Papers by Patricia O'Farrill-Romanillos
10 Replacement therapy with subcutaneous immunoglobulin in 25 patients with humoral immunodeficiencies: adverse effects and evaluation of quality of life
Clinical immunology, May 1, 2024
COVID-19 desde la perspectiva de una organización civil dedicada a las inmunodeficiencias primarias. Entrevistando a Roberta Anido de Pena
DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2020
Revista alergia México, Nov 22, 2019
Background: Chronic spontaneous urticaria (CSU) is linked to thyroid disease in up to 54%, with p... more Background: Chronic spontaneous urticaria (CSU) is linked to thyroid disease in up to 54%, with predominance of hypothyroidism. Objective: To describe the impairments of the thyroid function in patients with CSU in a third level of care. Methods: A cross-sectional, observational, and descriptive study in which we have included men and women over 18-year-old with CSU; in which TSH and free T4 were quantified. According to the results, they were classified as euthyroid, hyperthyroid, and hypothyroid; in the latter ones, the presence of antithyroid antibodies was intentionally sought. The demographic and biochemical characteristics of the results were assessed. Results: The clinical characteristics of 127 patients with CSU were analyzed. Women accounted for 78%. The average age was 44.5 ± 15.1 years. Impairments of the thyroid function were identified in 50 patients (39%), and subclinical hypothyroidism (SH) occurred in 41 (82%) of them; patients with hyperthyroidism were not found. Of the patients with hypothyroidism, 14 (28%) presented positive antibodies; all of them were women. Conclusions: More than a third of the analyzed patients with CSU presented impairments of the thyroid function; subclinical hypothyroidism (SH) was more common. The importance of identifying this entity lies in the possibility of a multidisciplinary treatment with endocrinology. Subsequent studies may establish whether the presence of hypothyroidism influences the activity of CSU.
Revista alergia México, 2014
Anafilaxia secundaria a pruebas cutáneas Prick-to-Prick para alimentos y sus factores de riesgo R... more Anafilaxia secundaria a pruebas cutáneas Prick-to-Prick para alimentos y sus factores de riesgo RESUMEN El diagnóstico de alergia alimentaria requiere una anamnesis adecuada y la realización de pruebas diagnósticas, las pruebas cutáneas con alimentos en fresco, con alergenos estandarizados, o con ambos; las pruebas de IgE específica para alimentos son útiles. El riesgo de reacciones sistémicas por pruebas cutáneas por punción es de 15 a 23 por cada 100,000 y el de anafilaxia es de 0.02%. Comunicamos el caso de cuatro pacientes que sufrieron anafilaxia durante la realización de prueba Prick-to-Prick con alimentos frescos. Los alimentos implicados fueron frutas de las familias Rosaceae, Anacardiaceae y Caricaceae. En dos pacientes la anafilaxia fue de grado 4, en una grado 2 y en otra grado 3, todas con adecuada respuesta al tratamiento farmacológico. Los factores de riesgo fueron: sexo femenino, antecedente personal de atopia, reacción sistémica previa a veneno de himenópteros y anafilaxia previa con pruebas por punción para aeroalergenos. Las cuatro pacientes tuvieron síndrome de alergia oral y 50% tenía antecedente de prueba por punción positiva a betuláceas. Durante la realización de pruebas Prick-to-Prick para alimentos los pacientes pueden presentar anafilaxia, por lo que deben realizarse en un área que cuente con equipo rojo. El antecedente de síndrome de alergia oral se observó en todos los casos y la mitad de las pacientes tuvieron positividad a betuláceas, estos antecedentes pueden ser factores de riesgo adicional de anafilaxia durante la realización de pruebas Prick-to-Prick para alimentos.
