Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica

Introducción: La sensibilización a Blomia tropicalis (B. tropicalis) ha aumentado en diferentes ciudades del trópico. A diferencia de Dermatophagoides spp., pocos estudios han evaluado la relevancia clínica de la sensibilización a B. tropicalis y hay escasa información acerca del impacto de la inmun...

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Autores:: Osorio Bernal, Laura Carolina
Caraballo Cordovez, Ana Lorena
Chinchilla Mejía, Carlos Fernando
Álvarez Ricardo, Leidy Lucía
Caraballo García, Luis Rafael

Tipo de recurso:: Tesis

Fecha de publicación:: 2025

Institución:: Universidad de Antioquia

Repositorio:: Repositorio UdeA

Idioma:: spa

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dc.title.spa.fl_str_mv	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
title	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
spellingShingle	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica Pyroglyphidae Rinitis alérgica Rhinitis, allergic Pruebas de provocación nasal Nasal provocation tests Inmunoterapia Immunotherapy Hipersensibilidad inmediata Hypersensitivity, immediate Diagnóstico Diagnosis Blomia tropicalis https://id.nlm.nih.gov/mesh/D039981 https://id.nlm.nih.gov/mesh/D065631 https://id.nlm.nih.gov/mesh/D009299 https://id.nlm.nih.gov/mesh/D007167 https://id.nlm.nih.gov/mesh/D006969 https://id.nlm.nih.gov/mesh/D003933 ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
title_short	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
title_full	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
title_fullStr	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
title_full_unstemmed	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
title_sort	Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica
dc.creator.fl_str_mv	Osorio Bernal, Laura Carolina Caraballo Cordovez, Ana Lorena Chinchilla Mejía, Carlos Fernando Álvarez Ricardo, Leidy Lucía Caraballo García, Luis Rafael
dc.contributor.advisor.none.fl_str_mv	Sánchez Caraballo, Jorge Mario Díez Zuluaga, Libia Susana
dc.contributor.author.none.fl_str_mv	Osorio Bernal, Laura Carolina Caraballo Cordovez, Ana Lorena Chinchilla Mejía, Carlos Fernando Álvarez Ricardo, Leidy Lucía Caraballo García, Luis Rafael
dc.contributor.researchgroup.none.fl_str_mv	Grupo de Alergología Clínica y Experimental (GACE)
dc.contributor.jury.none.fl_str_mv	Amaya Ruiz, Emerson Daniel Bedoya Gutiérrez, Juan David
dc.subject.decs.none.fl_str_mv	Pyroglyphidae Rinitis alérgica Rhinitis, allergic Pruebas de provocación nasal Nasal provocation tests Inmunoterapia Immunotherapy Hipersensibilidad inmediata Hypersensitivity, immediate Diagnóstico Diagnosis
topic	Pyroglyphidae Rinitis alérgica Rhinitis, allergic Pruebas de provocación nasal Nasal provocation tests Inmunoterapia Immunotherapy Hipersensibilidad inmediata Hypersensitivity, immediate Diagnóstico Diagnosis Blomia tropicalis https://id.nlm.nih.gov/mesh/D039981 https://id.nlm.nih.gov/mesh/D065631 https://id.nlm.nih.gov/mesh/D009299 https://id.nlm.nih.gov/mesh/D007167 https://id.nlm.nih.gov/mesh/D006969 https://id.nlm.nih.gov/mesh/D003933 ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
dc.subject.proposal.spa.fl_str_mv	Blomia tropicalis
dc.subject.meshuri.none.fl_str_mv	https://id.nlm.nih.gov/mesh/D039981 https://id.nlm.nih.gov/mesh/D065631 https://id.nlm.nih.gov/mesh/D009299 https://id.nlm.nih.gov/mesh/D007167 https://id.nlm.nih.gov/mesh/D006969 https://id.nlm.nih.gov/mesh/D003933
dc.subject.ods.none.fl_str_mv	ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
description	Introducción: La sensibilización a Blomia tropicalis (B. tropicalis) ha aumentado en diferentes ciudades del trópico. A diferencia de Dermatophagoides spp., pocos estudios han evaluado la relevancia clínica de la sensibilización a B. tropicalis y hay escasa información acerca del impacto de la inmunoterapia alérgeno-específica (ITA) con este extracto. Objetivo: Evaluar la relevancia clínica mediante prueba de provocación nasal (“nasal challenge test” (NCT)) de la sensibilización a B. tropicalis y conocer el desempeño diagnóstico de las pruebas intraepidérmicas con esta fuente. Además, explorar la efectividad de la ITA con este ácaro. Métodos: Se realizó un estudio de cohorte prospectivo, ejecutado en dos fases, incluyendo pacientes con rinitis persistente moderada/grave. En la primera fase se evaluó el rendimiento de las pruebas intraepidérmicas con B. tropicalis usando como parámetro de referencia la NCT. En la segunda fase, los pacientes NCT positiva para B. tropicalis recibieron por un año ITA y se les realizó una nueva NCT. Resultados: un total de 80 pacientes sensibilizados a B. tropicalis; el 56 % tuvo una NCT positiva. Para el prick test la sensibilidad fue 94 %, especificidad 40 % y la precisión global 64 %. De los pacientes con NCT positiva, 39 aceptaron iniciar ITA y fueron llevados a una segunda NCT con el 82 % de los pacientes logrando tolerar una concentración 10 veces mayor que lo tolerado en la NCT inicial y entre ellos el 77 % no presentaron síntomas con la concentración máxima. Conclusión: Las pruebas intraepidérmicas con B. tropicalis, presentan un moderado rendimiento diagnóstico. La ITA con B. tropicalis es altamente efectiva cuando la selección está basada en los resultados de la prueba de provocación.
