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Related Concept Videos

Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

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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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Overview
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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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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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Drug Toxicity: Allergic Reactions01:30

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Hypersensitivities01:30

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Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...
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Basophil Activation Test for Allergy Diagnosis
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Cholinergic Urticaria with Anaphylaxis: An Underrecognized Clinical Entity.

Peter Vadas1, Angela Sinilaite1, Marcus Chaim1

  • 1Division of Allergy and Clinical Immunology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

The Journal of Allergy and Clinical Immunology. in Practice
|December 2, 2015
PubMed
Summary

Anaphylaxis triggered by heat, exertion, or stress is often severe and underreported. This study details the clinical features of cholinergic urticaria-induced anaphylaxis, highlighting its multisystemic and potentially life-threatening nature.

Keywords:
AnaphylaxisCholinergicExerciseExertionHigh Ambient TemperatureIdiopathicMast cellMastocytosisUrticaria

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Area of Science:

  • Allergy and Immunology
  • Dermatology
  • Emergency Medicine

Background:

  • Cholinergic urticaria (CU) is a physical urticaria triggered by heat, exercise, and emotion.
  • These triggers can induce severe, multisystemic reactions, including life-threatening anaphylaxis.
  • The clinical spectrum of CU-induced anaphylaxis requires further characterization.

Purpose of the Study:

  • To describe the demographic and clinical features of patients experiencing anaphylaxis triggered by cholinergic stimuli.
  • To characterize the presentation and severity of anaphylaxis in a cohort with known cholinergic urticaria.

Main Methods:

  • Retrospective chart review of patients diagnosed with cholinergic urticaria and experiencing anaphylaxis.
  • Data collection included triggers, symptoms, reaction severity, and baseline tryptase levels.

Main Results:

  • Nineteen patients (79% female, mean age of onset 27.5 years) with recurrent anaphylaxis due to cholinergic triggers were identified.
  • Common triggers included high ambient temperature (100%), strenuous exertion (89.5%), and stress (78.9%).
  • Reactions frequently involved cutaneous (94.7%), airway (78.9%), and cardiovascular (78.9%) systems, with 44.4% experiencing severe anaphylaxis.

Conclusions:

  • Anaphylaxis triggered by cholinergic stimuli is underreported and often presents as a severe, multisystemic event.
  • The findings underscore the potential for life-threatening reactions in patients with cholinergic urticaria.
  • Early recognition and management are crucial for patients with this condition.