Inmunología de la piel
Esta segunda edición de Inmunología de la piel, responde a la necesidad de poner a dispocisión de... more Esta segunda edición de Inmunología de la piel, responde a la necesidad de poner a dispocisión de colegas, estudiantes, médicos, pediatras, dermatólogos, inmunólogos clínicos y alergólogos, entre otros, un contenido actualizado, analítico y de calidad. Con los avances que en la actualidad nos ofrecen la ciencia, el conocimiento y la tec-nología, los autores renovaron el contenido de los capítulos y, ahora, también se presentan otros temas como microbioma, cáncer e inmunomoduladores, todos estos, temas que ayudan a complementar y fortalecer la estructura del libro. Invitamos a nuestros lectores, desde su perspectiva de aprendizaje e interés académico, a emprender un nuevo viaje en la estructura y función inmunológica en la maravillosa profundidad de la piel.
[Patient with Good's syndrome and COVID-19. Report of a clinical case]
Revista médica del Instituto Mexicano del Seguro Social, Jul 4, 2022
Revista Alergia México, 2020
Antecedentes: La urticaria crónica afecta a 5 % de la población general y se asocia a enfermedad ... more Antecedentes: La urticaria crónica afecta a 5 % de la población general y se asocia a enfermedad tiroidea hasta en 54 % de los pacientes. Existe escasa información de la actividad de la urticaria en los pacientes con y sin alteraciones de la función tiroidea.Objetivo: Comparar el índice de actividad de la urticaria con el UAS7 (Urticaria Activity Score 7) en pacientes con y sin hipotiroidismo.Métodos: Estudio descriptivo, transversal y comparativo de pacientes con urticaria crónica espontánea > 18 años, clasificados en dos grupos según su función tiroidea: con hipotiroidismo y eutiroideos. A todos se les aplicó el UAS7.Resultados: Se analizaron 60 pacientes con urticaria crónica espontánea, 30 eutiroideos y 30 hipotiroideos. Predominó el sexo femenino (76 %), la edad promedio fue de 49.1 años; 40 % tenía actividad moderada, 25 % grave, 23 % leve y 12 % estaba controlado. En el grupo con hipotiroidismo, la mediana de hormona estimulante de la tiroides fue de 6.8 μUI/mL. Entre los ...
Journal of the European Academy of Dermatology and Venereology, 2020
Revista alergia México, 2014
La hipersensibilidad a corticoesteroides es un fenómeno complejo en el que interactúan múltiples ... more La hipersensibilidad a corticoesteroides es un fenómeno complejo en el que interactúan múltiples factores como idiosincrasia, intolerancia o alergia. La prevalencia de las reacciones de hipersensibilidad inmediata a corticoesteroides es de 0.2 a 0.5%. Debido a la relevancia terapéutica de los esteroides, es importante confirmar el diagnóstico de hipersensibilidad con pruebas in vivo, in vitro, o ambas, el patrón de referencia es la prueba de reto con el fármaco implicado. Una vez realizado el diagnóstico y en caso de que se requiera continuar con el tratamiento con esteroides, deberá considerarse la reactividad cruzada entre los diferentes grupos propuestos en la clasificación de Coopman, en la que los corticoesteroides pertenecientes a los grupos A, B y D2 tienen una elevada reactividad cruzada entre sí; sin embargo, hacen falta más estudios para determinar el grado de reactividad cruzada entre estos fármacos. Comunicamos el caso de una paciente en la que se confirmó el diagnóstico de hipersensibilidad a succinato de hidrocortisona con la prueba de reto.