publishDate	2025
dc.date.accessioned.none.fl_str_mv	2025-09-30T16:06:27Z
dc.date.issued.none.fl_str_mv	2025
dc.date.available.none.fl_str_mv	2027-09-30
dc.type.none.fl_str_mv	Trabajo de grado - Especialización
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dc.type.content.none.fl_str_mv	Text
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dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/10495/47465
url	https://hdl.handle.net/10495/47465
dc.language.iso.none.fl_str_mv	spa
language	spa
dc.relation.references.none.fl_str_mv	Zhang Y, Lan F, Zhang L. Advances and highlights in allergic rhinitis. Allergy. 2021 Nov;76(11):3383–9. Schuler Iv CF, Montejo JM. Allergic Rhinitis in Children and Adolescents. Immunol Allergy Clin North Am. 2021 Nov;41(4):613–25. Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. Journal of Allergy and Clinical Immunology. 2020 Jan;145(1):70-80.e3. Safia A, Elhadi UA, Karam M, Merchavy S, Khater A. A meta-analysis of the prevalence and risk of mental health problems in allergic rhinitis patients. J Psychosom Res. 2024 Sep;184:111813. Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta‐analysis. Allergy. 2017 Nov;72(11):1597–631. Pajno GB, Barberio G, De Luca Fr, Morabito L, Parmiani S. Prevention of new sensitizations in asthmatic children monosensitized to house dust mite by specific immunotherapy. A six-year follow-up study.: Prevention of new sensitizations. Clinical & Experimental Allergy. 2001 Sep;31(9):1392–7. Ünal D. Effects of Perennial Allergen Immunotherapy in Allergic Rhinitis in Patients with/without Asthma: A-Randomized Controlled Real-Life Study. Int Arch Allergy Immunol. 2020;181(2):141–8. Cao H, Liu Z. Clinical significance of dust mite allergens. Mol Biol Rep. 2020 Aug;47(8):6239–46. Matsumoto FY, Gonçalves TRT, Solé D, Wandalsen GF. Specific nasal provocation test with Dermatophagoides pteronyssinus, monitored by acoustic rhinometry, in children with rhinitis. Am J Rhinol Allergy. 2017 Jan 1;31(1):7–11. Tang R, Lyu X, Liu Y, Wang R, Wang L, Li H, et al. Diagnostic accuracy and safety of Dermatophagoides pteronyssinus extracts used for skin prick test. Chin Med J (Engl). 2022 Nov 5;135(21):2563–9. King MJ, Tamulis T, Lockey RF. Prick puncture skin tests and serum specific IgE as predictors of nasal challenge response to dermatophagoides pteronyssinus in older adults. Ann Allergy Asthma Immunol. 2008 Jul;101(1):12–7. Demoly P, Emminger W, Rehm D, Backer V, Tommerup L, Kleine-Tebbe J. Effective treatment of house dust mite–induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. Journal of Allergy and Clinical Immunology. 2016 Feb;137(2):444-451.e8. Valero A, Ibáñez-Echevarría E, Vidal C, Raducan I, Castelló Carrascosa JV, Sánchez-López J. Efficacy of subcutaneous house dust mite immunotherapy in patients with moderate to severe allergic rhinitis. Immunotherapy. 2022 Jun;14(9):683–94. Eifan AO, Akkoc T, Yildiz A, Keles S, Ozdemir C, Bahceciler NN, et al. Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial. Clin Exp Allergy. 2010 Jun;40(6):922–32. Rodriguez-Plata E, Callero Viera A, Ruiz-Garcia M, Gomez-Cardenosa A, Nieto E, García-Robaina JC. House dust mite subcutaneous immunotherapy has sustained long-term effectiveness on allergic rhinitis and asthma: A 10-year follow-up. Immun Inflamm Dis. 2023 Oct;11(10):e1004. Jutel M, Klimek L, Richter H, Brüggenjürgen B, Vogelberg C. House dust mite SCIT reduces asthma risk and significantly improves long-term rhinitis and asthma control-A RWE study. Allergy. 2024 Apr;79(4):1042–51. Puccio FA, Lynch NR, Noga O, Noda A, Hagel I, Lopez E, et al. Importance of including Blomia tropicalis in the routine diagnosis of Venezuelan patients with persistent allergic symptoms. Allergy. 2004 Jul;59(7):753–7. Caraballo L, Lockey R, Puerta L, Zakzuk J, Acevedo N, Fernández-Caldas E. Blomia tropicalis: A 50-Year History. The Journal of Allergy and Clinical Immunology: In Practice [Internet]. 2024 Nov 20 [cited 2025 Feb 18];0(0). Available from: https://www.jaci-inpractice.org/article/S2213-2198(24)01172-3/abstract Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, et al. Particularities of allergy in the Tropics. World Allergy Organization Journal. 2016 Jun 27;9(1):20. Sánchez J, Diez LS, Álvarez L, Munera M, Sánchez A. Changes in Prevalence of IgE Sensitization and Allergenic Exposition over a 10-Year Period in a Tropical Region. International Archives of Allergy and Immunology. 