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Hypersensitivity Reaction/ Allergy

Apr 04, 2018

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    HYPERSENSITIVITY

    OR ALLERGY

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    Is an increased or excessive response to the

    presence of an antigen ( foreign protein or

    allergen) to which the client has been

    previously exposed.

    Initial responses:

    ItchingWatery eyes

    sneezing

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    Leads to life-threatening conditions such as:

    Allegric asthma

    Anaphylaxis

    Bronchoconstriction or

    Circulatory collapse

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    BASIC TYPES

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    TYPE 1 HYPERSENSITIVITY

    REACTION

    Anaphylactic hypersensitivity

    ORGAN SPECIFIC

    The most severe form of hypersensitivity

    reaction

    The most severe immune-mediated

    reaction

    results from the increased production of the IgE antibody class

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    Signs and symptoms:

    ANAPHYLAXIS:

    Uneasiness

    Apprehension

    Weakness

    Impending doom

    ALLERGIC RHINITIS:Runny nose watery eyes

    Itching fever

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    BRONCHIAL ASTHMA

    Dyspnea wheezing

    ATOPIC ECZEMA/ DERMATITIS

    Urticaria angioedema

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    CLINICAL EXAMPLES

    Hay fever

    Allergic asthma

    Anaphylaxis

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    TYPE II: CYTOTOXIC

    REACTIONS

    ORGAN SPECIFIC

    May affect variety of organs and tisssues

    Reaction time is 10 to 14 mins.

    Primarily mediated by antibodies of Ig M and

    Ig G classes and phagocyte as well as T cells

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    Signs and symptoms

    Fever Nausea

    CIRCULATORY OVERLOAD

    Dyspnea headache tachypnea

    Cough chest tightness

    SEPSIS

    Fever nausea vomiting diarrhea

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    Treatment

    Autologous transfusion

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    CLINICAL EXAMPLES

    Autoimmune hemolytic anemia

    Good Pastures Syndrome

    Myasthenia Gravis

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    TYPE III: IMMUNE MEDIATED

    HR

    NON-ORGAN SPECIFIC

    May be general (serum sickness), may involve

    individual organs including skin (Systemic

    Lupus Erythematosus), kidneys (nephritis),lung (aspergillosis), blood vessels

    (polyarthritis), joints (arthralgia, athritis/

    rheumatoid arthritis)

    Reaction may take 3-10 hours after exposure

    of the antigen

    Mediated by Ig G and Ig M

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    Signs and symptoms:

    Urticaria

    Joint pain

    Fever

    Rash

    Adenopathy (swollen glands)

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    Treatment

    -symptomatic treatment

    Antihistamines- for

    itchingAspirin- for athralgia

    Prednisone- for severesymptoms

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    CLINICAL EXAMPLES

    Serum sickness

    Vasculitis

    Systemic Lupus Erythematosus

    Rheumatoid arthritis

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    TYPE IV : T- CELL MEDIATED

    HR

    ORGAN SPECIFIC

    Delayed Hypersensitivity reaction

    Mediated by T cells rather than antobodies

    Lesions are more papular

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    CLINICAL EXAMPLES

    Poison ivy

    Graft rejection

    Positive TB skin tests

    Sarcoidosis

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    TYPE V: STIMULATORY

    REACTIONS

    - B cell Mediated HR

    This type of reaction involves inappropriate

    type of hyperthyroidism, results from excessive

    output of thyroid hormones caused byabnormal stimulation of thyroid glands by

    circulating immunoglobulins.

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    CLINICAL EXAMPLES

    Graves disease

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    Signs and symptoms

    Exophthalmos

    Palpitations

    Abnormal increased pulse

    Pruritus

    perspiration

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    Treatment

    Antithyroid agents

    Radioactive iodine

    surgery

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    Diagnostic Evaluation

    Blood tests

    Smears of body secretions

    Skin tests

    Radioallergosorbent test (RAST)

    CBC differential

    Eosinophil count

    Total serum Ig E levels