Journal of Clinical Immunology, 2021
Highlights 1. What is already known about this topic? SARS-CoV-2 causes asymptomatic or mild infe... more Highlights 1. What is already known about this topic? SARS-CoV-2 causes asymptomatic or mild infection in about 80% of humans, while an excessive immune response has killed millions. Differential susceptibility and risk factors became a concern early in the pandemic. Several monogenic defects that involve innate viral sensors or affect interferon response pathways, as well as autoantibodies against type 1 interferons, have been identified in 14% of patients with life-threatening COVID-19. The impact of the novel betacoronavirus infection in patients with known inborn errors of immunity is less clear. Case series and reports from different countries have suggested a minor impact or even a potential protective effect of the IEI for some patients. 2. What does this article add to our knowledge? We describe findings and outcomes of COVID-19 in 31 pediatric and adult patients with known IEI from Mexico, 84% of whom survived. Pediatric patients had a higher hospitalization rate. Inpatient mortality was 40%, and ICU mortality was 63%. Six patients died of secondary bacterial infection or uncontrolled systemic inflammation, but not from overwhelming viral infection. One patient with an autoinflammatory disorder under treatment with anakinra had a catastrophic clinical course. Eighty percent of patients received IVIG as part of their treatment for acute SARS-CoV-2 infection. 3. How does this study impact current management guidelines? We recommend continued and/or high-dose IVIG in patients with known IEI seeking care for COVID-19. Patients with autoinflammatory disorders, especially those with inflammasome dysregulation, should probably take extreme measures to prevent exposure, while doctors taking care of SARS-CoV-2 infected patients with immune deficiencies must do everything they can to prevent secondary bacterial infections. The high survival of patients with COVID-19 in the context of inborn errors of immunity worldwide (over 80%) might be the result of patientphysician awareness and special care.
Atypical patterns of STAT3 phosphorylation in subpopulations B cells in patients with common variable immunodeficiency
Human Immunology, 2022
BACKGROUND Common Variable Immunodeficiency (CVID) is a heterogeneous disorder characterized by d... more BACKGROUND Common Variable Immunodeficiency (CVID) is a heterogeneous disorder characterized by defective B cell differentiation and antibody production. Interleukin (IL)-21 activates STAT3, a potent regulator of B cell differentiation into plasma cells. We have studied the phosphorylation of STAT3 in CVID patients and its contribution to B cells subsets. METHODS We studied 23 CVID patients and 14 healthy donors (HD), determining pSTAT3 in naïve and memory B cells, stimulated with IL-21 at 15 and 60 min. RESULTS pSTAT3 was increased in total (p = 0.044), naïve (p = 0.023), and memory (p = 0.001) B cells at 60 min in CVID patients compared with HD. We classified patients by the percentage of isotype-switched memory B cells. We observed an increase in pSTAT3 at 60 min in memory B cells in both CVID groups of patients (p = 0.026, p = 0.007, respectively). Interestingly, the analysis of each group individually; demonstrated that patients with decreased memory B cells exhibited an increase in pSTAT3 at 60 min (p = 0.023), while HD had an expected decrease in pSTAT3 (p = 0.045). CONCLUSION CVID patients showed an increased atypical of pSTAT3, which could affect the differentiation of B cells. Further studies in the IL-21 pathway are necessary to understand how this alteration could promote differentiation defects in patient B cells.
![Research paper thumbnail of [Chronic myeloid leukemia in an adult with common variable immunodeficiency]](https://attachments.academia-assets.com/88622480/thumbnails/1.jpg)
Revista médica del Instituto Mexicano del Seguro Social
Common variable immunodeficiency is a primary immunodeficiency, in which from 70 to 80 % of patie... more Common variable immunodeficiency is a primary immunodeficiency, in which from 70 to 80 % of patients have tumors and 25 % of cases are associated with autoimmune diseases. Common variable immunodeficiency patients have a higher incidence of neoplasms, with a risk 12-18 times higher than the general population. There are few cases of common variable immunodeficiency patients with leukemia. Female of 36 years old, with left upper quadrant pain, early satiety, weight loss of 8 kg in three months and splenomegaly. The complete blood count showed: leukocytosis 206 000/mL, with 8 % blasts, platelets 530 000/mL and hemoglobin 8 mg/dL. Abdominal ultrasound: 19??12 cm splenomegaly. Karyotype BCR/ABL IS 64.20 %, 100 % Philadelphia chromosome. The diagnosis was of chronic myeloid leukemia. Given the presence of recurrent respiratory tract infection, frequent diarrheas and reduced concentrations of IgG, IgM and IgA, common variable immunodeficiency was diagnosed and human immunoglobulin was use...
