ASSESSMENT AND MANAGEMENT Role of Immunoglobulins in Allergies

* IgG

MANAGEMENT OF PATIENTS WITH - Can act as a "blocking antibody" to help

reduce reduce allergic responses responses over
WITH ALLERGIC DISORDER
time with with immunotherapy.
- Allergic reactions occur when the immune
* IgE
system responds inappropriately to normally
harmless substances called allergens. This - The primary antibody involved in allergic
overview covers the physiological basis of reactions. Binds to mast cells and triggers
allergic reactions, common allergic disorders, release of chemical mediators when exposed to
diagnostic approaches, and management allergens.
strategies. Understanding the mechanisms and
* Other Immunoglobulins
manifestations of allergies is crucial for proper
assessment, diagnosis, and treatment of these - IgA, IgM, and IgD play various roles in
common and sometimes life-threatening immune function but are less directly involved
conditions. in typical allergic reactions.

Physiologic Overview of Allergic Reactions Chemical Mediators in Allergic Reactions

1. Allergen Exposure 1. Histamine
- The body encounters an allergen, usually a - Causes vasodilation, increased vascular
protein, that the immune system recognizes as permeability, and smooth muscle contraction.
foreign. Primary mediator in immediate allergic
responses.
2. Antibody Production
2. Leukotrienes
- B cells produce IgE antibodies specific to
that allergen. - Potent bronchoconstrictors that contribute
to airway inflammation in asthma.
3. Mast Cell Activation
3. Prostaglandins
- IgE antibodies bind to the mast cells, which
release chemical mediators like histamine when - Cause smooth muscle contraction and
re-exposed to the allergen. increase vascular permeability.
4. Symptom Onset 4. Cytokines
- Released chemicals cause allergy symptoms - Regulate various aspects of the immune
like inflammation, itching, and swelling. response in allergies.
Types of Hypersensitivity * Skin Tests

Reactions - Prick tests or intradermal tests to identify

specific allergens.
Type I Immediate, IgE-mediated mediated (e.g.
anaphylaxis) * Blood Tests

Type II Cytotoxic, antibody-dependent (e.g. - Measurement of allergen-specific IgE levels

blood transfusion reactions) in serum.

Type III Immune complex-mediated mediated Skin Testing for Allergies

(e.g. serum sickness)
1. Preparation
Type IV Delayed-type, cell-mediated mediated
- Small amounts of suspected allergens are
(e.g. contact dermatitis)
prepared for testing.

2. Application
Anaphylaxis: A Severe Allergic Reaction
- Allergens are applied to the skin, usually on
1. Allergen Exposure the back or forearm.

- Person is exposed to a triggering allergen, 3. Observation

often food, medication, or insect sting.
- Skin is observed for signs of reaction, such as
2. Rapid Onset redness or swelling.

- Symptoms begin within minutes to hours, 4. Interpretation

affecting multiple body systems.
- Results are evaluated to identify specific
3. Systemic Effects allergen sensitivities.

- May include difficulty breathing, swelling, Blood Tests for Allergy Diagnosis
hives, vomiting, and low blood pressure.
1. Total IgE
4. Emergency Treatment
- Measures overall levels of IgE antibodies,
- Requires immediate epinephrine and which may be elevated in allergic conditions.
medical attention to prevent life-threatening
2. Specific IgE
threatening complications.
- Detects IgE antibodies to specific allergens,
helping identify triggers.
Diagnostic Approaches for Allergies
3. Eosinophil Count
* Medical History
- Elevated levels may indicate an allergic
- Detailed patient history of symptoms, response or parasitic infection.
triggers, and family history of allergies.
4. Tryptase
* Physical Examination
- Can help diagnose anaphylaxis or mast cell
- Assessment of skin, respiratory system, and disorders.
other affected areas.
Allergic Rhinitis: Hay Fever * Treatment

Symptoms - May include inhaled corticosteroids,

bronchodilators, and avoiding triggers.
* Sneezing

* Runny nose
Atopic Dermatitis (Eczema)
* Itchy eyes
1. Onset
* Congestion
- Often begins in infancy or early childhood.
Triggers
2. Symptoms
* Pollen
- Dry, itchy skin with red, inflamed patches.
* Dust mites
May be chronic or flare periodically.
* Pet dander
3. Triggers
* Mold spores
- Can be exacerbated by allergens, irritants,
Treatment stress, or changes in temperature/humidity.
temperature/humidity.
* Antihistamines
4. Management
* Nasal corticosteroids
- Involves moisturizing, avoiding triggers, and
* Decongestants using topical medications as needed.
* Immunotherapy

Food Allergies: Common Culprits

Asthma: Allergic and Non-Allergic * Peanuts
* Allergic Asthma - One of the most common and potentially
- Triggered by allergens like pollen or pet severe food allergies.
dander. * Milk
- Often associated with other allergic - Common in children, often outgrown.
conditions.
* Eggs
* Non-Allergic Asthma
- Another common childhood allergy that may
- Triggered by factors like exercise, cold air, or be outgrown.
respiratory infections. Not directly related to
allergens. * Fish

* Symptoms - Often develops in adulthood and tends to be

lifelong.
- Both types can cause wheezing, coughing,
shortness of breath, and chest tightness.
Diagnosing Food Allergies * Hornets

1 Medical History * Fire ants

Detailed account of symptoms and Symptoms

suspected food triggers.
* Local swelling
2 Skin Prick Tests
* Hives
Small amounts of food proteins are
* Difficulty breathing
applied to the skin to check for reactions.
* Anaphylaxis (severe cases)
3 Blood Tests
Management
Measure levels of food-specific IgE
antibodies in the blood. * Avoid insect habitats
4 Oral Food Challenge * Carry epinephrine
Controlled ingestion of suspected * Consider immunotherapy
allergen under medical supervision.