2024 Sep 3;186(1):12–22. Klangkalya N, Kanchongkittiphon W, Sawatchai A, Kiewngam P, Jotikasthira W, Manuyakorn W. Skin prick test and serum specific IgE in predicting dust mite-induced allergic rhinitis diagnosed from nasal provocation test in chronic rhinitis children. Asian Pac J Allergy Immunol. 2024 Dec;42(4):354–60. Sánchez A, Cardona R, Munera M, Calvo V, Tejada-Giraldo M, Sánchez J. Nasal Provocation Test with Cat and Dog Extracts: Results according to Molecular Components. Pulm Med. 2020;2020:6365314. Barreto BA, Daher S, Naspitz CK, Solé D. Specific and non-specific nasal provocation tests in children with perennial allergic rhinitis. Allergol Immunopathol (Madr). 2001;29(6):255–63. Mourao EMM, Rosario NA. Conjunctival Provocation Test With Blomia tropicalis. Front Allergy [Internet]. 2021 May 7 [cited 2025 Feb 18];2. Available from: https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2021.673462/full Rodríguez O, Labrada A. Ensayo clínico diagnóstico en niños con extracto alergénico de Blomia tropicalis. Allergol Immunopathol (Madr). 2000 May 1;28(4):225–8. García Robaina JC, Sánchez Machín I, Fernández-Caldas E, Iraola Calvo V, Vázquez Moncholi C, Bonnet Moreno C, et al. Skin Tests and Conjunctival and Bronchial Challenges with Extracts of Blomia tropicalis and Dermatophagoides pteronyssinus in Patients with Allergic Asthma and/or Rhinoconjunctivitis. International Archives of Allergy and Immunology. 2003 Jul 25;131(3):182–8. Matsumoto FY, Gonçalves TRT, Solé D, Wandalsen GF. Nasal allergen challenge with Blomia tropicalis in children and adolescents. Allergologia et Immunopathologia. 2024 Nov 1;52(6):72–5. Stanaland BE, Fernández-Caldas E, Jacinto CM, Trudeau WL, Lockey RF. Positive nasal challenge responses to Blomia tropicalis. Journal of Allergy and Clinical Immunology. 1996 May 1;97(5):1045–9. Kuo IC, Yi FC, Cheong N, Shek LP, Chew FT, Lee BW, et al. Sensitization to Blomia tropicalis and dermatophagoides pteronyssinus-a comparative study between Singapore and Taiwan. Asian Pac J Allergy Immunol. 1999 Sep;17(3):179–88. Liu X, Zheng P, Zheng SG, Zhai Y, Zhao X, Chen Y, et al. Co-sensitization and cross-reactivity of Blomia tropicalis with two Dermatophagoides species in Guangzhou, China. J Clin Lab Anal. 2019 Nov;33(9):e22981. Macedo PRC, Moraes P, Arruda LK, Castro FFM, Kalil J, Galvão CES. Efficacy and safety of sublingual immunotherapy using a combination of Dermatophagoides pteronyssinus and Blomia tropicalis extracts in patients with allergic rhinitis: A randomized, double-blind, placebo-controlled trial. World Allergy Organ J. 2025 Feb;18(2):101020. Cardona-Villa R, Uribe-Garcia S, Calvo-Betancur VD, Cantillo JF, Fernández-Caldas E. Efficacy and safety of subcutaneous immunotherapy with a mixture of glutaraldehyde-modified extracts of Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis. World Allergy Organization Journal. 2022 Sep;15(9):100692. Soh JY, Thalayasingam M, Ong S, Loo EXL, Shek LP, Chao SS. Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period. The Journal of Laryngology & Otology. 2016 Mar;130(3):272–7. Castro-Almarales RL, Ronquillo-Díaz M, Álvarez-Castelló M, Rodríguez-Canosa J, González-León M, Enríquez-Domínguez I, et al. Subcutaneous allergen immunotherapy for asthma: A randomized, double-blind, placebo-controlled study with a standardized Blomia tropicalis vaccine. World Allergy Organization Journal. 2020 Apr;13(4):100098. Lebel B, Bousquet J, Morel A, Chanal I, Godard P, Michel F. Correlation between symptoms and the threshold for release of mediators in nasal secretions during nasal challenge with grass-pollen grains. Journal of Allergy and Clinical Immunology. 1988 Nov;82(5):869–77. Augé J, Vent J, Agache I, Airaksinen L, Campo Mozo P, Chaker A, et al. EAACI Position paper on the standardization of nasal allergen challenges. Allergy. 2018 Aug;73(8):1597–608. Sánchez Caraballo JM, Diez Zuluaga LS, Cardona Villa R. Sensibilización a aeroalergenos en pacientes alérgicos de Medellín, Colombia. Revista Alergia México. 2012;59(3):139–47. Eguiluz-Gracia I, Testera-Montes A, Salas M, Perez-Sanchez N, Ariza A, Bogas G, et al. Comparison of diagnostic accuracy of acoustic rhinometry and symptoms score for nasal allergen challenge monitoring. Allergy. 2021 Jan;76(1):371–5
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dc.publisher.none.fl_str_mv	Universidad de Antioquia
dc.publisher.program.none.fl_str_mv	Especialización en Alergología Clínica
