Allergy & Immuno Flashcards
Difference between anaphylaxis and anaphylactoid reaction
Anaphylaxis - Patient must have already been sensitized to the pathogen; IgE induced mast cell release of histamine, PGs, and leukotrienes
Anaphylactoid reaction - clinically identical to anaphylaxis but not IgE mediated
Urticaria definition
sudden swelling of the superficial layer of the skin
Hereditary angioedema
swelling and stridor with absence of pruritus, asso with C1 esterase inhibitor deficiency, does not respond to glucocorticoids
Tx of angioedema
1) ensure airway
2) FFP, ecallantide, icatibant (bradykinin and kallikrein ib’s, respectively)
3) if urticaria present - epinephrine, antihistamine, steroids
4) if severe laryngeal involvement and hx of hereditary angioedema - C1 esterase inhibitor concentrate
defect in B cell maturation, impaired B cell isotype switching, normal B cell count, low Ig’s (all subtypes), recurrent sinopulmonary infections, Giardiasis, inflammatory bowel-like and sprue-like intestinal malabsorption, autoimmune disease, increased risk of lymphoma
Common variable immunodeficiency
low B cells and lymphoid tissue, low Ig’s
X-liked (Bruton) agammaglobulinemia
low B and T cells, sinopulmonary and AIDS-like infections
Severe combined immunodeficiency
anaphylaxis to blood transfusion, atopic disease, sprue-like intestinal malabsorption, autoimmune disease
IgA deficiency
recurrent skin infections with Staph
Hyper IgE syndrome
thrombocytopenia, low T cells, eczema
Wiskott-Aldrich syndrome
lymph nodes with purulent material leaking out, Staph, Burkholderia, Nocardia, Aspergillus
Chronic granulomatous disease
delayed umbilical cord separation
Leukocyte adhesion deficiency
giant granules, pancytopenia, albinism, neurodegeneration
Chediak-Higashi syndrome
Dx of chronic granulomatous disease
nitro blue tetrazolium testing or dihydrorhodamine testing to detect decrease in the respiratory burst that produces hydrogen peroxide
Tx of immunodefiencies with low B cells and low Ig’s
IVIG
