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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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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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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 Drug Reactions01:27

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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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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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Hypersensitivity Reactions: Delayed Hypersensitivity Reactions01:29

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

58
Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...
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Allergic or Hypersensitivity Reactions to Orthopaedic Implants.

Timothy T Roberts1, Colin M Haines, Richard L Uhl

  • 1From the Neurological Institute, Cleveland Clinic, Cleveland, OH (Dr. Roberts and Dr. Haines) and the Division of Orthopaedic Surgery, Albany Medical Center, Albany, NY (Dr. Uhl).

The Journal of the American Academy of Orthopaedic Surgeons
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Hypersensitivity reactions to orthopaedic implants are rare but challenging. While skin sensitivity to metals is common, deep-tissue reactions are less frequent and often mimic other implant failures.

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Area of Science:

  • Orthopaedic Surgery
  • Allergy and Immunology
  • Biomaterials Science

Background:

  • Allergic reactions to orthopaedic implants present diagnostic and therapeutic difficulties.
  • While 10-15% of the population has metal sensitivity, deep-tissue reactions to implants are uncommon.
  • The relationship between cutaneous metal sensitivity and deep-tissue implant reactions remains unclear.

Purpose of the Study:

  • To explore the nature and challenges of hypersensitivity reactions to orthopaedic implants.
  • To differentiate implant hypersensitivity from other causes of implant failure.
  • To highlight key allergens and clinical presentations associated with implant hypersensitivity.

Main Methods:

  • Review of existing literature on orthopaedic implant hypersensitivity.
  • Analysis of common allergens (nickel, cobalt, chromium) and non-metal compounds.
  • Discussion of diagnostic challenges and differential diagnoses.

Main Results:

  • Most implant hypersensitivity reactions are Type IV (delayed-type).
  • Nickel, cobalt, and chromium are primary metal allergens; non-metals like PMMA can also cause reactions.
  • Symptoms are nonspecific (pain, swelling, skin reactions), mimicking infection or loosening.

Conclusions:

  • Implant hypersensitivity is a diagnosis of exclusion, requiring ruling out infection, loosening, and other failures.
  • Persistent or early inflammatory symptoms post-surgery warrant suspicion of hypersensitivity.
  • Understanding these reactions is crucial for accurate diagnosis and patient management.