Preguntas comunes en alergias. Enfoque práctico para el diagnóstico y manejo en atención primaria
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Palabras clave

Asma
Alergia
Atopia
Inmunoglobulina
Mascotas
Rinitis
Sensibilización

Resumen

Las alergias son enfermedades con diferentes manifestaciones clínicas, presentes en 20 a 40 % de la población general. Debido a que comparten un mismo mecanismo, en muchas ocasiones se presentan varios procesos de este tipo en una misma persona, generando numerosos síntomas y costos económicos importantes para el paciente y su familia. Actualmente, el manejo médico de estas enfermedades está enfocado en tres puntos principales: identificar y evitar el agente causal, control de los síntomas agudos mediante tratamiento farmacológico y generación de tolerancia con inmunomodulación o la desensibilización. Sin embargo, debido a los diferentes mecanismos subyacentes, es necesario realizar diferentes aproximaciones diagnósticas, las cuales pueden transformarse en un verdadero reto para el médico tratante. Adicionalmente, en ocasiones el paciente lleva a cabo restricciones y tratamientos innecesarios, limitando sus actividades diarias, modificando su dieta y afectando de forma directa su calidad de vida. Se realiza una revisión orientada a dar respuesta a diferentes inquietudes comunes que resultan de la consulta de la práctica diaria.

 

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Referencias

Sole D, Jacob C, Pastorino A, Porto A, Burns D, Sarinho E, et al. Pediatrician' knowledge on food allergy: pilot study. Rev Paul Pediatr. 2007;25(4):311-316.

Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113(5):832-836. DOI: 10.1016/j.jaci.2003.12.591

Altrichter S, Peter HJ, Pisarevskaja D, Metz M, Martus P, Maurer M. IgE mediated autoallergy against thyroid peroxidase -a novel pathomechanism of chronic spontaneous urticaria? PLoS One. 2011;6(4):e14794. DOI: 10.1371/journal.pone.0014794

Banerji A. Hereditary angioedema: classification, pathogenesis, and diagnosis. Allergy Asthma Proc. 2011;32(6):403-407. DOI: 10.2500/aap.2011.32.3492

Aalberse RC, Schuurman J. IgG4 breaking the rules. Immunology. 2002;105(1):9-19. DOI: 10.1046/j.0019-2805.2001.01341.x

Nakajima S, Igyártó BZ, Honda T, Egawa G, Otsuka A, Hara-Chikuma M, et al. Langerhans cells are critical in epicutaneous sensitization with protein antigen via thymic stromal lymphopoietin receptor signaling. J Allergy Clin Immunol. 2012;129(4):1048-1055. DOI: 10.1016/j.jaci.2012.01.063

Rajan TV. The Gell-Coombs classification of hypersensitivity reactions: a re-interpretation. Trends Immunol. 2003;24(7):376-379. DOI: 10.1016/S1471-4906(03)00142-X

Gould HJ, Sutton BJ. IgE in allergy and asthma today. Nat Rev Immunol. 2008;8(3):205-217. DOI: 10.1038/nri2273

Wahn U, Warner J, Simons FE, De-Benedictis FM, Diepgen TL, Naspitz CK, et al. IgE antibody responses in young children with atopic dermatitis. Pediatr Allergy Immunol. 2008;19(4):332-336. DOI: 10.1111/j.1399-3038.2007.00643.x

Zakzuk J, Acevedo N, Cifuentes L, Bornacelly A, Sánchez J, Ahumada V, et al. Early life IgE responses in children living in the tropics: a prospective analysis. Pediatr Allergy Immunol. 2013;24(8):788-797. DOI: 10.1111/pai.12161

Acevedo N, Sánchez J, Zakzuk J, Bornacelly A, Quiróz C, Álvarez A, et al. Particular characteristics of allergic symptoms in tropical environments: follow up to 24 months in the FRAAT birth cohort study. BMC Pulm Med. 2012;12:13. DOI: 10.1186/1471-2466-12-13

Paveglio S, Puddington L, Rafti E, Matson AP. FcRn-mediated intestinal absorption of IgG anti-IgE/IgE immune complexes in mice. Clin Exp Allergy. 2012;42(12):1791-800. DOI: 10.1111/j.1365-2222.2012.04043.x

Arroyave Hernández CM, Echavarría Pinto M, Hernández Montiel HL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007;54(5):162-168.

