Prueba de parche en el diagnóstico de alergia alimentaria
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Palabras clave

Alergia alimentaria
Pruba de parche
Dermatitis por contacto
Mecanismos de hipersensibilidad
Prueba de desafío
Prueba de parche de atopia

Cómo citar

Prueba de parche en el diagnóstico de alergia alimentaria. (2023). Revista Alergia México, 70(4), 250-254. https://doi.org/10.29262/ram.v70i4.1336

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Resumen

Los alergenos alimentarios son capaces de producir reacciones adversas por múltiples mecanismos de naturaleza alérgica o no, y mediante distintas vías de exposición; generalmente por ingestión o por contacto, como en la dermatitis por contacto a proteínas o urticaria por contacto, incluso por inhalación. Las reacciones de alergia alimentaria, a su vez, pueden ser mediadas por mecanismos de hipersensibilidad inmediata, hipersensibilidad retardada o mecanismos mixtos inmediato-retardados. El método diagnóstico de referencia en alergia alimentaria es la prueba de desafío con alimentos a doble ciego controlado con placebo (DBPCFC), pero las pruebas cutáneas y serológicas son importantes en el contexto clínico. El diagnóstico de alergia alimentaria inmediata depende de pruebas alergológicas bien estandarizadas, como la prueba de prick (skin prick test-SPT) o la dosificación de IgE específica, que idealmente se comprueban mediante la prueba de provocación con alimentos. Sin embargo, el diagnóstico de alergia alimentaria de mecanismo retardado y alergias mixtas, que combinan ambos mecanismos inmunes, resulta más complejo. Las reacciones de hipersensibilidad retardada se evalúan con la prueba de parche epicutáneo, o patch testing, para el diagnóstico de las dermatitis por contacto. La prueba de parche de atopia se utiliza, inicialmente, para la investigación de reacciones inflamatorias, que pueden vincularse con alergenos alimentarios en pacientes con dermatitis atópica. Posteriormente fue aplicada en otras enfermedades, cuya patogenia es principalmente mediada por un mecanismo de hipersensibilidad retardada a alérgenos proteicos: esofagitis eosinofílica, enterocolitis inducida por proteínas alimentarias, dermatitis por contacto a proteínas, urticaria por contacto, entre otras alteraciones. 

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Referencias

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