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    Allergic Reactions: Ahmad Asraf Bin Amirullah

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    asraf amirullah
    This document defines allergic reactions and discusses various types of allergies including allergic rhinitis, atopic dermatitis, urticaria, insect bites, food allergy, and anaphylaxis. It covers the pathophysiology, clinical features, investigations, and management of these conditions. Specifically, it notes that allergies are IgE-mediated hypersensitivity reactions that commonly involve the respiratory tract, skin, and gastrointestinal system. Testing like skin prick tests and RAST can help identify triggers, and treatment focuses on avoidance of allergens, antihistamines, topical steroids, and epinephrine for severe reactions like anaphylaxis.

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    Allergic Reactions: Ahmad Asraf Bin Amirullah

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    asraf amirullah
    38 views28 pages
    This document defines allergic reactions and discusses various types of allergies including allergic rhinitis, atopic dermatitis, urticaria, insect bites, food allergy, and anaphylaxis. It covers the pathophysiology, clinical features, investigations, and management of these conditions. Specifically, it notes that allergies are IgE-mediated hypersensitivity reactions that commonly involve the respiratory tract, skin, and gastrointestinal system. Testing like skin prick tests and RAST can help identify triggers, and treatment focuses on avoidance of allergens, antihistamines, topical steroids, and epinephrine for severe reactions like anaphylaxis.

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    ALLERGIC FINALE

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    This document defines allergic reactions and discusses various types of allergies including allergic rhinitis, atopic dermatitis, urticaria, insect bites, food allergy, and anaphylaxis. It covers the pathophysiology, clinical features, investigations, and management of these conditions. Specifically, it notes that allergies are IgE-mediated hypersensitivity reactions that commonly involve the respiratory tract, skin, and gastrointestinal system. Testing like skin prick tests and RAST can help identify triggers, and treatment focuses on avoidance of allergens, antihistamines, topical steroids, and epinephrine for severe reactions like anaphylaxis.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    38 views28 pages

    Allergic Reactions: Ahmad Asraf Bin Amirullah

    Uploaded by

    asraf amirullah
    This document defines allergic reactions and discusses various types of allergies including allergic rhinitis, atopic dermatitis, urticaria, insect bites, food allergy, and anaphylaxis. It covers the pathophysiology, clinical features, investigations, and management of these conditions. Specifically, it notes that allergies are IgE-mediated hypersensitivity reactions that commonly involve the respiratory tract, skin, and gastrointestinal system. Testing like skin prick tests and RAST can help identify triggers, and treatment focuses on avoidance of allergens, antihistamines, topical steroids, and epinephrine for severe reactions like anaphylaxis.

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    ALLERGIC REACTIONS

    AHMAD ASRAF BIN AMIRULLAH


    Definitions
    • ALLERGY - clinical conditions of IgE-mediated allergic diseases that have have a familial
    predisposition and manifest as hyperresponsiveness in the target organs
    • Atopy - results of a complex interaction between multiple gense and environmental factors to
    develop allergic diseases
    Gell and Coombs Classification of Hypersensitivity
    Disorders
    INTERVAL
    BETWEEN
    TYPE EFFECTOR CELL EXAMPLES
    EXPOSURE &
    REACTION
    Anaphylaxis, urticaria,
    I Anaphylactic <30min
    IgE allergic rhinitis,
    (Immediate) 2-12h
    asthma

    Variable - minutes to Rh hempolytic anemia,


    II Cytotoxic Antibody IgG, IgM, IgA
    hours thrombocytopenia
    Antigen-Antibody
    III Immune complex agregates leading to Rheumatoid arthritis,
    1-3 weeks
    reaction local or systemic SLE
    inflamation
    TB skin test, contact
    2-7 days after drug
    IV Delayed type Lymphocytes dermatitis, graft versus
    exposure
    host disease
    Pathophysiology
    Allergies to be covered
    • Allergic rhinitis

    • Atopic dermatitis

    • Urticaria and Angioedema

    • Insect bites

    • Food allergy

    • Anaphylaxis
    Allergic Rhinitis
    Inflammatory disorder of the nasal mucosa marked by nasal congestion,
    - Known as Hay fever
    It could be:
    - Seasonal : airborne pollens
    - Perennial (indoor allergens) : house dust mites, mold, cockroaches, pets
    Clinical manifestation:
    - Sneezing, Snorting throat clearing
    - Rhinorhea
    - Red eye
    - Cough
    - Hoarseness
    Physical examination:
    • Allergic shiners - dark periorbital swollen
    eyelids or conjuctiva
    • Nose - allergic salute --> transverse nasal crease,
    turbinate hypertrophy, polyps
    • Mouth - cobbletoning of oropharynx

