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Related Concept Videos

Allergic Reactions02:06

Allergic Reactions

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Overview
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Allergic Reactions: Anaphylaxis01:30

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Inflammatory Response01:28

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An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
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Hypersensitivity Reactions: Immune-Complex Reactions01:19

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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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The inflammatory response is the body's defense against infection, injury, or irritation from bacteria, trauma, toxins, or heat. Inflammation helps locate and destroy pathogens and remove damaged tissue elements to heal the body. During this initial phase, fluid, blood products, and nutrients migrate to the injured area, resulting in redness, heat, swelling, ache, and loss of function. Moreover, signs of systemic inflammation include fever, increased WBC count, malaise, anorexia, nausea,...
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Measuring Local Anaphylaxis in Mice
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Large local reactions to insect stings.

David B K Golden1

  • 1Division of Allergy & Clinical Immunology, Johns Hopkins University, Baltimore, Md.

The Journal of Allergy and Clinical Immunology. in Practice
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PubMed
Summary

Large local reactions (LLRs) from insect stings rarely lead to anaphylaxis. Venom immunotherapy (VIT) is typically not recommended for LLRs unless exposure is unavoidable and frequent.

Keywords:
Epinephrine injectorInsect sting allergyLarge local reactionsVenom allergy testsVenom immunotherapy

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Area of Science:

  • Allergy and Immunology
  • Insect Sting Reactions

Background:

  • Large local reactions (LLRs) are inflammatory responses to insect stings.
  • While causing significant discomfort, LLRs have a low risk (<5%) of progressing to systemic anaphylaxis.

Purpose of the Study:

  • To clarify the risks associated with LLRs.
  • To guide management decisions, including allergy testing and venom immunotherapy (VIT).
  • To inform the decision-making process regarding epinephrine autoinjector prescription.

Main Methods:

  • Review of clinical guidelines and evidence regarding LLRs.
  • Analysis of risk factors for future anaphylaxis.
  • Consideration of treatment options such as VIT and epinephrine.

Main Results:

  • LLRs generally do not necessitate VIT due to the low risk of subsequent anaphylaxis.
  • VIT may be considered for individuals with unavoidable, frequent exposures requiring annual treatment.
  • Epinephrine prescription depends on exposure frequency, proximity to care, and quality of life impact.

Conclusions:

  • Patients experiencing LLRs should consult an allergist for personalized risk assessment and management planning.
  • VIT is effective and safe for selected individuals with frequent LLRs and unavoidable exposure.
  • Management strategies should balance the risk of anaphylaxis with the morbidity of LLRs.