GUIMIT 2019, Guía Mexicana de Inmunoterapia. Guía de diagnóstico de alergia mediada por IgE e inmunoterapia aplicando el método ADAPTE

Désirée Larenas-Linnemann, Jorge A. Luna-Pech, Noel Rodríguez-Pérez, Mónica Rodríguez-González, Alfredo Arias-Cruz, María Virginia Blandón-Vijil, María del Carmen Costa-Domínguez, Blanca E. Del Río-Navarro, Alan Estrada-Cardona, Elsy Maureen Navarrete-Rodríguez, José Antonio Ortega-Martell, César Fireth Pozo-Beltrán, Herson Brito-Díaz, María del Rosario Canseco-Raymundo, Enrique Emanuel Castelán-Chávez, Margarita Gabriela Domínguez-Silva, Alberto José Escalante-Domínguez, José Luis Gálvez-Romero, María Guadalupe García-Reyes, Javier Gómez-Vera, Sandra Nora González-Díaz, María Gracias Belinda Guerrero-Núñez, Dante Hernández-Colín, Alejandra Macías-Weinmann, David Alejandro Mendoza-Hernández, Néstor Alejandro Meneses-Sánchez, María Dolores Mogica-Martínez, Carol Vivian Moncayo-Coello, Manuel Montiel-Herrera, Patricia O’Farril-Romanillos, Ernesto Onuma-Takane, Margarita Ortega-Cisneros, Lorena Rangel-Garza, Héctor Stone-Aguilar, Carlos Torres-Lozano, Edna Venegas-Montoya, Guillermo Wakida-Kusunoki, Carlos Macouzet-Sánchez, Armando Partida-Gaytán, Aída Inés López-García, Ana Paola Macías-Robles, María de Jesús Ambriz-Moreno, Amyra Ali Azamar-Jácome, Carlos Báez-Loyola, Claudia Yusdivia Beltrán-De Paz, Chrystopherson Caballero-López, Juan Carlos Fernández de Córdova-Aguirre, Roberto Fernández-Soto, José Santos Lozano-Sáenz, José Joel Oyoqui-Flores, Roberto Osorio-Escamilla, Fernando Ramírez, Daniela Rivero-Yeverino, María del Socorro Orozco-Martínez, María Isabel Rojo-Gutiérrez, Eric Martínez, Miguel Alejandro Medina-Ávalos

Resumen


Antecedentes: En México, la inmunoterapia con alérgenos (ITA) y con veneno de himenópteros (VIT) se practica tradicionalmente combinando criterios de las escuelas europea y estadounidense; los dos tipos de extractos están comercialmente disponibles en México. Para una ITA adecuada es crucial un diagnóstico oportuno.

Objetivo: Presentar GUIMIT 2019, Guía Mexicana de Inmunoterapia 2019, de base amplia, actualizada, que abarca temas de diagnóstico, indicaciones, dosificación, mecanismos, efectos adversos de la ITA y expectativas con esta modalidad de tratamiento.

Método: Con la participación de múltiples grupos mexicanos de alergólogos, que incluían los centros formadores universitarios en alergia e inmunología, se desarrolló el documento de la guía según la metodología ADAPTE. Las guías de inmunoterapia de la European Academy of Allergy and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology, German Society for Allergology and Clinical Immunology y del American College of Allergy, Asthma, and Immunology se seleccionaron como guías fuente, ya que recibieron la puntuación AGREE-II más alta entre las guías internacionales disponibles; su evidencia conforma la base científica de GUIMIT 2019.

Resultados: En GUIMIT 2019 se emiten recomendaciones fuertes o débiles (sugerencias) acerca de temas directamente relacionados con el diagnóstico in vivo o in vitro de las enfermedades alérgicas mediadas por IgE, la preparación y aplicación de ITA o VIT y sus efectos adversos; se incluye la revisión de las modalidades de ITA para el futuro. Todos los argumentos que se exponen fueron discutidos y votados con > 80 % de aprobación.

Conclusión: Un grupo amplio y diverso de expertos en ITA y VIT emitió recomendaciones transculturizadas basadas en evidencia, que alcanzaron consenso; con ellas se pretende mejorar y homologar la práctica de la inmunoterapia en México. 


Palabras clave


Pruebas cutáneas por punción; Pruebas intradérmicas; Diagnóstico de alergia in vitro; Diagnóstico molecular; Inmunoterapia con alérgenos; Inmunoterapia subcutánea; Inmunoterapia sublingual; Inmunoterapia con veneno de himenóptero; Anafilaxia; Adrenalina

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Referencias


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DOI: http://dx.doi.org/10.29262/ram.v66i5.631

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