Sá DC, Festa CN. Inflammasomes and dermatology. An Bras Dermatol. 2016;91(5):566-578. DOI: 10.1590/abd1806-4841.20165577

Hijnen D, Knol EF, Gent YY, Giovannone B, Beijn SJ, Kupper TS, et al. CD8(+) T cells in the lesional skin of atopic dermatitis and psoriasis patients are an important source of IFN-, IL-13, IL-17, and IL-22. J Invest Dermatol. 2013;133(4):973-979. DOI: 10.1038/jid.2012.456

Padial A, Antunez C, Blanca-López N, Fernández T, Cornejo-García J, Mayorga C, et al. Non-immediate reactions to beta-lactams: diagnostic value of skin testing and drug provocation test. Clin Exp Allergy. 2008;38(5):822-828. DOI: 10.1111/j.1365-2222.2008.02961.x

Cottin V, Cordier JF. Eosinophilic lung diseases. Immunol Allergy Clin North Am. 2012;32(4):557-586. DOI: 10.1016/j.iac.2012.08.007

Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity reactions. J Allergy Clin Immunol. 2011;127(Suppl 3):S67-S73. DOI: 10.1016/j.jaci.2010.11.047

Dal-Negro RW, Guerriero M, Micheletto C. Pattern of airway inflammation and remodelling in mild persistent atopic asthma and in mild persistent asthma related to gastroesophageal reflux. Eur Ann Allergy Clin Immunol. 2012;44(6):236-242.

Rojanapremsuk T, Kasprowicz S, Schafer E, Story R, Clarke MS, Walls T, et al. Clinicopathologic findings in (anti-FcepsilonR1alpha) autoimmune-related chronic urticaria. J Cutan Pathol. 2015;42(5):329-332. DOI: 10.1111/cup.12471

Altman K, Chang C. Pathogenic intracellular and autoimmune mechanisms in urticaria and angioedema. Clin Rev Allergy Immunol. 2013;45(1):47-62. DOI: 10.1007/s12016-012-8326-y

Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466-476. DOI: 10.1016/j.jaci.2010.06.047

Sánchez J, Páez B, Macías A, Olmos C, De-Falco A. Atopic dermatitis guideline. Position paper from the Latin American Society of Allergy, Asthma and Immunology. Rev Alerg Mex. 2014;61(3):178-211.

Brown SG, Stone SF, Fatovich DM, Burrows SA, Holdgate A, Celenza A, et al. Anaphylaxis: clinical patterns, mediator release, and severity. J Allergy Clin Immunol. 2013;132(5):1141-1149. DOI: 10.1016/j.jaci.2013.06.015

Burbach G, Heinzerling L, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy. 2009;64(10):1507-1515. DOI: 10.1111/j.1398-9995.2009.02089.x

Heinzerling LM, Burbach GJ, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe. Allergy. 2009;64(10):1498-1506. DOI: 10.1111/j.1398-9995.2009.02093.x

Sánchez J, Diez S, Cardona R. Frequency of sensitization to animals in a tropical area. Rev Alerg Mex. 2014;61(2):81-89.

Sánchez-Caraballo J, Diez-Zuluaga S, Cardona-Villa R. Sensibilización a aeroalergenos en pacientes alérgicos de Medellín, Colombia. Rev Alerg Mex. 2012;59(3):139-147.

White JM. Patch testing: what allergists should know. Clin Exp Allergy. 2012;42(2):180-185. DOI: 10.1111/j.1365-2222.2011.03862.x

Friedmann PS, Ardern-Jones M. Patch testing in drug allergy. Curr Opin Allergy Clin Immunol. 2010;10(4):291-296. DOI: 10.1097/ACI.0b013e32833aa54d

Lammintausta K, Kortekangas-Savolainen O. The usefulness of skin tests to prove drug hypersensitivity. Br J Dermatol. 2005;152(5):968-974. DOI: 10.1111/j.1365-2133.2005.06429.x

García-Núñez I, Barasona-Villarejo MJ, Algaba-Mármol MA, Moreno-Aguilar C, Guerra-Pasadas F. Diagnosis of patients with immediate hypersensitivity to beta-lactams using retest. J Investig Allergol Clin Immunol. 2012;22(1):41-47.

Koletzko S, Niggemann B, Arato A, Dias JA, Heuschkel R, Husby S, et al. Diagnostic approach and management of cow’s-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr. 2012;55(2):221-229. DOI: 10.1097/MPG.0b013e31825c9482

Jeong KY, Lee JY, Son M, Yi MH, Yong TS, Shin JU, et al. Profiles of IgE Sensitization to Der f 1, Der f 2, Der f 6, Der f 8, Der f 10, and Der f 20 in Korean House Dust Mite Allergy Patients. Allergy Asthma Immunol Res. 2015;7(5):483-488. DOI: 10.4168/aair.2015.7.5.483

Mopan J, Sánchez J, Chinchilla C, Cardona R. Prevalence of sensitization to cow’s milk and egg among patients with suspicion of IgE mediated diseases. Rev Alerg Mex. 2015;62(1):41-47.