[Quality of life in adults with variable common immunodeficiency and bronchiectasis]
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammag... more Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia. Its prevalence is 1:10000 to 1:50000 with the highest incidence in children, 6 to 10 years, and in adults around age 29. The association of CVID and bronchiectasis has a prevalence of 17-90%. The quality of life in these patients can be assessed through instruments such as the Saint George Respiratory Questionnaire (SGRQ), which is designed for patients with chronic lung diseases and validated for the Mexican population. [corrected] To evaluate the quality of life in adult patients with CVID and bronchiectasis using the SGRQ. We applied CRSG to all the patients of the Immunodeficiencies Clinic from Hospital Especialidades CMN SXXI diagnosed with CVID and bronchiectasis for assessing quality of life which was evaluated in the three areas of application 1)Symptoms, 2)Activities and 3)Impact and the overall quality of life. We also analyzed its relationship with the severity of...
[Vitamin D deficiency in patients with common variable immunodeficiency, with autoimmune diseases and bronchiectasis]
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
Vitamin D regulates cellular activity, also it has effects on: innate and adaptive immunity, anti... more Vitamin D regulates cellular activity, also it has effects on: innate and adaptive immunity, antimicrobial, anti-inflammatory and immunomodulatory functions. It has been suggested a possible association between vitamin D deficiency and increased risk and length of respiratory infections in patients with common variable immunodeficiency (CVID). We conducted a descriptive study in patients with CVID. Vitamin D serum levels were measured in all patients. The results were analyzed using descriptive statistics by calculating measures of dispersion and central tendency. We studied 20 patients, 13 women and 7 males, with an age average of 37 ± 13.43 years. The mean concentration of vitamin D in patients was 15.43 ng/mL ± 7.23. Thirty percent of all patients had severe Vitamin D deficiency, 45% had mild to moderate deficiency and 25% had insufficiency. Autoimmune diseases were associated in 35% of CVID patients, 42.8% of them had severe vitamin D deficiency. In patients with bronchiectasis,...
[Autoimmune hematologic diseases in adult patients with common variable immunodeficiency]
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by defective ... more Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by defective immunoglobulin production. Twenty percent of patients may also have associated autoimmune diseases, especially hematologic, whose prevalence is estimated at 5 to 8%. To report the occurrence of autoimmune haematological disorders in CVID adults. We included 18 patients with CVID, who underwent hematologic evaluation, which included: CBC, serum folate or vitamin B complex and bone marrow aspirate. Of a total of 18 patients, 11 women (61%), mean age 38 ± 13.5, six patients (33.3%) had autoimmune diseases, five of them had blood diseases (4 with PTI and one with Evans syndrome). Three patients had more than one autoimmune disease and one presented three autoimmune diseases (Evans syndrome, hypoparathyroidism and celiac disease with a history of autoimmune hemolytic anemia). The prevalence of autoimmune diseases in this group of patients with CVID was higher than the 20% reported in the lite...
Revista Alergia México, 2014
Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria sintomática má... more Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria sintomática más frecuente, afecta a 1 por cada 25,000 a 75,000 sujetos. Se distingue por la ausencia o disminución de anticuerpos. Su tratamiento consiste en el reemplazo de anticuerpos con inmunoglobulina humana y la vía de administración más frecuente es la intravenosa, a dosis de 400 a 800 mg/kg de peso/dosis cada tres a cuatro semanas. Los efectos adversos asociados con la administración de inmunoglobulina intravenosa (IgIV) ocurren incluso en 25% de todas las infusiones realizadas, las reacciones severas afectan a menos de 1% de los pacientes. Entre las reacciones adversas severas están la insuficiencia renal aguda, que sobreviene 1 a 10 días después del inicio de tratamiento con IgIV. En nuestro centro elaboramos e implementamos un esquema ambulatorio para la aplicación de IgIV que permite su administración en un promedio de 3 h, sin efectos adversos graves.Objetivos: describir los efectos adver...
