Allergic disorder & homoeopathy management

Compiled by: Dr.Endresh katiyarB H M S . M.D. (PGR)Email: [email protected]

Type of hypersensitivity reactions of the immune system. Allergy may involve more the one type of reaction.

An allergy is a immune reaction to something that does not affect most other people. Substances that often cause reactions are:

Pollen Dust mites Mold spores Pet dander Food Insect stings Medicines

Allergy

Risk factor

Host factors; heredity, gender, race, and age.

Environmental factor; infectious diseases during early childhood, environmental pollution, allergen levels and dietary changes.

Allergy

Allergy• Allergy refers to certain diseases in which immune

responses to environmental antigens cause tissue inflammation and organ dysfunction. Hypersensitivity and sensitivity are synonyms for allergy.

• Allergen is any antigen that causes allergy. Red eyes , Itchiness,Runny nose , Eczema, Hives, Asthma attack.

Allergic Reaction Its overreaction to a harmless substance (an

allergen)

This harmless substance that is contacted through the skin,

inhaled into the lungs, swallowed, or injected.

Types of Hypersensitivity Reaction

• Hypersensitivity reactions can be divided into four types: type I, type II, type III and type IV, based on the mechanisms involved and time taken for the reaction.

•Type I hypersensitivity is also known as immediate or anaphylactic hypersensitivity. The reaction may involve skin (urticaria and eczema), eyes (conjunctivitis), nasopharynx (rhinorrhea, rhinitis), bronchopulmonary tissues (asthma) and gastrointestinal tract The reaction may cause a range of symptoms from minor to death. The reaction usually takes 15 - 30 minutes from the time of exposure to the antigen.vascular dialation,edema, mucus production, inflammation.

•Type II hypersensitivity is also known as cytotoxic hypersensitivity and may affect a variety of organs and tissues. The antigens are normally endogenous, although exogenous chemicals which can attach to cell membranes can also lead to type II hypersensitivity. •e.g. Drug-induced hemolytic anemia, granulocytopenia and thrombocytopenia . Cell lysis, Inflammation,

•The reaction time is minutes to hours.

Type III Hypersensitivity -Immune complex

•The reaction may be general e.g., serum sickness or may involve individual organs including: e.g. kidney (lupus nephritis), •The reaction may take 3 - 10 hours after exposure to the antigen as in Necrotizing vasculitis, Inflammation

•Type IV hypersensitivity is also known as cell mediated or delayed type hypersensitivity. Contact dermatitis, Multiple sclerosis, Type-1 diabetes, Tuberculosis,

Edema , Cell destruction, Granuloma formation.

Allergy

Ig E mediated (Type I

hypersensitivity)

Non Ig E mediated

Allergy

Overreaction to an allergen that is contact through skin, inhaled through lung, swallowed or injected.

Triggered by harmless substances such as; pollen, dust, animal danders, food,

An allergen; an antigen that causes allergy. Either inhaled, ingested, .. Can be complete protein antigens (Pollen and animal dander) or low molecular weight proteins.

IgE Mediated: Type I

Atopy is the genetic predisposition to make IgE antibodies in response to allergen exposure.

Allergic rhinitis, allergic athma, atopic dermatitis are the most common manifestation of atopy.

Atopy

Immunopathogenesis

Both mast cells and basophils are involved in immunopathogenesis of IgE mediated diseases. Mast cells and basophils have a high affinity IgE cell membrane receptors for IgE.

Immediate hypersensitivity reactions are mediated by IgE, but T and B cells play important roles in the development of these antibodies

Mast Cell

IgEAllergen

CrosslinkingHistaminerelease

Mast cells 

Release pre-formed mediators (histamine) and lipids together with several TH2 cytokines

Histamine

• Therapeutic intervention in allergy often focused on blocking the effects of histamine

• Histamine also functions as a neurotransmitter in CNS

• Very important in maintaining a state of arousal or awareness

Common allergens include:

• Plants • Pollens • Animal dander • Bee stings or stings from other insects • Insect bites • Medication• Foods, especially nuts and shellfish

Allergic Rhinitis: Most common clinical expression of atopic hypersenstivity . IgE mediated allergy localized in the nasal mucosa and conjunctiva. Pollens and fungal spores, dust and animal danders usual atmospheric allergens.

Allergic asthma (IgE mediated allergy in bronchial mucosa)Allergen exposure results in bronchoconstriction, and patients may report shortness of breath , wheezing, cough, chest tightness. Long-term allergen exposure can cause chronic changes of increased difficulty breathing and chest tightness,

Allergic GastroenteropathyLocalized IgE reactions in the gut to an ingested food. Gastrointestinal loss of serum proteins and blood leading to edema and anemia.

Urticaria

• Diffuse hives or wheals may occur and cause significant purities; individual wheals resolve after minutes to hours, but new wheals can continue to form.

• Acute urticaria: (lasting <6 wk) can be caused by foods, drugs, or contact allergens.

• Chronic urticaria: lasts longer than 6 weeks.