dc.publisher.department.none.fl_str_mv	Departamento de Pediatría y Puericultura
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dc.publisher.faculty.none.fl_str_mv	Facultad de Medicina
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publisher.none.fl_str_mv	Universidad de Antioquia
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spelling	Sánchez Caraballo, Jorge MarioDíez Zuluaga, Libia SusanaOsorio Bernal, Laura CarolinaCaraballo Cordovez, Ana LorenaChinchilla Mejía, Carlos FernandoÁlvarez Ricardo, Leidy LucíaCaraballo García, Luis RafaelGrupo de Alergología Clínica y Experimental (GACE)Amaya Ruiz, Emerson DanielBedoya Gutiérrez, Juan David2025-09-30T16:06:27Z2027-09-302025https://hdl.handle.net/10495/47465Introducción: La sensibilización a Blomia tropicalis (B. tropicalis) ha aumentado en diferentes ciudades del trópico. A diferencia de Dermatophagoides spp., pocos estudios han evaluado la relevancia clínica de la sensibilización a B. tropicalis y hay escasa información acerca del impacto de la inmunoterapia alérgeno-específica (ITA) con este extracto. Objetivo: Evaluar la relevancia clínica mediante prueba de provocación nasal (“nasal challenge test” (NCT)) de la sensibilización a B. tropicalis y conocer el desempeño diagnóstico de las pruebas intraepidérmicas con esta fuente. Además, explorar la efectividad de la ITA con este ácaro. Métodos: Se realizó un estudio de cohorte prospectivo, ejecutado en dos fases, incluyendo pacientes con rinitis persistente moderada/grave. En la primera fase se evaluó el rendimiento de las pruebas intraepidérmicas con B. tropicalis usando como parámetro de referencia la NCT. En la segunda fase, los pacientes NCT positiva para B. tropicalis recibieron por un año ITA y se les realizó una nueva NCT. Resultados: un total de 80 pacientes sensibilizados a B. tropicalis; el 56 % tuvo una NCT positiva. Para el prick test la sensibilidad fue 94 %, especificidad 40 % y la precisión global 64 %. De los pacientes con NCT positiva, 39 aceptaron iniciar ITA y fueron llevados a una segunda NCT con el 82 % de los pacientes logrando tolerar una concentración 10 veces mayor que lo tolerado en la NCT inicial y entre ellos el 77 % no presentaron síntomas con la concentración máxima. Conclusión: Las pruebas intraepidérmicas con B. tropicalis, presentan un moderado rendimiento diagnóstico. La ITA con B. tropicalis es altamente efectiva cuando la selección está basada en los resultados de la prueba de provocación.COL0059567EspecializaciónEspecialista en Alergología Clínica16 páginasapplication/pdfspaUniversidad de AntioquiaEspecialización en Alergología ClínicaDepartamento de Pediatría y PuericulturaMedellín, ColombiaFacultad de MedicinaCampus en el Área de la saludhttp://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/embargoedAccessAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://purl.org/coar/access_right/c_f1cfEvaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgicaTrabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_46ecTexthttp://purl.org/coar/version/c_b1a7d7d4d402bcceinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/draftZhang Y, Lan F, Zhang L. Advances and highlights in allergic rhinitis. Allergy. 2021 Nov;76(11):3383–9.Schuler Iv CF, Montejo JM. Allergic Rhinitis in Children and Adolescents. Immunol Allergy Clin North Am. 2021 Nov;41(4):613–25.Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. Journal of Allergy and Clinical Immunology. 2020 Jan;145(1):70-80.e3.Safia A, Elhadi UA, Karam M, Merchavy S, Khater A. A meta-analysis of the prevalence and risk of mental health problems in allergic rhinitis patients. J Psychosom Res. 2024 Sep;184:111813.Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta‐analysis. Allergy. 2017 Nov;72(11):1597–631.Pajno GB, Barberio G, De Luca Fr, Morabito L, Parmiani S. Prevention of new sensitizations in asthmatic children monosensitized to house dust mite by specific immunotherapy. A six-year follow-up study.: Prevention of new sensitizations. Clinical & Experimental Allergy. 2001 Sep;31(9):1392–7.Ünal D. Effects of Perennial Allergen Immunotherapy in Allergic Rhinitis in Patients with/without Asthma: A-Randomized Controlled Real-Life Study. Int Arch Allergy Immunol. 2020;181(2):141–8.Cao H, Liu Z. Clinical significance of dust mite allergens. Mol Biol Rep. 2020 Aug;47(8):6239–46.Matsumoto FY, Gonçalves TRT, Solé D, Wandalsen GF. Specific nasal provocation test with Dermatophagoides pteronyssinus, monitored by acoustic rhinometry, in children with rhinitis. Am J Rhinol Allergy. 