Antecedentes: Los desórdenes gastrointestinales eosinofílicos son poco frecuentes. En Colombia no hay estudios en población pediátrica.Objetivo: Describir características epidemiológicas, clínicas y diagnósticas de una población pediátrica con desórdenes gastrointestinales eosinofílicos.Métodos: Estudio observacional, retrospectivo en niños entre 0 y 12 años evaluados en tres hospitales de alta complejidad de Medellín, Colombia, entre 2010 y 2015.Resultados: De 151 niños, 74 (49 %) padecían esofagitis eosinofílica, 35 (23.2 %) gastritis eosinofílica, 20 (13.2 %) duodenitis eosinofílica y 65 (43 %) ileítis o colitis eosinofílica; 60.9 % era del sexo masculino, la mediana de edad fue de cinco años, 66.9 % tenía antecedente de enfermedad alérgica y 78.8 %, afectación de un solo segmento del tracto gastrointestinal. Los principales síntomas fueron dolor abdominal y vómito. El conteo máximo de eosinófilos por campo de alto poder en esófago, estómago, duodeno, íleon y colon fue de 34, 21, 42, 45 y 60, respectivamente. La eosinofilia periférica fue más frecuente en pacientes con afectación de esófago y estómago. Los alimentos más sensibilizantes fueron huevo, leche, camarón, trigo y pollo. Se utilizaron inhibidores de bomba de protones, esteroides o inmunosupresores y dietas de exclusión de alimentos.Conclusiones: Los desórdenes gastrointestinales eosinofílicos pueden afectar múltiples segmentos y sus síntomas son inespecíficos, por lo que se requiere manejo multidisciplinario.

Impacto clínico en la vida real de las recomendaciones de las guías para el manejo de la dermatitis atópica en una población tropical (cohorte TECCEMA) AbstractBackground: Real-life impact of guidelines for the management of atopic dermatitis has been poorly studied. Objective: To assess atopic dermatitis clinical control in residents of a tropical area managed according to international consensuses. Methods: Prospective study with a 24-month follow-up. Clinical response was assessed with SCORAD, DLQI and a subjective scale (SS) on severity perception by the patient. Results: Two-hundred and thirty-three patients were stratified according to SCORAD: 53 had mild severity (22%), 116 moderate (49%) and 64 severe (27%). Baseline SCORAD mean was 33 (15-41), for DLQI, it was 14 (11-20), and for the subjective scale, 85% (67-99). At 6 months, there was significant reduction (p < 0.5): SCORAD 29 (14-41), DLQI 12 (8-16) and subjective scale 62% (45-80). At 2 years, SCORAD was 21 (9-34), DLQI 7 (4-10) and subjective scale 41% (27-56); only 33% achieved complete control (SCORAD < 15%, DLQI < 5, subjective scale < 20%). Conclusions: Following international guidelines' recommendations reduces eczema severity and improves quality of life, although only 33% achieved complete control after 2 years.Keywords: Atopic; Dermatitis; Eczema; Guidelines; Quality of life; Pharmacotherapy ResumenAntecedentes: Se ha estudiado poco el impacto en la vida real de las guías de manejo de la dermatitis atópica. Objetivo: Evaluar el control clínico de la dermatitis atópica en residentes de un área tropical manejados conforme a los consensos internacionales. Métodos: Estudio prospectivo con seguimiento por 24 meses. La respuesta clínica fue evaluada mediante SCORAD, DLQI y una escala subjetiva (SS) de la percepción de severidad del paciente. Resultados: 233 pacientes fueron estratificados conforme el SCORAD: gravedad leve 53 (22 %), moderada 116 (49 %) y severa 64 (27 %). La media inicial del SCORAD fue de 33 (15-41), del DLQI de 14 (11-20) y de la escala subjetiva de 85 % (67-99). A los 6 meses existió reducción significativa (p < 0.5): SCORAD 29 (14-41), DLQI 12 (8-16) y escala subjetiva 62 % (45-80). A los 2 años, SCORAD (21, 9-34), DLQI (7, 4-10) y escala subjetiva (41 %, 27-56); solo 33 % consiguió control completo (SCORAD < 15 %, DLQI < 5, escala subjetiva < 20 %).Conclusiones: El apego a las guías internacionales reduce la gravedad del eccema y mejora de forma importante la calidad de vida de los pacientes con dermatitis. Sin embargo, solo 33 % de los pacientes alcanza un control completo a los 2 años de seguir las recomendaciones.

Este artículo debe citarse como: Raigosa M, Toro Y, Sánchez J. Urticaria solar. Reporte de un caso y revisión de la literatura. Rev Alerg Mex. 2017;64(3):371-375 AbstractBackground: Solar urticaria is a rare type of inducible urticaria characterized by wheal and erythema formation shortly after exposure to sunlight or to an artificial light source; its pathophysiology is not yet entirely understood. The treatment of choice, in addition to exposure avoidance, consists in antihistamine administration. Clinical case: This is the case of a 27-year-old woman with no personal history of allergic diseases and with a 2-year history of erythema and wheals in photo-exposed areas associated with sunlight exposure for periods longer than 10 minutes. A provocation test was carried out; she was started on fexofenadine at 4-fold the standard dose (720 mg/day). Six weeks later, a new challenge was carried out without the antihistamine being discontinued; the reaction was less severe, but she continued with erythema for the first 60 minutes post-exposure. After 3 months on high-dose antihistamines, she referred marked improvement in her quality of life and tolerance to brief sunlight exposure (for less than 15 minutes). Conclusions: Solar urticaria is a rare process but with a high impact on the patient. The use of antihistamines partially relieves symptoms and allows better tolerance to lighting expositions.

Background/Objectives: To quantify the rate of progressive failure of very-low-birth-weight (VLBW) infants over time in the neonatal intensive care unit to meet growth milestones. Subjects/Methods: In a prospective longitudinal study, 114 VLBW preterm infants (p1500 g) of both sexes, with normal and/or low weight for gestational age were included. At the start, weight, length, mid-upper arm (MUAC), thigh and cephalic circumferences were measured. Weight/age (W/A), length/age and weight/length ( ± 2 z-score) indices were calculated. All measurements were taken at inclusion, at 7, 15 and 30 days of hospitalization. Chi-square test, analysis of variance and repeated-measures tests were estimated. Results: Thirteen cases (14%) died and were excluded soon after the first determinations. In all, 9 (8.9%) died during the study, 12 (11.9%) were discharged before 30 days of life and 80 (79.2%) completed the study. At 7 days, the percentage of preterm infants with an index of W/A oÀ2 z-scores increased from 44 to 67% (44-68 subjects; Po0.01), with no changes afterwards; the indicator MUAC oÀ2 z-scores increased at 7 days from 23 to 49% (23-49 subjects); at 15 from 23 to 65% (23-61 subjects) and at 30 days from 23 to 79% (23-63 subjects; Po0.001). Conclusions: Clinicians could use these indicators for earlier detection of growth failure in VLBW infants in order to target more aggressive nutrition early.