I allergic reactions

The term anaphylactic shock describes a severe generalized type I allergic reaction associated with cardiovascular shock, airway constriction and heart arrhythmias, which, if left untreated, may cause death. 

Type I allergic reactions are inappropriate immune responses to an allergen with preferential synthesis of immunoglobulin E (IgE), a special antibody class, which binds to mast cells and basophilic granulocytes via Fee receptors. Binding of the allergen to the cell-bound IgE initiates the rapid release of allergic mediators, most prominently histamine, and the de novo synthesis of arachidonic acid metabolites and cytokines, which are responsible for the clinical symptoms. 

Emulsifiers. Natural lecithin is one of the most widely used emulsifiers because it is metabolized in the body. However, type I allergic reaction to soybean lecithin emulsified in lipid solutions has been observed [195], Among the synthetic emulsifying agents, block copolymers of polyoxyethylene-polyoxypropylene (poloxamer) have attracted increasing interest for parenteral emulsions. Other examples of emulsifiers commonly found in parenteral formulations are given in Table 9 [190]. 

In susceptibie individuais, NSAIDs may precipitate acute bronchospasm. It affects 10-20% of adults with asthma but is rare in asthmatic children. The mechanism is related to cyclooxygenase inhibition, with shunting of arachidonic acid metabolism from the prostaglandin pathway to the biosynthesis of ieukotrienes with increased mucosal permeability and bronchospasm. Susceptible patients should avoid NSAIDs since the bronchospasm may be severe and has been fatal. Paracetamol in doses up to 1000 mg daiiy wiii be toierated by most patients. True type I allergic reactions to NSAIDs, with specific IgE, are rare but anaphyloactoid reactions have occasionally been described in patients with a history of aiiergy or bronchiai asthma. 

This report demonstrates a rare case of a type I allergic reaction towards a commonly used ingredient of tablets and widely used disinfectants. 

Urticaria, commonly known as hives, is a type I allergic reaction that results very rapidly from exposure to a toxicant to which the subject has become sensitized. It is characterized by the release of histamine from a type of white blood cell. Histamine causes many of the symptoms of allergic reaction, including tissue edema. In addition to edema, erythema, and accompanying raised welts on skin, urticaria is accompanied by severe itching. In severe cases, such as happen in some people as the result of bee or wasp stings, urticaria can result in systemic anaphylaxis, a potentially fatal allergic reaction. 

Jensen-Jarolim, E., Wiedermann, U., Ganglberger, E. et al. 1999. Allergen mimotopes in food enhance type I allergic reactions in mice, FASEB J 13 1586-1592. 

As noted, mast cells and their mediators are integral components of the allergic response. Histamine, the main mediator involved in type I allergic reactions, is released from mast cells and basophils. Histamine is synthesized and stored in nearly all tissues, with especially high concentrations in the lungs, skin, stomach, duodenum, and nasal mucosa. Histamine causes smooth muscle contraction, increased vascular permeability, vasodilation,... 

Susceptible or atopic individuals often have a hereditary or femilial predisposition to allergic responses. A genetic defect may account for the IgE response. When both parents are atopic, their child has a 50% chance of developing type I allergic reactions, and when only one parent is atopic the likelihood is 30%. 

An unexpected high incidence of type I allergic reactions to cisplatin and dacarbazine has been observed, several hours after administration to patients on a combination of aldesleukin and interferon alfa (127). The reactions occurred at least after the first cycle and increased in incidence thereafter, suggesting that immunotherapy can sensitize patients to several chemotherapeutic agents. 

Two patients developed severe type I allergic reactions to... 

Type I allergic reactions have caused pruritic rashes and urticaria. 

Urticarial and maculopapular rashes are the most frequent adverse reactions to sulfonamides after gastrointestinal symptoms. Although hypersusceptibility is suspected to be the mechanism for these adverse effects, type I allergic reactions, which are induced by IgE antibodies, have been confirmed only rarely. It appears that with the older sulfonamides severe reactions were more frequent. In some patients who have immediate hypersensitivity reactions to sulfonamides, IgE has been found that can bind to an N4-sulfonamidoyl determinant (N4-SM) (169). 

IV reactions as clinical correlates. Nevertheless, the penicillin RAST offers a reliable and safe way to explore at least type I allergic reactions. An extension of that procedure to other drugs commonly responsible for allergic reactions is therefore highly desirable. 

Type I allergic reactions result from contact of the inhaled allergen with cell-bound IgE. This causes the release of histamine and other vasodilators. These reactions cause localised inflammation leading to irritation of the nose, skin or respiratory tract depending on where the challenge is deposited. This is in turn dependent on the particle size of the challenge. The effect of this irritation on the respiratory system is to constrict the airways which leads to breathing difficulties and so produces the symptoms of asthma. 

Water-soluble blue dyes with and without isotope, in particular, patent blue V, isosulfan blue, and methylene blue, are being increasingly used to identify sentinel lymph nodes in melanoma patients and in cases of breast, bladder, cervical, endometrial, and other cancers. Reports of adverse reactions to blue dyes date to at least the 1960s and it is now clear that type I allergic reactions including anaphylaxis occur occasionally with all three of the above-mentioned drugs. Unfortunately, confusion surrounds the terminol-... 

N-DEX Eree is free from the accelerators common in other disposable nitrile gloves, which have been linked to workplace conditions like Type IV dermatitis. It s free from natural rabber latex and Type I allergic reactions linked to latex proteins. The high-visibility green glove is ideal for jobs where increased visibility and color-coded operations are critical. Available in a smooth finish or with new textured... 

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