Search

Several international guidelines on immunotherapy exist, but they only apply partially in Mexico. The Mexican guideline of immunotherapy dates from 1998.To establish clinical recommendations and suggestions for Allergy residents and specialists for skin testing and allergen immunotherapy based on evidence and Mexican expert opinion, according to the GRADE system.The guidelines were developed following the methodology of a guideline for clinical practice starting with the formulation of clinical questions, in the context of Mexican environmental conditions and morbidity, with the participation of allergists from all regions of the country. External validation was obtained. Its development followed three steps: 1. formulation of 24 clinical questions. 2. Search for consensus on the answers among members of the Regional chapters of both Mexican Colleges of Allergists (CMICA and COMPEDIA) during regional meetings. 3. Literature search for articles related to the questions and grading of its quality according to GRADE.Based on the regional consensus, 116 articles and the safety, patient acceptance/ comfort and cost clinical recommendations and suggestions were developed on basic aspects of skin testing, subcutaneous and sublingual immunotherapy (patient preparation, vial preparation and application schedules) and the treatment of eventual adverse reactions.A clinical guideline was developed respecting particular methodology, validated by CMICA and COMPEDIA for its implementation among Mexican allergists. Several aspects deserve further study to improve scientific evidence.Allergen immunotherapy, subcutaneous immunotherapy, sublingual immunotherapy, skin testing, allergy diagnosis, rhinitis, asthma, atopic dermatitis, house dust mite, pollens, anaphylaxis, adrenaline, Mexico.

Chronic granulomatous disease is a little common primary immunodeficiency affecting innate immune system. This article presents the case of an 8-year-old female patient whose disease started at three months of age with respiratory ways' infections. When she was two years old, she suffered another presentation of right basal pneumonia and right cervical mass, whose biopsy reported childhood chronic granulomatous disease. At eight years old, patient suffered bacteraemia due to Salmonella group D, thus patient started prophylaxis with trimethoprim-sulfamethoxazole and, to date, she has continued stable.

Consequences of obstructive sleep apnea syndrome in children include reduced performance during day, behaviour problems, diurmal hypersomnia, psychomotor development delay, severe forms of cor pulmonale, systemic hypertension, growing delay and death. This paper describes the clinical case of a 3-year-old girl with perennial symptoms of nasal obstruction characterized by nocturnal snoring, oral breathing, nasal voice, sleep apnea, nasal pruritus and rhinorrhea. Her treatment is also described.