2. 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
3. Risk factor
Host factors; heredity, gender, race, and
age.
Environmental factor; infectious
diseases during early childhood,
environmental pollution, allergen levels
and dietary changes.
Allergy
4. 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.
5. 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.
6. 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.
7.
8. •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.
9. •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.
10. 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
11. •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.
13. 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
14. 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
15. 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
18. 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
19.
20. Common allergens include:
• Plants
• Pollens
• Animal dander
• Bee stings or stings from other insects
• Insect bites
• Medication
• Foods, especially nuts and shellfish
21. 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 Gastroenteropathy
Localized IgE reactions in the gut to an ingested food.
Gastrointestinal loss of serum proteins and blood leading to
edema and anemia.
22. 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.
23. 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.
24. 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.
25. 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.
.
26. 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
28. 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
29. 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
30. Nasal smear
Elevated eosinophil levels can be consistent with allergic
rhinitis.
Spirometry or pulmonary function test
Nasal smear/ Spirometry
32. Prevention
Avoid 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.
36. 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
37. 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.
38. 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
39.
40. 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.
41. 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.
42. 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.
43. 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 headache
Bad effects of coffee, tobacco, alcoholic stimulants, highly
spicy or seasoned foods.
45. 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.
46.
47. Intolerable itching worse undressing(rumex).
Chronic eczema worse from warmth, walking, undressing.
Fissures in the bend of arms and knees.
48. 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.
49. 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.
50. 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.
51. 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.
52. 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
53. FREQUENT sneezing with profuse discharge from
nose loss of smell and taste, itching in ears,
confusion of head with dim vision.
CYCLAMEN
54. 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
55. 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.
56. 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.
57. 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
58. 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
59. Sailors suffer from asthma “on shore”.
Asthma ,difficulty in getting air into the lung
Dyspnoea : 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
60. 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.
JUSTICIAADHATODA
61. 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