Revista Alergia México, 2014
Corticosteroid hypersensitivity is a complex phenomenon in which many factors interact, such as i... more Corticosteroid hypersensitivity is a complex phenomenon in which many factors interact, such as idiosyncrasy, intolerance or allergic reactions. The prevalence of immediate hypersensitivity reactions to corticosteroids is 0.2%-0.5%. Corticosteroids have major therapeutic implications; thus, when hypersensitivity is suspected, in-vitro and/or in-vivo testing can be performed to confirm diagnosis, being the drug challenge the gold standard. After definitive diagnosis, cross-reactivity among the different corticosteroid groups should be considered, to choose wisely if corticosteroid therapy is still required. In Coopman classification, steroids belonging to groups A, B and D2 have high cross-reactivity, however, more studies are needed to determine the degree of cross-reaction among these drugs. This paper presents the case of a woman, in who hypersensitivity to hydrocortisone succinate was confirmed by drug challenge test.
Revista Alergia México, 2014
The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick ... more The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick tests with fresh foods and/or standardized allergen, or specific IgE tests. The risk of systemic reactions is of 15-23 per 100,000 skin tests performed by prick method, specifically anaphylaxis at 0.02%. This paper reports the case of four patients, who while performing prick to prick test with fresh food presented anaphylactic reaction. Implicated foods were fruits of the Rosaceae, Anacardiaceae and Caricaceae families. The severity of anaphylaxis was: two patients with grade 4, one patient grade 2 and one grade 3, all with appropriate response to drug treatment. The risk factors identified were: female sex, personal history of atopy, previous systemic reaction to Hymenoptera venom, prior anaphylaxis to prick tests to aeroallergens. We found that a history of positive skin test for Betulla v, can be a risk factor for anaphylaxis in patients with oral syndrome. During testing prick to pr...
Revista Alergia México, 2014
DRESS syndrome (Drug rash with Eosinophilia and Systemic Symptoms) is an idiosyncratic reaction (... more DRESS syndrome (Drug rash with Eosinophilia and Systemic Symptoms) is an idiosyncratic reaction (type B), characterized by peripheral eosinophilia and systemic symptoms, such as fever, rash, lymphadenopathy, hepatitis, atypical lymphocytes and elevation of liver enzymes at least twice its normal level or increase of alanine amino transferase (ALT) >100 U/L. Its incidence is of 1/1,000 to 10,000 exposures and its mortality is of 10%-20%. Treatment is based on steroids and on the suspension of the suspect drug. This paper reports the cases of six patients with DRESS syndrome attended at Centro Medico Nacional Siglo XXI, Mexico City, from September 2012 to September 2013, which accounted for 12.5% of patients attended with adverse reactions to drugs.
Revista Alergia México
El síndrome polen-alimento (SPA) se caracteriza por la sensibilización alérgica a proteínas de pó... more El síndrome polen-alimento (SPA) se caracteriza por la sensibilización alérgica a proteínas de pólenes de pastos, malezas y árboles, que producen una reacción de hipersensibilidad de tipo I, asociada a la ingesta de alimentos derivados de plantas, usualmente en forma cruda. Las familias de proteínas que más frecuentemente están asociadas son las profilinas, las PR-10 y las ns LTP; sin embargo, se ha documentado otras, como las taumatinas, isoflavonas reductasas y las B1,2 gluconasas. El síndrome prototipo es el abedul-frutas-vegetales, y de ellos el más común es el abedul-manzana, debido a que más de 70 % de los pacientes sensibilizados al abedul presentan síntomas asociados a la ingesta de alimentos derivados de plantas. Los síntomas están restringidos a la cavidad oral; sin embargo, algunos pacientes pueden presentar síntomas sistémicos, incluso anafilaxia, por lo que es importante identificar el tipo de proteína implicada, ya que de eso depende el tipo de reacción que puede prese...
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Papers by Patricia O'Farrill-Romanillos