HYPERSENSITIVITY OR ALLERGY

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:
Itching

Watery

eyes sneezing

Leads to life-threatening conditions such as:

Allegric

asthma Anaphylaxis Bronchoconstriction or Circulatory collapse

BASIC TYPES

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 Ig E antibody class

Signs and symptoms:

ANAPHYLAXIS:
Uneasiness
Apprehension Weakness

Impending

doom

ALLERGIC RHINITIS: Runny nose watery eyes Itching fever

BRONCHIAL ASTHMA
Dyspnea

wheezing

ATOPIC ECZEMA/ DERMATITIS

Urticaria

angioedema

CLINICAL EXAMPLES

Hay fever Allergic asthma Anaphylaxis

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

Signs and symptoms

Fever

Nausea

CIRCULATORY OVERLOAD Dyspnea headache tachypnea Cough chest tightness

SEPSIS Fever

nausea

vomiting

diarrhea

Treatment

Autologous transfusion

CLINICAL EXAMPLES

Autoimmune hemolytic anemia Good Pastures Syndrome Myasthenia Gravis

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

Signs and symptoms:

Urticaria
Joint

pain Fever Rash Adenopathy (swollen glands)

Treatment

-symptomatic treatment

Antihistamines-

for

itching Aspirin- for athralgia Prednisone- for severe symptoms

CLINICAL EXAMPLES

Serum sickness Vasculitis Systemic Lupus Erythematosus Rheumatoid arthritis

TYPE IV : T- CELL MEDIATED HR

ORGAN SPECIFIC Delayed Hypersensitivity reaction Mediated by T cells rather than antobodies Lesions are more papular

CLINICAL EXAMPLES

Poison ivy Graft rejection Positive TB skin tests Sarcoidosis

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 by abnormal stimulation of thyroid glands by circulating immunoglobulins.

CLINICAL EXAMPLES

Graves disease

Signs and symptoms

Exophthalmos Palpitations Abnormal increased pulse Pruritus perspiration

Treatment

Antithyroid agents Radioactive iodine surgery

Diagnostic Evaluation

Blood tests Smears of body secretions Skin tests Radioallergosorbent test (RAST) CBC differential Eosinophil count Total serum Ig E levels