2017 Jan 1;31(1):7–11.Tang R, Lyu X, Liu Y, Wang R, Wang L, Li H, et al. Diagnostic accuracy and safety of Dermatophagoides pteronyssinus extracts used for skin prick test. Chin Med J (Engl). 2022 Nov 5;135(21):2563–9.King MJ, Tamulis T, Lockey RF. Prick puncture skin tests and serum specific IgE as predictors of nasal challenge response to dermatophagoides pteronyssinus in older adults. Ann Allergy Asthma Immunol. 2008 Jul;101(1):12–7.Demoly P, Emminger W, Rehm D, Backer V, Tommerup L, Kleine-Tebbe J. Effective treatment of house dust mite–induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. Journal of Allergy and Clinical Immunology. 2016 Feb;137(2):444-451.e8.Valero A, Ibáñez-Echevarría E, Vidal C, Raducan I, Castelló Carrascosa JV, Sánchez-López J. Efficacy of subcutaneous house dust mite immunotherapy in patients with moderate to severe allergic rhinitis. Immunotherapy. 2022 Jun;14(9):683–94.Eifan AO, Akkoc T, Yildiz A, Keles S, Ozdemir C, Bahceciler NN, et al. Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial. Clin Exp Allergy. 2010 Jun;40(6):922–32.Rodriguez-Plata E, Callero Viera A, Ruiz-Garcia M, Gomez-Cardenosa A, Nieto E, García-Robaina JC. House dust mite subcutaneous immunotherapy has sustained long-term effectiveness on allergic rhinitis and asthma: A 10-year follow-up. Immun Inflamm Dis. 2023 Oct;11(10):e1004.Jutel M, Klimek L, Richter H, Brüggenjürgen B, Vogelberg C. House dust mite SCIT reduces asthma risk and significantly improves long-term rhinitis and asthma control-A RWE study. Allergy. 2024 Apr;79(4):1042–51.Puccio FA, Lynch NR, Noga O, Noda A, Hagel I, Lopez E, et al. Importance of including Blomia tropicalis in the routine diagnosis of Venezuelan patients with persistent allergic symptoms. 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Allergy. 2018 Aug;73(8):1597–608.Sánchez Caraballo JM, Diez Zuluaga LS, Cardona Villa R. Sensibilización a aeroalergenos en pacientes alérgicos de Medellín, Colombia. Revista Alergia México. 2012;59(3):139–47.Eguiluz-Gracia I, Testera-Montes A, Salas M, Perez-Sanchez N, Ariza A, Bogas G, et al. Comparison of diagnostic accuracy of acoustic rhinometry and symptoms score for nasal allergen challenge monitoring. Allergy. 2021 Jan;76(1):371–5PyroglyphidaeRinitis alérgicaRhinitis, allergicPruebas de provocación nasalNasal provocation testsInmunoterapiaImmunotherapyHipersensibilidad inmediataHypersensitivity, immediateDiagnósticoDiagnosisBlomia tropicalishttps://id.nlm.nih.gov/mesh/D039981https://id.nlm.nih.gov/mesh/D065631https://id.nlm.nih.gov/mesh/D009299https://id.nlm.nih.gov/mesh/D007167https://id.nlm.nih.gov/mesh/D006969https://id.nlm.nih.gov/mesh/D003933ODS 3: Salud y bienestar. 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Vwcm9kdWNpciBsYSBPYnJhIGluY29ycG9yYWRhIGVuIGxhcyBPYnJhcyBDb2xlY3RpdmFzLgpiLiBEaXN0cmlidWlyIGNvcGlhcyBvIGZvbm9ncmFtYXMgZGUgbGFzIE9icmFzLCBleGhpYmlybGFzIHDDumJsaWNhbWVudGUsIGVqZWN1dGFybGFzIHDDumJsaWNhbWVudGUgeS9vIHBvbmVybGFzIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhLCBpbmNsdXnDqW5kb2xhcyBjb21vIGluY29ycG9yYWRhcyBlbiBPYnJhcyBDb2xlY3RpdmFzLCBzZWfDum4gY29ycmVzcG9uZGEuCmMuIERpc3RyaWJ1aXIgY29waWFzIGRlIGxhcyBPYnJhcyBEZXJpdmFkYXMgcXVlIHNlIGdlbmVyZW4sIGV4aGliaXJsYXMgcMO6YmxpY2FtZW50ZSwgZWplY3V0YXJsYXMgcMO6YmxpY2FtZW50ZSB5L28gcG9uZXJsYXMgYSBkaXNwb3NpY2nDs24gcMO6YmxpY2EuCgpMb3MgZGVyZWNob3MgbWVuY2lvbmFkb3MgYW50ZXJpb3JtZW50ZSBwdWVkZW4gc2VyIGVqZXJjaWRvcyBlbiB0b2RvcyBsb3MgbWVkaW9zIHkgZm9ybWF0b3MsIGFjdHVhbG1lbnRlIGNvbm9jaWRvcyBvIHF1ZSBzZSBpbnZlbnRlbiBlbiBlbCBmdXR1cm8uIExvcyBkZXJlY2hvcyBhbnRlcyBtZW5jaW9uYWRvcyBpbmNsdXllbiBlbCBkZXJlY2hvIGEgcmVhbGl6YXIgZGljaGFzIG1vZGlmaWNhY2lvbmVzIGVuIGxhIG1lZGlkYSBxdWUgc2VhbiB0w6ljbmljYW1lbnRlIG5lY2VzYXJpYXMgcGFyYSBlamVyY2VyIGxvcyBkZXJlY2hvcyBlbiBvdHJvIG1lZGlvIG8gZm9ybWF0b3MsIHBlcm8gZGUgb3RyYSBtYW5lcmEgdXN0ZWQgbm8gZXN0w6EgYXV0b3JpemFkbyBwYXJhIHJlYWxpemFyIG9icmFzIGRlcml2YWRhcy4gVG9kb3MgbG9zIGRlcmVjaG9zIG5vIG90b3JnYWRvcyBleHByZXNhbWVudGUgcG9yIGVsIExpY2VuY2lhbnRlIHF1ZWRhbiBwb3IgZXN0ZSBtZWRpbyByZXNlcnZhZG9zLCBpbmNsdXllbmRvIHBlcm8gc2luIGxpbWl0YXJzZSBhIGFxdWVsbG9zIHF1ZSBzZSBtZW5jaW9uYW4gZW4gbGFzIHNlY2Npb25lcyA0KGQpIHkgNChlKS4KICAgIAo0LiBSZXN0cmljY2lvbmVzLgpMYSBsaWNlbmNpYSBvdG9yZ2FkYSBlbiBsYSBhbnRlcmlvciBTZWNjacOzbiAzIGVzdMOhIGV4cHJlc2FtZW50ZSBzdWpldGEgeSBsaW1pdGFkYSBwb3IgbGFzIHNpZ3VpZW50ZXMgcmVzdHJpY2Npb25lczoKYS4gVXN0ZWQgcHVlZGUgZGlzdHJpYnVpciwgZXhoaWJpciBww7pibGljYW1lbnRlLCBlamVjdXRhciBww7pibGljYW1lbnRlLCBvIHBvbmVyIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhIGxhIE9icmEgc8OzbG8gYmFqbyBsYXMgY29uZGljaW9uZXMgZGUgZXN0YSBMaWNlbmNpYSwgeSBVc3RlZCBkZWJlIGluY2x1aXIgdW5hIGNvcGlhIGRlIGVzdGEgbGljZW5jaWEgbyBkZWwgSWRlbnRpZmljYWRvciBVbml2ZXJzYWwgZGUgUmVjdXJzb3MgZGUgbGEgbWlzbWEgY29uIGNhZGEgY29waWEgZGUgbGEgT2JyYSBxdWUgZGlzdHJpYnV5YSwgZXhoaWJhIHDDumJsaWNhbWVudGUsIGVqZWN1dGUgcMO6YmxpY2FtZW50ZSBvIHBvbmdhIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhLiBObyBlcyBwb3NpYmxlIG9mcmVjZXIgbyBpbXBvbmVyIG5pbmd1bmEgY29uZGljacOzbiBzb2JyZSBsYSBPYnJhIHF1ZSBhbHRlcmUgbyBsaW1pdGUgbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEgbyBlbCBlamVyY2ljaW8gZGUgbG9zIGRlcmVjaG9zIGRlIGxvcyBkZXN0aW5hdGFyaW9zIG90b3JnYWRvcyBlbiBlc3RlIGRvY3VtZW50by4gTm8gZXMgcG9zaWJsZSBzdWJsaWNlbmNpYXIgbGEgT2JyYS4gVXN0ZWQgZGViZSBtYW50ZW5lciBpbnRhY3RvcyB0b2RvcyBsb3MgYXZpc29zIHF1ZSBoYWdhbiByZWZlcmVuY2lhIGEgZXN0YSBMaWNlbmNpYSB5IGEgbGEgY2zDoXVzdWxhIGRlIGxpbWl0YWNpw7NuIGRlIGdhcmFudMOtYXMuIFVzdGVkIG5vIHB1ZWRlIGRpc3RyaWJ1aXIsIGV4aGliaXIgcMO6YmxpY2FtZW50ZSwgZWplY3V0YXIgcMO6YmxpY2FtZW50ZSwgbyBwb25lciBhIGRpc3Bvc2ljacOzbiBww7pibGljYSBsYSBPYnJhIGNvbiBhbGd1bmEgbWVkaWRhIHRlY25vbMOzZ2ljYSBxdWUgY29udHJvbGUgZWwgYWNjZXNvIG8gbGEgdXRpbGl6YWNpw7NuIGRlIGVsbGEgZGUgdW5hIGZvcm1hIHF1ZSBzZWEgaW5jb25zaXN0ZW50ZSBjb24gbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEuIExvIGFudGVyaW9yIHNlIGFwbGljYSBhIGxhIE9icmEgaW5jb3Jwb3JhZGEgYSB1bmEgT2JyYSBDb2xlY3RpdmEsIHBlcm8gZXN0byBubyBleGlnZSBxdWUgbGEgT2JyYSBDb2xlY3RpdmEgYXBhcnRlIGRlIGxhIG9icmEgbWlzbWEgcXVlZGUgc3VqZXRhIGEgbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEuIFNpIFVzdGVkIGNyZWEgdW5hIE9icmEgQ29sZWN0aXZhLCBwcmV2aW8gYXZpc28gZGUgY3VhbHF1aWVyIExpY2VuY2lhbnRlIGRlYmUsIGVuIGxhIG1lZGlkYSBkZSBsbyBwb3NpYmxlLCBlbGltaW5hciBkZSBsYSBPYnJhIENvbGVjdGl2YSBjdWFscXVpZXIgcmVmZXJlbmNpYSBhIGRpY2hvIExpY2VuY2lhbnRlIG8gYWwgQXV0b3IgT3JpZ2luYWwsIHNlZ8O6biBsbyBzb2xpY2l0YWRvIHBvciBlbCBMaWNlbmNpYW50ZSB5IGNvbmZvcm1lIGxvIGV4aWdlIGxhIGNsw6F1c3VsYSA0KGMpLgpiLiBVc3RlZCBubyBwdWVkZSBlamVyY2VyIG5pbmd1bm8gZGUgbG9zIGRlcmVjaG9zIHF1ZSBsZSBoYW4gc2lkbyBvdG9yZ2Fkb3MgZW4gbGEgU2VjY2nDs24gMyBwcmVjZWRlbnRlIGRlIG1vZG8gcXVlIGVzdMOpbiBwcmluY2lwYWxtZW50ZSBkZXN0aW5hZG9zIG8gZGlyZWN0YW1lbnRlIGRpcmlnaWRvcyBhIGNvbnNlZ3VpciB1biBwcm92ZWNobyBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYS4gRWwgaW50ZXJjYW1iaW8gZGUgbGEgT2JyYSBwb3Igb3RyYXMgb2JyYXMgcHJvdGVnaWRhcyBwb3IgZGVyZWNob3MgZGUgYXV0b3IsIHlhIHNlYSBhIHRyYXbDqXMgZGUgdW4gc2lzdGVtYSBwYXJhIGNvbXBhcnRpciBhcmNoaXZvcyBkaWdpdGFsZXMgKGRpZ2l0YWwgZmlsZS1zaGFyaW5nKSBvIGRlIGN1YWxxdWllciBvdHJhIG1hbmVyYSBubyBzZXLDoSBjb25zaWRlcmFkbyBjb21vIGVzdGFyIGRlc3RpbmFkbyBwcmluY2lwYWxtZW50ZSBvIGRpcmlnaWRvIGRpcmVjdGFtZW50ZSBhIGNvbnNlZ3VpciB1biBwcm92ZWNobyBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYSwgc2llbXByZSBxdWUgbm8gc2UgcmVhbGljZSB1biBwYWdvIG1lZGlhbnRlIHVuYSBjb21wZW5zYWNpw7NuIG1vbmV0YXJpYSBlbiByZWxhY2nDs24gY29uIGVsIGludGVyY2FtYmlvIGRlIG9icmFzIHByb3RlZ2lkYXMgcG9yIGVsIGRlcmVjaG8gZGUgYXV0b3IuCmMuIFNpIHVzdGVkIGRpc3RyaWJ1eWUsIGV4aGliZSBww7pibGljYW1lbnRlLCBlamVjdXRhIHDDumJsaWNhbWVudGUgbyBlamVjdXRhIHDDumJsaWNhbWVudGUgZW4gZm9ybWEgZGlnaXRhbCBsYSBPYnJhIG8gY3VhbHF1aWVyIE9icmEgRGVyaXZhZGEgdSBPYnJhIENvbGVjdGl2YSwgVXN0ZWQgZGViZSBtYW50ZW5lciBpbnRhY3RhIHRvZGEgbGEgaW5mb3JtYWNpw7NuIGRlIGRlcmVjaG8gZGUgYXV0b3IgZGUgbGEgT2JyYSB5IHByb3BvcmNpb25hciwgZGUgZm9ybWEgcmF6b25hYmxlIHNlZ8O6biBlbCBtZWRpbyBvIG1hbmVyYSBxdWUgVXN0ZWQgZXN0w6kgdXRpbGl6YW5kbzogKGkpIGVsIG5vbWJyZSBkZWwgQXV0b3IgT3JpZ2luYWwgc2kgZXN0w6EgcHJvdmlzdG8gKG8gc2V1ZMOzbmltbywgc2kgZnVlcmUgYXBsaWNhYmxlKSwgeS9vIChpaSkgZWwgbm9tYnJlIGRlIGxhIHBhcnRlIG8gbGFzIHBhcnRlcyBxdWUgZWwgQXV0b3IgT3JpZ2luYWwgeS9vIGVsIExpY2VuY2lhbnRlIGh1YmllcmVuIGRlc2lnbmFkbyBwYXJhIGxhIGF0cmlidWNpw7NuICh2LmcuLCB1biBpbnN0aXR1dG8gcGF0cm9jaW5hZG9yLCBlZGl0b3JpYWwsIHB1YmxpY2FjacOzbikgZW4gbGEgaW5mb3JtYWNpw7NuIGRlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBkZWwgTGljZW5jaWFudGUsIHTDqXJtaW5vcyBkZSBzZXJ2aWNpb3MgbyBkZSBvdHJhcyBmb3JtYXMgcmF6b25hYmxlczsgZWwgdMOtdHVsbyBkZSBsYSBPYnJhIHNpIGVzdMOhIHByb3Zpc3RvOyBlbiBsYSBtZWRpZGEgZGUgbG8gcmF6b25hYmxlbWVudGUgZmFjdGlibGUgeSwgc2kgZXN0w6EgcHJvdmlzdG8sIGVsIElkZW50aWZpY2Fkb3IgVW5pZm9ybWUgZGUgUmVjdXJzb3MgKFVuaWZvcm0gUmVzb3VyY2UgSWRlbnRpZmllcikgcXVlIGVsIExpY2VuY2lhbnRlIGVzcGVjaWZpY2EgcGFyYSBzZXIgYXNvY2lhZG8gY29uIGxhIE9icmEsIHNhbHZvIHF1ZSB0YWwgVVJJIG5vIHNlIHJlZmllcmEgYSBsYSBub3RhIHNvYnJlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBvIGEgbGEgaW5mb3JtYWNpw7NuIHNvYnJlIGVsIGxpY2VuY2lhbWllbnRvIGRlIGxhIE9icmE7IHkgZW4gZWwgY2FzbyBkZSB1bmEgT2JyYSBEZXJpdmFkYSwgYXRyaWJ1aXIgZWwgY3LDqWRpdG8gaWRlbnRpZmljYW5kbyBlbCB1c28gZGUgbGEgT2JyYSBlbiBsYSBPYnJhIERlcml2YWRhICh2LmcuLCAiVHJhZHVjY2nDs24gRnJhbmNlc2EgZGUgbGEgT2JyYSBkZWwgQXV0b3IgT3JpZ2luYWwsIiBvICJHdWnDs24gQ2luZW1hdG9ncsOhZmljbyBiYXNhZG8gZW4gbGEgT2JyYSBvcmlnaW5hbCBkZWwgQXV0b3IgT3JpZ2luYWwiKS4gVGFsIGNyw6lkaXRvIHB1ZWRlIHNlciBpbXBsZW1lbnRhZG8gZGUgY3VhbHF1aWVyIGZvcm1hIHJhem9uYWJsZTsgZW4gZWwgY2Fzbywgc2luIGVtYmFyZ28sIGRlIE9icmFzIERlcml2YWRhcyB1IE9icmFzIENvbGVjdGl2YXMsIHRhbCBjcsOpZGl0byBhcGFyZWNlcsOhLCBjb21vIG3DrW5pbW8sIGRvbmRlIGFwYXJlY2UgZWwgY3LDqWRpdG8gZGUgY3VhbHF1aWVyIG90cm8gYXV0b3IgY29tcGFyYWJsZSB5IGRlIHVuYSBtYW5lcmEsIGFsIG1lbm9zLCB0YW4gZGVzdGFjYWRhIGNvbW8gZWwgY3LDqWRpdG8gZGUgb3RybyBhdXRvciBjb21wYXJhYmxlLiAgCmQuIFBhcmEgZXZpdGFyIHRvZGEgY29uZnVzacOzbiwgZWwgTGljZW5jaWFudGUgYWNsYXJhIHF1ZSwgY3VhbmRvIGxhIG9icmEgZXMgdW5hIGNvbXBvc2ljacOzbiBtdXNpY2FsOgoKaS4gUmVnYWzDrWFzIHBvciBpbnRlcnByZXRhY2nDs24geSBlamVjdWNpw7NuIGJham8gbGljZW5jaWFzIGdlbmVyYWxlcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSBhdXRvcml6YXIgbGEgZWplY3VjacOzbiBww7pibGljYSBvIGxhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBkZSBsYSBvYnJhIHkgZGUgcmVjb2xlY3Rhciwgc2VhIGluZGl2aWR1YWxtZW50ZSBvIGEgdHJhdsOpcyBkZSB1bmEgc29jaWVkYWQgZGUgZ2VzdGnDs24gY29sZWN0aXZhIGRlIGRlcmVjaG9zIGRlIGF1dG9yIHkgZGVyZWNob3MgY29uZXhvcyAocG9yIGVqZW1wbG8sIFNBWUNPKSwgbGFzIHJlZ2Fsw61hcyBwb3IgbGEgZWplY3VjacOzbiBww7pibGljYSBvIHBvciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8gV2ViY2FzdCkgbGljZW5jaWFkYSBiYWpvIGxpY2VuY2lhcyBnZW5lcmFsZXMsIHNpIGxhIGludGVycHJldGFjacOzbiBvIGVqZWN1Y2nDs24gZGUgbGEgb2JyYSBlc3TDoSBwcmltb3JkaWFsbWVudGUgb3JpZW50YWRhIHBvciBvIGRpcmlnaWRhIGEgbGEgb2J0ZW5jacOzbiBkZSB1bmEgdmVudGFqYSBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYS4KaWkuIFJlZ2Fsw61hcyBwb3IgRm9ub2dyYW1hcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSByZWNvbGVjdGFyLCBpbmRpdmlkdWFsbWVudGUgbyBhIHRyYXbDqXMgZGUgdW5hIHNvY2llZGFkIGRlIGdlc3Rpw7NuIGNvbGVjdGl2YSBkZSBkZXJlY2hvcyBkZSBhdXRvciB5IGRlcmVjaG9zIGNvbmV4b3MgKHBvciBlamVtcGxvLCBsb3MgY29uc2FncmFkb3MgcG9yIGxhIFNBWUNPKSwgdW5hIGFnZW5jaWEgZGUgZGVyZWNob3MgbXVzaWNhbGVzIG8gYWxnw7puIGFnZW50ZSBkZXNpZ25hZG8sIGxhcyByZWdhbMOtYXMgcG9yIGN1YWxxdWllciBmb25vZ3JhbWEgcXVlIFVzdGVkIGNyZWUgYSBwYXJ0aXIgZGUgbGEgb2JyYSAo4oCcdmVyc2nDs24gY292ZXLigJ0pIHkgZGlzdHJpYnV5YSwgZW4gbG9zIHTDqXJtaW5vcyBkZWwgcsOpZ2ltZW4gZGUgZGVyZWNob3MgZGUgYXV0b3IsIHNpIGxhIGNyZWFjacOzbiBvIGRpc3RyaWJ1Y2nDs24gZGUgZXNhIHZlcnNpw7NuIGNvdmVyIGVzdMOhIHByaW1vcmRpYWxtZW50ZSBkZXN0aW5hZGEgbyBkaXJpZ2lkYSBhIG9idGVuZXIgdW5hIHZlbnRhamEgY29tZXJjaWFsIG8gdW5hIGNvbXBlbnNhY2nDs24gbW9uZXRhcmlhIHByaXZhZGEuCiAgICAgIAplLiBHZXN0acOzbiBkZSBEZXJlY2hvcyBkZSBBdXRvciBzb2JyZSBJbnRlcnByZXRhY2lvbmVzIHkgRWplY3VjaW9uZXMgRGlnaXRhbGVzIChXZWJDYXN0aW5nKS4gUGFyYSBldml0YXIgdG9kYSBjb25mdXNpw7NuLCBlbCBMaWNlbmNpYW50ZSBhY2xhcmEgcXVlLCBjdWFuZG8gbGEgb2JyYSBzZWEgdW4gZm9ub2dyYW1hLCBlbCBMaWNlbmNpYW50ZSBzZSByZXNlcnZhIGVsIGRlcmVjaG8gZXhjbHVzaXZvIGRlIGF1dG9yaXphciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8sIHdlYmNhc3QpIHkgZGUgcmVjb2xlY3RhciwgaW5kaXZpZHVhbG1lbnRlIG8gYSB0cmF2w6lzIGRlIHVuYSBzb2NpZWRhZCBkZSBnZXN0acOzbiBjb2xlY3RpdmEgZGUgZGVyZWNob3MgZGUgYXV0b3IgeSBkZXJlY2hvcyBjb25leG9zIChwb3IgZWplbXBsbywgQUNJTlBSTyksIGxhcyByZWdhbMOtYXMgcG9yIGxhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBkZSBsYSBvYnJhIChwb3IgZWplbXBsbywgd2ViY2FzdCksIHN1amV0YSBhIGxhcyBkaXNwb3NpY2lvbmVzIGFwbGljYWJsZXMgZGVsIHLDqWdpbWVuIGRlIERlcmVjaG8gZGUgQXV0b3IsIHNpIGVzdGEgZWplY3VjacOzbiBww7pibGljYSBkaWdpdGFsIGVzdMOhIHByaW1vcmRpYWxtZW50ZSBkaXJpZ2lkYSBhIG9idGVuZXIgdW5hIHZlbnRhamEgY29tZXJjaWFsIG8gdW5hIGNvbXBlbnNhY2nDs24gbW9uZXRhcmlhIHByaXZhZGEuCiAgCjUuIFJlcHJlc2VudGFjaW9uZXMsIEdhcmFudMOtYXMgeSBMaW1pdGFjaW9uZXMgZGUgUmVzcG9uc2FiaWxpZGFkLgpBIE1FTk9TIFFVRSBMQVMgUEFSVEVTIExPIEFDT1JEQVJBTiBERSBPVFJBIEZPUk1BIFBPUiBFU0NSSVRPLCBFTCBMSUNFTkNJQU5URSBPRlJFQ0UgTEEgT0JSQSAoRU4gRUwgRVNUQURPIEVOIEVMIFFVRSBTRSBFTkNVRU5UUkEpIOKAnFRBTCBDVUFM4oCdLCBTSU4gQlJJTkRBUiBHQVJBTlTDjUFTIERFIENMQVNFIEFMR1VOQSBSRVNQRUNUTyBERSBMQSBPQlJBLCBZQSBTRUEgRVhQUkVTQSwgSU1QTMONQ0lUQSwgTEVHQUwgTyBDVUFMUVVJRVJBIE9UUkEsIElOQ0xVWUVORE8sIFNJTiBMSU1JVEFSU0UgQSBFTExBUywgR0FSQU5Uw41BUyBERSBUSVRVTEFSSURBRCwgQ09NRVJDSUFCSUxJREFELCBBREFQVEFCSUxJREFEIE8gQURFQ1VBQ0nDk04gQSBQUk9Qw5NTSVRPIERFVEVSTUlOQURPLCBBVVNFTkNJQSBERSBJTkZSQUNDScOTTiwgREUgQVVTRU5DSUEgREUgREVGRUNUT1MgTEFURU5URVMgTyBERSBPVFJPIFRJUE8sIE8gTEEgUFJFU0VOQ0lBIE8gQVVTRU5DSUEgREUgRVJST1JFUywgU0VBTiBPIE5PIERFU0NVQlJJQkxFUyAoUFVFREFOIE8gTk8gU0VSIEVTVE9TIERFU0NVQklFUlRPUykuIEFMR1VOQVMgSlVSSVNESUNDSU9ORVMgTk8gUEVSTUlURU4gTEEgRVhDTFVTScOTTiBERSBHQVJBTlTDjUFTIElNUEzDjUNJVEFTLCBFTiBDVVlPIENBU08gRVNUQSBFWENMVVNJw5