    • Ears - Retracted tympanic membrane

    • Chest - wheezing
    Investigation
    3 common test:
    • Skin testing

    • Nasal smear

    • In vitro testing for serum levels of specific IgE antibodies

    (RAST - radioallergosorbent test)


    Management
    Prevention
    • Removing pet, room / house hygiene

    Pharmacotherapy:

    1. Intranasal corticosteroids - beclometasone, budesonide,


    fluticasone, mometasone

    2. Antihistamine - diphenhydramine, cetirizine, loratadine

    3. Decongestants - pseydoephedrine
    Atopic Dermatitis
    Chronic, pruritic, relapsing inflammatory skin condition

    Factors like genetic predesposition(family history), disturbances of skin barrier, environmental


    interactions, infectious trigger

    Triggers like anxiety, stress, climate, allerges, infections

    35% of child with atopic dermatitis have coexisting food allergies

    Filaggrin structural protein in the epidermis play a role to skin barrier function. Gene mutation in
    fillagrin gene plays a role with severe AD
    Clinical Features of A Dermatitis
    Investigation & Management
    Investigation
    - skin test
    - RAST (Radioallergosorbent test)

    Management
    - reduce number or severity of flares and to increase the number of disease-free periods , reduce trigger factors
    - bland emollients, mild non alkali soaps
    - Topical steroids - topical beclomethasone
    - Topical immunomodulating drugs - topical tacrolimus (2nd line)
    Urticaria
    • URTICARIA - hives, vascular reaction of skin
    characterized by wheals surrounded by a red
    halo or erythema
    • PRURITUS
    • swelling of upper dermis
    • ACUTE causes - foods(eggs,milk,
    peanuts,shellfish), medications, insect
    stings(hornets,wasp), contact
    allergy(latex,pollen,caterpillar), transfusion
    reactions
    • Management - antihistamines, corticosteroid
    Angioedema
    • caused by similar pathogenic mechanism as
    urticaria but pathology is in the deep dermis and
    subcutaneous tissue
    • SWELLING commonly affects the face or
    portion of an extremity
    • may be painful or burning and last several days
    Drug Allergy
    Hypersensitivity reaction occurs during or after use of the drug

    Type A (PREDICTABLE) - side effects, drug interaction, drug toxicity

    Type B (UNPREDICTABLE) - hypersensitivity

    Clinical features - severe skin reactions, high grade fever, join pain(50%), changes in vision,
    difficult breathing, abdominal discomfort, vomiting

    Management - depends on severity. severe drug allergy require supportive treatment with
    corticosteroids, fluid and electrolytes maintenance, good oxygenation or ventilatory support
    Anaphylaxis
    Severe life threatening generalised or systemic
    hypersent reaction.

    Characterized by rapidly (minutes to hours)


    developing airway, breathing and circulation
    problems associated with skin or mucosa changes
    Discharge plan:

    1. education to caregivers

    2. adrenaline auto injector (adrenaline card /


    allergic card)
    Anaphylaxis
    Anaphylaxis is likely when 3 criteria’s met:

    - Sudden onset or rapid progression of symptoms (minutes to hours)


    - Life threatening airway and/or Breathing and/or Circulation problems
    - Skin and/or mucosal changes ( flushing, urticaria, angioedema)
    Anaphylaxis
    Life threatening features:
    Airways:
    - Airway swelling e.g. throat or tongue swelling
    - Hoarseness of voice
    - Stridor
    Breathing:
    - Dyspnea (bronchospasm, pulmonary edema)
    - Wheeze
    - Confusion by hypoxia
    - Cyanosis
    - Respiratory arrest
    Anaphylaxis
    Circulation problems

    - Shock
    - Cardiovascular collapse (faintness, palpitation, LOC)
    - Cardiac arrest
    Key points for severe reaction:

    - Previous severe reaction


    - History of increasingly severe reaction
    - History of asthma
    - Treatment with B-blocker
    Anaphylaxis
    Anaphylaxis
    Anaphylaxis
    Anaphylaxis
    Anaphylaxis
    Anaphylaxis

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