Summary of all the hypersensitivity disorders Flashcards
List the most important Type 1 hypersenstiivty disorders
- atopic dermatitis
- food allergy
- oral allergy dysndorme
- latex food syndrome
- allergic rhinitis
- acute urticaria
- anaphylaxis
Pathophysiology of atopic dermatitis
Food allergy: summary
allergens: milk egg peanut tree nut fish shellfish
pathology: IgE (anaphylaxis, OAS); cell mediated (coeliac); IgE/cell mediated (atopic dermatitis)
diagnosis: Food Diary, Skin Prick Tests, RAST, Challenge Test àMost resolve by adulthood.
treatment: Dietician, Food Allergy
tree nut, fish, Avoidance, Epipen, shellfish
Control asthma if present
Oral allergy syndrome
Allergen: Birch pollen + rosacea fruit, ragweed + melons,
mugwort + Celery(cross- reactivity)
Pathology: exposure to allergen idnuces allergy to food. sx limite dto mouth, 2% get anaphylaxis
Dx: clinicl, skin prick test
tx: avoid food, if ingested wash mouth + anti histamine
Latex food syndrome

allergic rhinitis

acute urticaria

Which triggers of anaphylaxis are IgE mediated vs non-IgE mediated?
IgE-mediated mast cell degranulation - peanut, penicillin, stings, latex
Non-IgE-mediated mast cell degranulation: NSAIDs, IV contrast, opioids, exercise.
DDx of anaphylaxis
C1 inhibitor deficiency - hereditary angioedema • ACEi induced angioedema • Acute anxiety • Urticaria
Mx of anaphylaxis
Elevate Legs, 100% Oxygen, IM Adrenaline 500 mcg, inhaled bronchodilators, Hydrocortisone 200mg IV, Chlorphenamine 10mg IV, IV Fluids, Seek Help
what type of hypersensitivity is HDN?
Type 3
What is autoimmune haemolutic anaemia + ITP known as?
Evan’s syndrome
**this is what you can get in CLL?
Tx of evan’s syndrome?
steroids
treatment of evan’s syndrome?
steroids
goodpasture’s syndrome?

target of graves disease antibody
TSH receptor
target of myasthenia gravis autoatibody
how do you diagnose it?
tx?
acetylcholine receptor
diagnosis: anti AchR antibodies, abnormal EMG, tensilon test
tx: pyridostigmine, neostigmine
what type of hypersenstiivty reaction is acute rhuemtaic fever?
type 2- against M proteins on group A strep
what are ab against in pernicious anaemia?
anti gastric parietal cells - 90%
anti intrinsic factor
what size vasuclitis is churg strauss syndrome?
medium and small vessel
what antibody is present in churg strauss syndrome?
what type of vasculitis is wegener’s granulomatosis?
medium and small vessel vasuculitis
antibody in wegener’s?
c-anca - against proteinaise 3
antibody in microscopic polyangitis?
p-anca against myeloperoxidase
chronic urticaria

what type of hypersenstiivty reaction is serum sickness?
type 3
reaction to proteins in antiserum (penicillin)

what type of hypersensitivity is polyarteritis nodosa?
type 3
- antibodies against HepB and HepC virus antigens
ROSARY SIGN, high esr, high wcc
Features of SLE
SOAP BRAIN MD

antibodes in SLE
anti-dsDNA
anti ro
anti la
anti sm
anti u1rnp
give some examples of type 4 hypersensitivity reacions
- type 1 diabetes
- multiple sclerosis
- rheumatoid arthritis - also type 2 and type 3
- contact dermatitis
- mantoux test
- crohn’s disease
what is the type 4 hypersensitivity involved in rheumatoid arthritis?
antigen is in the synovial membrane
antibodies in rhematoid arthritis
anti ccp- more specific
rheumatoid factor - sensitive but not specifi c
((also- raised ESR and raised CRP unlike SLE with isolated raised ESR)
wha
what type of hypersensitivity reaction is crohn’s disease
type 4
antibodies in crest syndrome vs diffuse cutaneous scleroderma
crest syndrome: anti centromere
diffuse cutaneous: anti scl70, anti rna pol 1, 2, 3
skin involvement in crest syndrome vs diffuse cutaneous
crest syndrome: only up to forearms+ perioral
diffuse cutaneous: more diffuse involvement
what test tests for tear rpdocution?
schirmer test - for sjogren’s (reduced)
antibodies in sjogren’s syndrome
anti ro
anti la
antibodies in coeliac disease
anti ema
anti ttg 0 95% specific, 90-94% sensitive
anti gliadin
Antiphospholipid Syndrome
(Hugh’s Syndrome)
anti cardiolipin antibody
lupus anticoagulant
autoimmune hepatitis antibody
anti smooth muscle anyibody
anti liver kidney microsomal 1
anti soluble liver antigen
antibody in autoimmune haemolytic anaemia
Anti-Rh Blood Group Antigen
antibody in Autoimmune Thrombocytopenic Purpura
Anti-Glycoprotein IIb-IIIa or Ib-IX Antibody
dermatitis herpetiformis antibody
anti EMA
antibody in demratomyosits
anti jo 1
hashimotors Ab
anti thyroglobulin
anti thyroid peroxidase
mixed connective tissue disease
Anti-U1RNP antibody (speckled pattern)
polymyositis antibody
anti jo 1
PBC antibody
anti mitochondrial antibody
what type of immunofluorescence in sjogrens?
speckled
fluorescence pattern in sle
anti dsDNA: homogenous
anti ro and anti la: speckled
**so it depends on which antibodye syou have
What are the two types of ANA and what are their immunofluorescence patterns?
• Anti-dsDNA – homogenous staining pattern, they are highly specific for SLE and high titres are associated with severe disease (useful for disease monitoring)
• Anti-ENA4 (extractable nuclear antigens such as ribonucleoproteins (e.g. Ro, La, Sm)) - speckled immunofluorescence
antibodues in type 1 diabetes mellitus
anti glutamic acid decarboxylase
anti islet cell antibodies