76–15.07), “perceived FA, ever” 10.93% (9.08–13.08), “physician-diagnosed FA, ever” 4.33% (3.14–5.81), “immediate-type FA, ever” 6.81% (5.30–8.58), “immediate-type FA, current” 3.30% (2.26–4.63), and food-dependent anaphylaxis 1.85% (1.10–2.92). The most frequently reported food allergens were milk (1.44%), fruits (0.41%), meat (0.41%), and peanut (0.3%). Sixty-one percent of “food-dependent anaphylaxis” cases sought medical attention, but only eleven percent of the cases reported the prescription of an epinephrine autoinjector. Conclusions: FA and food-dependent anaphylaxis are not uncommon among schoolchildren from Colombia. The prescription of epinephrine autoinjectors should be encouraged among health personnel for the optimal management of suspected cases of food-dependent anaphylaxis.
Collapse
Affiliation(s)
- Carlos Eduardo Beltrán-Cárdenas
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
| | - Diana María Granda-Restrepo
- Food Department, Faculty of Pharmaceutical and Food Sciences, University of Antioquia, Medellín, Antioquia 50010, Colombia; (D.M.G.-R.); (A.F.-A.)
| | - Alejandro Franco-Aguilar
- Food Department, Faculty of Pharmaceutical and Food Sciences, University of Antioquia, Medellín, Antioquia 50010, Colombia; (D.M.G.-R.); (A.F.-A.)
| | - Veronica Lopez-Teros
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
| | - Aldo Alejandro Arvizu-Flores
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
| | - Feliznando Isidro Cárdenas-Torres
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
| | - Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, URS), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, University of Sonora, Navojoa, Sonora 85880, Mexico;
| | - Francisco Cabrera-Chávez
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
- Correspondence: (F.C.-C.); (J.G.A.-G.)
| | - Jesús Gilberto Arámburo-Gálvez
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
- Correspondence: (F.C.-C.); (J.G.A.-G.)
| |
Collapse
|
9
|
Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S, Geller M, Gonzalez-Estrada A, Greenberger PA, Sanchez Borges M, Senna G, Sheikh A, Tanno LK, Thong BY, Turner PJ, Worm M. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J 2020; 13:100472. [PMID: 33204386 PMCID: PMC7607509 DOI: 10.1016/j.waojou.2020.100472] [Citation(s) in RCA: 378] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/03/2020] [Indexed: 12/16/2022] Open
Abstract
Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions. The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies. The rationale of this updated position document is the need to keep guidance aligned with the current state of the art of knowledge in anaphylaxis management. The World Allergy Organization (WAO) anaphylaxis guidelines were published in 2011, and the current guidance adopts their major indications, incorporating some novel changes. Intramuscular epinephrine (adrenaline) continues to be the first-line treatment for anaphylaxis. Nevertheless, its use remains suboptimal. After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management. The limited availability of epinephrine auto-injectors remains a major problem in many countries, as well as their affordability for some patients.
Collapse
Affiliation(s)
- Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, and ARADyAL research network, Barcelona, Spain,Corresponding author. Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain.
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | | | - Stanley Fineman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Mario Geller
- Division of Medicine, Academy of Medicine of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexei Gonzalez-Estrada
- Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Paul A. Greenberger
- Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mario Sanchez Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad and Clinica El Ávila, Caracas, Venezuela
| | - Gianenrico Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - Aziz Sheikh
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Luciana Kase Tanno
- Hospital Sírio Libanês, Brazil andUniversity Hospital of Montpellier, São Paulo, Montpellier, and Sorbonne Université, INSERM Paris, France, and WHO Collaborating Centre on Scientific Classification Support Montpellier, and WHO ICD-11 Medical and Scientific Advisory Committee Geneva, Switzerland
| | - Bernard Y. Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Paul J. Turner
- National Heart Lung Institute, Imperial College London and Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, Australia
| | - Margitta Worm
- Department of Dermatology and Allergology, Charite-Universitätsmedizin, Berlin, Germany
| |
Collapse
|