Borres MP, Ebisawa M, Eigenmann PA. Use of allergen components begins a new era in pediatric allergology. Pediatr Allergy Immunol. 2011;22(5):454-461. DOI: 10.1111/j.1399-3038.2011.01197.x

Kawamoto N, Fukao T, Kaneko H, Hirayama K, Sakurai S, Arai T, et al. Total IgE at 6 months predicts remittance or persistence of atopic dermatitis at 14 months. Allergy Asthma Proc. 2013;34(4):362-369. DOI: 10.2500/aap.2013.34.3678

Wijga AH, Kerkhof M, Gehring U, De-Jongste JC, Postma DS, Aalberse RC, et al. Cohort profile: the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort. Int J Epidemiol. 2013;43(2):527-535. DOI: 10.1093/ije/dys231

Van-Strien RT, Koopman LP, Kerkhof M, Spithoven J, De-Jongste JC, Gerritsen J, et al. Mite and pet allergen levels in homes of children born to allergic and nonallergic parents: the PIAMA study. Environ Health Perspect. 2002;110(11):A693-A698. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241089/pdf/ehp0110-a00693.pdf

Caudri D, Wijga AH, Smit HA, Koppelman GH, Kerkhof M, Hoekstra MO, et al. Asthma symptoms and medication in the PIAMA birth cohort: evidence for under and overtreatment. Pediatr Allergy Immunol. 2011;22(7):652-659. DOI: 10.1111/j.1399-3038.2011.01193.x

Brunekreef B, Smit J, De-Jongste J, Neijens H, Gerritsen J, Postma D, et al. The prevention and incidence of asthma and mite allergy (PIAMA) birth cohort study: design and first results. Pediatr Allergy Immunol. 2002;13(Suppl 15):55-60.

Sánchez J, Díez S, Cardona R. Pet avoidance in allergy cases: is it possible to implement it? Biomedica. 2015;35(3):357-362. DOI: 10.7705/biomedica.v35i3.2634

Lin W, Gehring U, Oldenwening M, De-Jongste JC, Kerkhof M, Postma D, et al. Gas cooking, respiratory and allergic outcomes in the PIAMA birth cohort study. Occup Environ Med. 2013;70(3):187-194. DOI: 10.1136/oemed-2012-101025

Sánchez J, Sánchez A, Cardona R. Economic consequences in real life of allergen immunotherapy in asthma, rhinitis and dermatitis. Rev Alerg Mex. 2016;63(4):323-333. DOI: 10.29262/ram.v63i4.238

Baena-Cagnani CE, Larenas-Linnemann D, Gómez M, Díaz SG, Solé D, Borges MS, et al. Allergy training and immunotherapy in Latin America: results of a regional overview. Ann Allergy Asthma Immunol. 2013;111(5):415-419. DOI: 10.1016/j.anai.2013.08.011

Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy: multiple suppressor factors at work in immune tolerance to allergens. J Allergy Clin Immunol. 2014;133(3):621-631. DOI: 10.1016/j.jaci.2013.12.1088

Smaldini PL, Orsini Delgado ML, Fossati CA, Docena GH. Orally-induced intestinal CD4+ CD25+ FoxP3+ Treg controlled undesired responses towards oral antigens and effectively dampened food allergic reactions. PLoS One. 2015;10(10):e0141116. DOI: 10.1371/journal.pone.0141116

Berin MC, Mayer L. Can we produce true tolerance in patients with food allergy? J Allergy Clin Immunol. 2013;131(1):14-22. DOI: 10.1016/j.jaci.2012.10.058

Simons FE, Ardusso LR, Bilò MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. 2011;127(3):587-93. DOI: 10.1016/j.jaci.2011.01.038

Sánchez J, Sánchez A. Epidemiology of food allergy in Latin America. Allergol Immunopathol (Madr). 2015;43(2):185-195. DOI: 10.1016/j.aller.2013.07.001

Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-887. DOI: 10.1111/all.12313

Sánchez J, Cardona R, Caraballo L, Serrano C, Ramírez R, Díez S, et al. Allergen immunotherapy: mechanisms of action, and therapeutic and socioeconomic impact Consensus of the Asociación Colombiana de Alergia, Asma e Imunología. Biomedica. 2016;36(3):463-474. DOI: 10.7705/biomedica.v36i3.3183

Heinzerling LM, Tomsitz D, Anliker MD. Is drug allergy less prevalent than previously assumed? A 5-year analysis. Br J Dermatol. 2012;166(1):107-114. DOI: 10.1111/j.1365-2133.2011.10623.x

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