Angioedema• Angioedema is localized tissue swelling that can occur in

soft tissues throughout the body., which may account for a substantial volume of fluid loss from the intravascular compartment. Patients may report pain at the site of swelling instead of pruritus, which occurs with urticaria.

• Angioedema of the laryngopharynx can obstruct the airway, and patients may report difficulty breathing. Stridor or hoarseness may be present.

Anaphylaxis• Anaphylaxis is a sudden and severe allergic reaction

that occurs within minutes of exposure. Immediate medical attention is needed .

• Anaphylaxis is a severe allergic reaction marked by swelling of the throat or tongue, hives, and trouble breathing.

Food Allergy

from the sensitization of the patient to one or more foods, in which symptoms manifest locally in t Food Allergy may be defined as a complex of clinical syndromes (sick all over) resulting he GI tract or in other remote organs.

.

Respiratory symptoms: Sneezing, runny nose , stuffy nose wheezing, watery eyes, persistent cough, bronchitis, itchy feeling in the mouth or throat.

Skin affection: Red, sandpaper-like facial rash, dry scaly, itchy skin (mostly on face), swelling in hands and feet, puffy eyelids, dark circles under eye, tongue soreness and cracks, sore throat.

Behavior changes: fatigue, migraine, headaches, hyperactivity, crying, irritability, anxiety, sore muscles and joints.

GIT Symptoms: vomiting, constipation , abdominal discomfort, mucous diarrhea, intestinal bleeding poor weight gain, bloating,

Symptoms

Laboratory Diagnosis

IgE-Mediated Allergies

The cutaneous test (prick test, puncture test epicutaneous test)

Routine diagnosis in diseases (atopic or anaphylactic). A single drop of concentrated aqueous allergen extract placed on the skin

which is then pricked lightly with a needle point at the center of the drop. After 20 minutes the reaction is graded and recorded

Skin Tests

IgE levels may be elevated in patients who are atopic,

The tryptase level can be elevated, which is indicative of mast cell degranulation.

An elevated eosinophil count may be observed in patients with atopic disease.

Laboratory Tests

Nasal smear

Elevated eosinophil levels can be consistent with allergic rhinitis.

Spirometry or pulmonary function test

Nasal smear/ Spirometry

Treatment

PreventionAvoid triggers such as foods and medications,…… that

have caused an allergic reaction, even a mild one.

A medical ID tag should be worn by people who know that they have serious allergic reaction.

If any history of a serious allergic reactions, carry emergency medications (such as diphenihydramine and injectable epinephrine.

Miasms

Urticaria ,Angioedema,Food allergy -Psoric

Auto immune haemolytic anemia, Tumors ,Tuberrculosis ,Typhoid , Contact

dermatitis – Psoro- syphilitic

Stopping of nose, mostly at night; must breath through mouth. Long lasting coryza,

Cough : dry, from tickling in throat from dust, every morning from 3 to 4 a.m.

Amelioration lying on abdomen(acetic acid).

AMMONIUM CARB

Dry cough coming on after first sleep, about middle of night.

Asthma on lying down at night with spasmodic cough.Constriction of chest; feels as if foreign body were in

throat.Hay fever; the least current of air causes sneezing, with

copious watery, excoriating nasal discharge, of salty acrid taste.

Hay fever. thin, watery excoriating discharge. Nose feels stopped up. Sneezing without relief. Unable to lie down with a fear of suffocation. Worse in open air,

Asthma worse midday and midnight. Cough worse lying on back.Great anguish and restlessness with extreme prostration.Dry, rough, scaly skin; worse cold and scratching better from heat.Urticaria , with burning and restlessness.

AMELIORATION FROM WARMTH IN GENERAL EXCEPT COMPLAINTS OF HEAD

ARSENICUM ALBUM

OVERSENSITIVE TO COLD AIR. PATIENTS CATCHES COLD WITH EVERY CHANGE OF WEATHER.

Indicated for lungs of old people, with chronic catarrhal condition ,attacks of suffocation at night with difficult cough. The patients expectorates less.

Humid asthma ,muco- purulent expectoration.Ringworm ; eczema of eyelids. Gland of neck are enlarged and tender.Worse at night and early morning, cold air.

Dry coryza. Complete stoppage of nose. Nose stuffs up in cold rain. Wants nose kept warm, least cold air stops the nose. Coryza of a new born.

Loose rattling cough worse wet weather. Must cough a long time to expel phlegm. Cough after physical exertion.

Urticaria over whole body, no fever; itching burns after scratching agg in warmth amel in cold.

Hot days and cold nights towards the close of summer are especially favorable to its action. As a effects of damp weather, colds after exposure to wet.

This is a very useful remedy in the early stages of any inflammation. Taken when allergy symptoms start, it often slows or stops an episode. Symptoms include runny eyes with a burning or gritty feeling, facial flushing, watery nose, and short, hard, tickling cough.

Catarrh : coryza dry at night, fluent by day agg in warm room amel in cold air.