NOIFBVRURFIE5PIEFQTElDQVJTRSBBIFVTVEVELgogIAo2LiBMaW1pdGFjacOzbiBkZSByZXNwb25zYWJpbGlkYWQuCkEgTUVOT1MgUVVFIExPIEVYSUpBIEVYUFJFU0FNRU5URSBMQSBMRVkgQVBMSUNBQkxFLCBFTCBMSUNFTkNJQU5URSBOTyBTRVLDgSBSRVNQT05TQUJMRSBBTlRFIFVTVEVEIFBPUiBEQcORTyBBTEdVTk8sIFNFQSBQT1IgUkVTUE9OU0FCSUxJREFEIEVYVFJBQ09OVFJBQ1RVQUwsIFBSRUNPTlRSQUNUVUFMIE8gQ09OVFJBQ1RVQUwsIE9CSkVUSVZBIE8gU1VCSkVUSVZBLCBTRSBUUkFURSBERSBEQcORT1MgTU9SQUxFUyBPIFBBVFJJTU9OSUFMRVMsIERJUkVDVE9TIE8gSU5ESVJFQ1RPUywgUFJFVklTVE9TIE8gSU1QUkVWSVNUT1MgUFJPRFVDSURPUyBQT1IgRUwgVVNPIERFIEVTVEEgTElDRU5DSUEgTyBERSBMQSBPQlJBLCBBVU4gQ1VBTkRPIEVMIExJQ0VOQ0lBTlRFIEhBWUEgU0lETyBBRFZFUlRJRE8gREUgTEEgUE9TSUJJTElEQUQgREUgRElDSE9TIERBw5FPUy4gQUxHVU5BUyBMRVlFUyBOTyBQRVJNSVRFTiBMQSBFWENMVVNJw5NOIERFIENJRVJUQSBSRVNQT05TQUJJTElEQUQsIEVOIENVWU8gQ0FTTyBFU1RBIEVYQ0xVU0nDk04gUFVFREUgTk8gQVBMSUNBUlNFIEEgVVNURUQuCiAgCjcuIFTDqXJtaW5vLgkKYS4gRXN0YSBMaWNlbmNpYSB5IGxvcyBkZXJlY2hvcyBvdG9yZ2Fkb3MgZW4gdmlydHVkIGRlIGVsbGEgdGVybWluYXLDoW4gYXV0b23DoXRpY2FtZW50ZSBzaSBVc3RlZCBpbmZyaW5nZSBhbGd1bmEgY29uZGljacOzbiBlc3RhYmxlY2lkYSBlbiBlbGxhLiBTaW4gZW1iYXJnbywgbG9zIGluZGl2aWR1b3MgbyBlbnRpZGFkZXMgcXVlIGhhbiByZWNpYmlkbyBPYnJhcyBEZXJpdmFkYXMgbyBDb2xlY3RpdmFzIGRlIFVzdGVkIGRlIGNvbmZvcm1pZGFkIGNvbiBlc3RhIExpY2VuY2lhLCBubyB2ZXLDoW4gdGVybWluYWRhcyBzdXMgbGljZW5jaWFzLCBzaWVtcHJlIHF1ZSBlc3RvcyBpbmRpdmlkdW9zIG8gZW50aWRhZGVzIHNpZ2FuIGN1bXBsaWVuZG8gw61udGVncmFtZW50ZSBsYXMgY29uZGljaW9uZXMgZGUgZXN0YXMgbGljZW5jaWFzLiBMYXMgU2VjY2lvbmVzIDEsIDIsIDUsIDYsIDcsIHkgOCBzdWJzaXN0aXLDoW4gYSBjdWFscXVpZXIgdGVybWluYWNpw7NuIGRlIGVzdGEgTGljZW5jaWEuCmIuIFN1amV0YSBhIGxhcyBjb25kaWNpb25lcyB5IHTDqXJtaW5vcyBhbnRlcmlvcmVzLCBsYSBsaWNlbmNpYSBvdG9yZ2FkYSBhcXXDrSBlcyBwZXJwZXR1YSAoZHVyYW50ZSBlbCBwZXLDrW9kbyBkZSB2aWdlbmNpYSBkZSBsb3MgZGVyZWNob3MgZGUgYXV0b3IgZGUgbGEgb2JyYSkuIE5vIG9ic3RhbnRlIGxvIGFudGVyaW9yLCBlbCBMaWNlbmNpYW50ZSBzZSByZXNlcnZhIGVsIGRlcmVjaG8gYSBwdWJsaWNhciB5L28gZXN0cmVuYXIgbGEgT2JyYSBiYWpvIGNvbmRpY2lvbmVzIGRlIGxpY2VuY2lhIGRpZmVyZW50ZXMgbyBhIGRlamFyIGRlIGRpc3RyaWJ1aXJsYSBlbiBsb3MgdMOpcm1pbm9zIGRlIGVzdGEgTGljZW5jaWEgZW4gY3VhbHF1aWVyIG1vbWVudG87IGVuIGVsIGVudGVuZGlkbywgc2luIGVtYmFyZ28sIHF1ZSBlc2EgZWxlY2Npw7NuIG5vIHNlcnZpcsOhIHBhcmEgcmV2b2NhciBlc3RhIGxpY2VuY2lhIG8gcXVlIGRlYmEgc2VyIG90b3JnYWRhICwgYmFqbyBsb3MgdMOpcm1pbm9zIGRlIGVzdGEgbGljZW5jaWEpLCB5IGVzdGEgbGljZW5jaWEgY29udGludWFyw6EgZW4gcGxlbm8gdmlnb3IgeSBlZmVjdG8gYSBtZW5vcyBxdWUgc2VhIHRlcm1pbmFkYSBjb21vIHNlIGV4cHJlc2EgYXRyw6FzLiBMYSBMaWNlbmNpYSByZXZvY2FkYSBjb250aW51YXLDoSBzaWVuZG8gcGxlbmFtZW50ZSB2aWdlbnRlIHkgZWZlY3RpdmEgc2kgbm8gc2UgbGUgZGEgdMOpcm1pbm8gZW4gbGFzIGNvbmRpY2lvbmVzIGluZGljYWRhcyBhbnRlcmlvcm1lbnRlLgogIAo4LiBWYXJpb3MuCmEuIENhZGEgdmV6IHF1ZSBVc3RlZCBkaXN0cmlidXlhIG8gcG9uZ2EgYSBkaXNwb3NpY2nDs24gcMO6YmxpY2EgbGEgT2JyYSBvIHVuYSBPYnJhIENvbGVjdGl2YSwgZWwgTGljZW5jaWFudGUgb2ZyZWNlcsOhIGFsIGRlc3RpbmF0YXJpbyB1bmEgbGljZW5jaWEgZW4gbG9zIG1pc21vcyB0w6lybWlub3MgeSBjb25kaWNpb25lcyBxdWUgbGEgbGljZW5jaWEgb3RvcmdhZGEgYSBVc3RlZCBiYWpvIGVzdGEgTGljZW5jaWEuCmIuIFNpIGFsZ3VuYSBkaXNwb3NpY2nDs24gZGUgZXN0YSBMaWNlbmNpYSByZXN1bHRhIGludmFsaWRhZGEgbyBubyBleGlnaWJsZSwgc2Vnw7puIGxhIGxlZ2lzbGFjacOzbiB2aWdlbnRlLCBlc3RvIG5vIGFmZWN0YXLDoSBuaSBsYSB2YWxpZGV6IG5pIGxhIGFwbGljYWJpbGlkYWQgZGVsIHJlc3RvIGRlIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEgeSwgc2luIGFjY2nDs24gYWRpY2lvbmFsIHBvciBwYXJ0ZSBkZSBsb3Mgc3VqZXRvcyBkZSBlc3RlIGFjdWVyZG8sIGFxdcOpbGxhIHNlIGVudGVuZGVyw6EgcmVmb3JtYWRhIGxvIG3DrW5pbW8gbmVjZXNhcmlvIHBhcmEgaGFjZXIgcXVlIGRpY2hhIGRpc3Bvc2ljacOzbiBzZWEgdsOhbGlkYSB5IGV4aWdpYmxlLgpjLiBOaW5nw7puIHTDqXJtaW5vIG8gZGlzcG9zaWNpw7NuIGRlIGVzdGEgTGljZW5jaWEgc2UgZXN0aW1hcsOhIHJlbnVuY2lhZGEgeSBuaW5ndW5hIHZpb2xhY2nDs24gZGUgZWxsYSBzZXLDoSBjb25zZW50aWRhIGEgbWVub3MgcXVlIGVzYSByZW51bmNpYSBvIGNvbnNlbnRpbWllbnRvIHNlYSBvdG9yZ2FkbyBwb3IgZXNjcml0byB5IGZpcm1hZG8gcG9yIGxhIHBhcnRlIHF1ZSByZW51bmNpZSBvIGNvbnNpZW50YS4KZC4gRXN0YSBMaWNlbmNpYSByZWZsZWphIGVsIGFjdWVyZG8gcGxlbm8gZW50cmUgbGFzIHBhcnRlcyByZXNwZWN0byBhIGxhIE9icmEgYXF1w60gbGljZW5jaWFkYS4gTm8gaGF5IGFycmVnbG9zLCBhY3VlcmRvcyBvIGRlY2xhcmFjaW9uZXMgcmVzcGVjdG8gYSBsYSBPYnJhIHF1ZSBubyBlc3TDqW4gZXNwZWNpZmljYWRvcyBlbiBlc3RlIGRvY3VtZW50by4gRWwgTGljZW5jaWFudGUgbm8gc2UgdmVyw6EgbGltaXRhZG8gcG9yIG5pbmd1bmEgZGlzcG9zaWNpw7NuIGFkaWNpb25hbCBxdWUgcHVlZGEgc3VyZ2lyIGVuIGFsZ3VuYSBjb211bmljYWNpw7NuIGVtYW5hZGEgZGUgVXN0ZWQuIEVzdGEgTGljZW5jaWEgbm8gcHVlZGUgc2VyIG1vZGlmaWNhZGEgc2luIGVsIGNvbnNlbnRpbWllbnRvIG11dHVvIHBvciBlc2NyaXRvIGRlbCBMaWNlbmNpYW50ZSB5IFVzdGVkLgo=

Evaluación diagnóstica y terapéutica de Blomia tropicalis en pacientes con rinitis alérgica

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