{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:29:06Z","timestamp":1785414546359,"version":"3.56.0"},"reference-count":0,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"2","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>ANTECEDENTES: El diagn\u00f3stico de alergia a himen\u00f3pteros puede resultar especialmente complejo, y la historia cl\u00ednica supone un pilar fundamental para orientar la identificaci\u00f3n del insecto responsable. No obstante, el reconocimiento visual, por parte del paciente, suele ser inexacto y conducir a errores en el diagn\u00f3stico si no se realizan pruebas espec\u00edficas de inmunoalergia.\nREPORTE DEL CASO: Var\u00f3n de 37 a\u00f1os, que durante su estancia en Taramundi (Asturias), sufri\u00f3 una picadura de insecto que identific\u00f3 visualmente como Nomada flava. Diez minutos despu\u00e9s manifest\u00f3 una reacci\u00f3n anafil\u00e1ctica de grado III de M\u00fcller, con p\u00e9rdida de la conciencia, leve angioedema y v\u00f3mito. El estudio alergol\u00f3gico revel\u00f3 doble sensibilizaci\u00f3n a Vespula spp. y Polistes dominula mediante pruebas cut\u00e1neas y determinaci\u00f3n de IgE espec\u00edfica, sin evidencia de sensibilizaci\u00f3n a Apis mellifera. El inmunoblot mostr\u00f3 reconocimiento s\u00e9rico dirigido contra el veneno de Polistes dominula, fundamentalmente al componente Pol d 1. Con estos resultados se estableci\u00f3 el diagn\u00f3stico de alergia a Polistes dominula y se indic\u00f3 inmunoterapia espec\u00edfica frente a este veneno. El paciente fue adem\u00e1s diagnosticado con s\u00edndrome de activaci\u00f3n mastocitaria clonal, confirmado mediante estudio de m\u00e9dula \u00f3sea.\nCONCLUSI\u00d3N: Este caso destaca la necesidad del estudio alergol\u00f3gico completo, que permita identificar con precisi\u00f3n la especie implicada y seleccionar el tratamiento adecuado, pues el reconocimiento visual del insecto agresor puede ser limitado.\nPALABRAS CLAVE: Veneno de himen\u00f3pteros; Alergia; Insecto; Anafilaxia; Angioedema; IgE; Apis mellifera; Polistes dominula; Inmunoterapia espec\u00edfica; S\u00edndrome de activaci\u00f3n de mastocitos; M\u00e9dula \u00f3sea.<\/jats:p>","DOI":"10.29262\/ram.v73i2.1586","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T20:26:53Z","timestamp":1783369613000},"page":"202-206","source":"Crossref","is-referenced-by-count":0,"title":["&lt;b&gt;Alergia a himen\u00f3pteros, dificultades en el diagn\u00f3stico diferencial: a prop\u00f3sito de un caso&lt;\/b&gt;","&lt;b&gt;Hymenoptera allergy, difficulties in differential diagnosis: A case report&lt;\/b&gt;"],"prefix":"10.29262","volume":"73","author":[{"given":"Jimena","family":"Laiseca Garc\u00eda","sequence":"first","affiliation":[{"name":"Hospital Universitario Puerta de Hierro (Madrid)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Pretre","sequence":"additional","affiliation":[{"name":"Roxall Medicina Espa\u00f1a, Zamudio, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfedo","family":"Iglesias Cadarso","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01e57nb43","id-type":"ROR","asserted-by":"publisher"}],"name":"Hospital Universitario Puerta de Hierro Majadahonda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Barrios Albajar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01e57nb43","id-type":"ROR","asserted-by":"publisher"}],"name":"Hospital Universitario Puerta de Hierro Majadahonda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11808","published-online":{"date-parts":[[2026,6,30]]},"container-title":["Revista Alergia M\u00e9xico"],"original-title":[],"link":[{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1586\/2898","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1586\/2898","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T20:26:54Z","timestamp":1783369614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,30]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v73i2.1586","relation":{},"ISSN":["2448-9190","0002-5151"],"issn-type":[{"value":"2448-9190","type":"electronic"},{"value":"0002-5151","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}