Latex Allergy
Managing Food Allergies
1. Risk Factors
* Avoidance
- Healthcare workers, patients with multiple
- Strict avoidance of allergen-containing foods surgeries, and those with other allergies are at
is crucial. higher risk.
* Label Reading 2. Symptoms
- Carefully check ingredient lists for hidden - Can range from mild skin irritation to severe
allergens. anaphylaxis.
* Emergency Plan 3. Common Sources
- Carry epinephrine auto-injector and know - Gloves, medical devices, balloons, and many
how to use it. household items.
* Education 4. Management
- Inform family, friends, and caregivers about - Strict avoidance of latex products and use of
the allergy and management. latex-free alternatives.

Insect Sting Allergies Antihistamines for Allergy

Common Culprits Treatment
* Bees First Generation Diphenhydramine, ne,
* Wasps
Chlorpheniramine More sedating, shorter- - Used in asthma management to reduce
acting airway inflammation.

Second * Oral/Systemic

Generation Loratadine, Cetirizine Less - For severe allergic reactions or when other
sedating, longer-acting treatments are ineffective.

Third Generation Fexofenadine,

Desloratadine Minimal sedation, once daily Immunotherapy for Allergies

dosing
1. Initial Assessment

- Identify specific allergens through testing.

Antihistamines - Classification
2. Build-up Phase
Generation I Examples
- Gradually increasing doses of allergen
Most sedative, Most potent: extract are administered.
Diphenhydramine, Dimenhydrinate,
3. Maintenance Phase
Hydroxyzine,
- Regular doses are given to maintain
Promethazine
tolerance.
Moderate sedative,
4. Evaluation
Moderate potent: Pheniramine, Meclizine,
- Assess effectiveness and adjust treatment as
Buclizine, Cyproheptadine, Cetrizine
needed.
Less sedative,

Less potent: Chlorpheniramine,

Epinephrine Auto-Injectors
Mebhydroline, Dimethindone, Clemastine
1. Prescription
Generation Il Examples
- Prescribed for patients at risk of anaphylaxis.
Mainly antiallergic: Levocetrizine,
Loratadine, Desloratadine, Fexofenadine 2. Training
Antivertigo, Antimigraine: Flunnarizine, - Patients and caregivers learn proper use and
Cinnarizine technique.

3. Carrying
Corticosteroids in Allergy Management - Always carry two auto-injectors in case of
severe reaction.
* Topical
4. Use
- Creams and ointments for skin allergies,
nasal sprays for allergic rhinitis.

* Inhaled
Environmental Control for Allergies Allergies in Children

* Dust Mites 1. Infancy

- Use allergen-proof bedding covers and wash - Food allergies and atopic dermatitis often
bedding in hot water weekly. first appear.

* Pollen 2. Early Childhood

- Keep windows closed during high pollen - Respiratory allergies like asthma may
seasons, shower after being outdoors. develop.

* Pet Dander 3. School Age

- Keep pets out of bedrooms, use HEPA air - Allergic rhinitis becomes more common.
purifiers.
4. Adolescence
* Mold
- Some allergies may be outgrown, others
- Control humidity levels, fix leaks promptly, persist persist into adulthood
clean visible mold growth.

Allergies and Pregnancy

Occupational Allergies
1. Symptom Changes
Common Causes
- Allergies may improve, worsen, or stay the
* Latex same during pregnancy.

* Clean ng products 2. Medication Safety

* Animal allergens - Some allergy medications are considered

safe, others should be avoided
* Wood dust
3. Asthma Management
At-Risk Occupations
- Crucial to control asthma during pregnancy
* Healthcare workers
for maternal and fetal health.
* Bakers
4. Allergy Prevention
* Hairdressers
- No clear evidence that maternal diet during
* Laboratory warkers pregnancy prevents allergies in allergies in
offspring.
Prevention

* Use protective equipment

* improve ventilation

* Substitute allergens when possible

Anaphylaxis Management - Promising approach for desensitizing
patients to food allergens,
1. Recognition
3. Epicutaneous Immunotherapy
- Identify signs of severe allergic reaction.
- Patch-based method for allergen
2. Epinephrine
desensitization.
- Administer epinephrine immediately.
4. Gene Therapy
3. Call for Help
- Potential future approach to modify allergic
- Activate emergency medical services. responses at the genetic level.

4. Supportive Care

- Monitor and support breathing and Living with Allergies: Quality of Life
circulation.
Challenges

* Symptom management
Allergy Prevention Strategies
* Dietary restrictions
* Early Introduction
* Activity limitations
- Introducing potential allergens in infancy
may reduce risk reduce risk of developing
allergies. Coping Strategies

* Breastfeeding * Education and awareness

- May offer some protection against * Support groups

development of allergies.
* Stress management
* Avoid Smoke Exposure

- Secondhand smoke can increase risk of

Positive Outcomes
allergies and and asthma.
* Improved self-management
* Probiotics
* Increased resilience
- May help prevent eczema in high-risk
infants, but more more research is needed * Better overall health

Emerging Treatments for Allergies

1. Biologics

- Targeted therapies for severe asthma and

other allergic conditions.

2. Oral Immunotherapy