Abstract
Background: Adverse reaction to food has increased around the world in last years. Prevalence of food allergy raises between 2-4% in adults, and 6-8% in children. The clinical presentation is heterogeneous and varies from mild symptoms to anaphylactic reactions. Even the clinical history focused in the food is important; demonstration of allergen sensitization is mandatory.
Objective: To describe the profile of the patients with suspicion of food allergy and the regular clinical practice followed in Mexico.
Material and method: An observational, descriptive, cross-sectional study was carried out from March 2013 to March 2014 using a convenience sample of allergic patients who were treated in the office, both private and public, of those physicians who seen food allergy patients.
Results: Clinical, epidemiological, diagnostic and therapeutic data were collected from 1,971 suspicious food allergic patients presenting for the first time in the departments of the researchers involved in the study. No difference was found in relation to gender. In relation to age, a bimodal distribution, with peaks at 2 and 35 years old, was found. A history of respiratory allergy was present in 75% of cases; 80% of patients had had any previous symptoms before seeking consultation and the most frequent clinical manifestations were cutaneous, 5% reported anaphylaxis.
Conclusion: The foods involved in reactions change with age. The clinical presentation changes with the food, although the skin is the most frequently affected organ. Even if the suspicious were high, the confirmation with specific diagnostic tools is strongly recommended.
References
Bocquet H, Boagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity (drug rash with eosinophilia and systemic symptoms: DRESS). Semin Cutan Med Surg 1996;15:250-257.
Walsh SA, Creamer D. Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking. Clinical and Experimental Dermatology 2011;36:6-11.
Bopaka RG, El Khattabi W, Afif H, Aichane A, Bouayad Z. The “DRESS” syndrome in antituberculosis drugs. Rev Pneumol Clin 2014;70:185.
Eshki M, Allanore L, Musette P, et al. Twelve-year analysis of severe cases of drug reaction with eosinophilia and systemic symptoms: a cause of unpredictable multiorgan failure. Arch Dermatol 2009;145:67-72.
Shebe K, Ngwanya MR, Gantsho N, Lehloenya RJ. Severe recurrence of drug rash with eosinophilia and systemic symptoms syndrome secondary to rifampicin patch testing in a human immunodeficiency virus-infected man. Contact Dermatitis 2014;70:125-127.
World Health Organization. Guidelines for the programmatic management of drug resistant tuberculosis, 2011 update. Geneva: WHO 2011, WHO/HTM/TB/2011.6.
Programa de control de la tuberculosis. Ministerio de Salud Pública del Ecuador. Manual de normas y procedimientos para el control de la tuberculosis en Ecuador. 2a ed. 2010.
Katsube O, Anzai M, Nomura Y, Ikeda N, et al. A case of drug-induced hypersensitivity syndrome caused by levofloxacin used for treating pulmonary tuberculosis. Kekkaku 2014;89:51-56.
Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: part II. Management and therapeutics. J Am Acad Dermatol 2013;68:709,718-720.
Shiohara T, Kano Y, Takahashi R. Current concepts on the diagnosis and pathogenesis of drug-induced hypersensitivity syndrome. JMAJ 2009;52:347-352.
Criado PR, Criado RFJ, Avancini J, et al. Drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS): a review of current concepts. An Bras Dermatol 2012;87:435-449.
Cacoub P, Musette P, Descamps V, et al. The DRESS syndrome: A literature review. Am J Med 2011;124:588-597.
Bauer KA, Brimhall AK, Chang TT: Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with azithromycin in acute Epstein-Barr virus infection. Pediatr Dermatol 2011;28:741-743.
Wang XQ, Lang SY, Shi XB, et al. Cross-reactivity of skin rashes with current antiepileptic drugs in Chinese population. Seizure 2012;19:562.
Kish DD, Volokh N, Baldwin WM III, Fairchild RL. Hapten application to the skin induces an inflammatory program directing hapten-primed effector CD8 T cell interaction with hapten-presenting endothelial cells. J Immunol 2011;186:2117-2126.
Ahmed R, Cooper R, Foisy M, Der E, Kunimoto D. Factors associated with reduced antituberculous serum drug concentration in patients with HIV-TB coinfection. J Int Assoc Physicians AIDS Care 2012;11:273-276.
Wang F, Li Y, Mo Y, Shen C, et al. Cutaneous adverse drug reactions: an 8-year retrospective study on hospitalized patients in Southern China. Indian J Dermatol Venereol Leprol 2012;78:488-490.
Kaswala DH. Drug rash with eosinophilia and systemic symptoms syndrome due to anti-TB medication. J Family Med Prim Care 2013;2:83-85.
Bloss E, Chan PC, Cheng NW, et al. Increasing directly observed therapy related to improved tuberculosis treatment outcomes in Taiwan. Int J Tuberc Lung Dis 2012;16:462-467.
Moonan PK, Quitugua TN, Pogoda JM, et al. Does directly observed therapy (DOT) reduce drug resistant tuberculosis? BMC Public Health 2011;11:19.
Prasad K, Singh MB. Corticosteroids for managing tuberculosis meningitis. Cochrane Database Syst Rev 2013;23:CDC002244.
Pan-Canadian Public Health Network. Guidance for tuberculosis prevention and control programs in Canada: Ottawa: Government of Canada 2013. Disponible en: http://www.phn-rsp.ca/pubs/index-eng.php
Cacoub P, Musette P, Descamps V, Meyer O, et al. The DRESS syndrome: a literature review. Am J Med 2011;124:588.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2015 Revista Alergia México