Acrid discharge, but with stuffed up feeling.Asthma with fullness in stomach in morning and after eating.

Cough brings on bursting headacheBad effects of coffee, tobacco, alcoholic stimulants, highly

spicy or seasoned foods.

SANGUINARIA CANADENSIS

Dry coryza of infants, snuffles. Nose dry and obstructed.Paroxysmal suffocative cough coming on about midnight, with

crying and dyspnoea.Child awakes suddenly, nearly suffocating, sits up, turns blue.

Cannot expire(mephitis).Profuse sweat on waking.

Intolerable itching worse undressing(rumex).Chronic eczema worse from warmth, walking, undressing.Fissures in the bend of arms and knees.

Dry, cough preventing sleep.agg by pressure, talking, and especially by inspiring cool air and at night.

Copious mucus discharge from nose and trachea.Urticaria.- Intolerable itching of skin, esp. of lower

extremities worse exposure to cold air when undressing.

Violent Fluent coryza for 1-3 days then changing into stoppage of nose, making breathing difficult. Loss of smell and taste.

Discharge thin watery like raw white of an egg.Internal soreness of nose.Eczema – eruptions esp. around the root of hairs.

Dread of least cold air and washing. Wants warm clothing even in summers.

Asthma worse sitting up; better lying down and keeping arms spread wide apart.

Dirty, filthy look of the patient.Hay fever. Intolerable itching. Eczema behind ears. Urticaria after

every exertion.Constant sneezing; dropping of mucus from posterior nares. Better

lying down.

Urticaria, covering whole body. Itching at the tip of coccyx, esp. when the body is warm, and which receives no relief from scratching.  

Urticaria on least excitement, on waking in the morning worse from bathing.

Itching, burning in swollen nose, violent incessant sneezing. Stoppage of nose, though discharge is watery and profuse.

Eyes deeply suffused, lachrymation, itching and burning in eyes and ears, buzzing, singing in ears.

ANTI PYRIN

FREQUENT sneezing with profuse discharge from nose loss of smell and taste, itching in ears, confusion of head with dim vision.

CYCLAMEN

Sore, discharge of burning ichorous fluid from nose, excoriating nostrils and upper lip. Nose stopped; can only breathe with mouth open; dry coryza. Right nostril open, left blocked.Throat sore, feels excoriated; cannot swallow. , agg. from talking

Hay fever. scanty, acrid discharge with STOPPAGE OF LEFT NOSTRIL all day or in afternoon and evening

NOSTRILS ALTERNATELY STOPPED. Asthmatic breathing. Loud cough spells with barking expiration.Dry sensation back of nose and throat >> by swallowing or by efforts to cough.Cough is relieved by lying down.Chronic eczema. Burning heat and stitches in chest. Skin turns red.

COUGH OFTEN ENDS IN SNEEZE.Dry coryza; much watery mucus and sneezing. Nostrils feels peppery.Old asthmatic with congestive attack. Difficult raising of tough,

profuse mucus, in the aged.Bronchial catarrh, with sore chest walls; much mucus; sensation of

oppression and weight of chest. Rattling in chest.Worse walking in open air, during rest. Better from sweat; bending

head backwards.

CATARRH; BAD SMELL OF NASAL SECRETION.Posterior nasal catarrh. Hawking much mucus from throat;

worse slightest draught.Dry cough when coming into warm room from out doors.Modalities ◦worse sitting, from music, summer heat, mental exertion and

thunderstorm. Least draught, change of weather,

NATRUM CARB

Sneezing with fullness at the root of nose. Swelling of turbinates. Watery, excoriating discharge. Acute coryza with dull headache and fever.

Dry cough with sore chest and fluent coryza.Spasm of glottis.Skin hot, dry, itching with measles like eruption. Catarrhal symptoms ;

aids in bringing out eruptions.Dullness, dizziness, drowsiness accompanies all complaints.

GELSEMIUM

Sailors suffer from asthma “on shore”. Asthma ,difficulty in getting air into the lungDyspnoea : cannot inspire deep enough; as if breathing through a sponge or the

air passages were full of smoke or vapor of sulphur; rattling, sawing; Coryza with corrosive soreness of nose. Pressure at the root of nose. Tickling,

smarting, as from cobweb. Cold sensation in larynx on inspiration(rhus tox, sulph).

BROMIUM

Acute catarrhal condition of the respiratory tract(used in the beginning)

Lachrymation with coryza, profuse, fluent with constant sneezing.Coryza with cough. Dry cough from sternal region all over chest.

Paroxysmal cough, with suffocative obstruction of respiration. With severe dyspnoea.

Asthmatic attacks, cannot endure a close, warm room.

JUSTICIA ADHATODA

The profuse watery, acrid coryza that the drug produces serves as a sure guiding symptom, especially when associated with pain in frontal sinus.

Stuffiness and dryness of nose without discharge.Asthma , violent cough worse in morning. Expectoration like soap-

suds, greenish.Worse warm room, warm clothing, night, damp weather.Better motion, in open air

KALI HYDRIODICUM