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Related Concept Videos

Hypersensitivity Reactions: Immune-Complex Reactions01:19

Hypersensitivity Reactions: Immune-Complex Reactions

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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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Hypersensitivity Reactions: Cytolytic Reactions01:01

Hypersensitivity Reactions: Cytolytic Reactions

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Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
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Hypersensitivities01:30

Hypersensitivities

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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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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

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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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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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Related Experiment Video

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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Hypersensitivity reactions to heparins.

Purificación Gonzalez-Delgado1, Javier Fernandez

  • 1aAllergy Section, University General Hospital of Alicante bDepartment of Clinical Medicine, University Miguel Hernandez, ISABIAL - FISABIO, Alicante, Spain.

Current Opinion in Allergy and Clinical Immunology
|June 11, 2016
PubMed
Summary
This summary is machine-generated.

Hypersensitivity reactions to heparins, including delayed skin lesions and heparin-induced thrombocytopenia, are uncommon but require prompt diagnosis. Novel oral anticoagulants offer safe alternatives for patients experiencing these reactions.

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Area of Science:

  • Pharmacology
  • Immunology
  • Dermatology

Background:

  • Heparins are widely used anticoagulants, but hypersensitivity reactions can occur.
  • Hypersensitivity reactions to heparins range from cutaneous delayed reactions to severe heparin-induced thrombocytopenia.
  • Novel oral anticoagulants (NOACs) are associated with fewer hypersensitivity reactions compared to heparins.

Purpose of the Study:

  • To provide an update on hypersensitivity reactions to heparins and NOACs.
  • To emphasize diagnostic methods for these reactions.
  • To discuss the management of patients experiencing hypersensitivity reactions.

Main Methods:

  • Review of current literature on heparin and NOAC hypersensitivity.
  • Discussion of diagnostic tools including skin tests, provocation tests, skin biopsy, and in-vitro assays.
  • Analysis of management strategies and alternative anticoagulant options.

Main Results:

  • Cutaneous delayed hypersensitivity reactions affect up to 7.5% of patients receiving subcutaneous heparin.
  • Heparin-induced thrombocytopenia is an uncommon but severe reaction requiring specific diagnostic approaches.
  • Immediate hypersensitivity reactions to heparins are rare, and to NOACs even rarer, though exanthemas have been reported.

Conclusions:

  • Delayed skin lesions and heparin-induced thrombocytopenia are the most common hypersensitivity reactions to heparins.
  • Allergologic studies are valuable for diagnosing hypersensitivity and identifying safe alternatives.
  • Fondaparinux and NOACs represent potential safe alternatives for patients with heparin hypersensitivity.