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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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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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Irritable Bowel Syndrome I: Introduction01:17

Irritable Bowel Syndrome I: Introduction

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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
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Allergic Reactions02:06

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Other Disorders of Digestive System01:30

Other Disorders of Digestive System

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The gastrointestinal tract is susceptible to various disorders. If the lower esophageal sphincter is damaged, stomach acid can flow back into the esophagus, causing irritation and inflammation of the lining. This condition is called gastroesophageal reflux disease (known as heartburn) and may cause chest pain and difficulty swallowing. In the stomach, prolonged use of nonsteroidal anti-inflammatory drugs like aspirin, chronic alcohol consumption, bacterial infections such as Helicobacter...
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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation

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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
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Related Experiment Video

Updated: Mar 10, 2026

Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
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Non-syndromic hyper-IgE in children: A practical approach.

Riccardo Castagnoli1,2, Luca Pecoraro3, Carla Mastrorilli4

  • 1Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 27100, Italy.

The World Allergy Organization Journal
|March 9, 2026
PubMed
Summary

Elevated serum IgE in children can indicate common allergies or rare inborn errors of immunity (IEI). This review offers a diagnostic framework to differentiate these conditions, improving accuracy and early intervention for hyper-IgE syndromes.

Keywords:
Elevated IgE levelsHyper-IgEInborn errors of immunityallergyatopyparasitic infections

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Area of Science:

  • Pediatric Immunology
  • Clinical Diagnostics

Background:

  • Hyper-immunoglobulin E (Hyper-IgE) is defined by serum IgE >2000 IU/mL, posing a diagnostic challenge in pediatrics.
  • Elevated IgE can stem from atopic conditions, infections, or rarer inborn errors of immunity (IEI), specifically hyper-IgE syndrome (HIES).
  • Differentiating common causes from HIES is crucial for early-onset, severe, or treatment-resistant cases.

Purpose of the Study:

  • To provide a practical, structured framework for clinicians managing non-syndromic hyper-IgE in children.
  • To guide diagnostic reasoning through a systematic approach incorporating clinical history, examination, and investigations.
  • To facilitate timely referral for immunologic or genetic evaluation when IEI is suspected.

Main Methods:

  • Review of diverse etiologies of elevated serum IgE, including allergic diseases, infections, inflammatory disorders, malignancies, drug reactions, and environmental factors.
  • Proposal of a stepwise diagnostic algorithm to prioritize common causes and identify red flags for rare conditions.
  • Emphasis on detailed clinical history, physical examination, and targeted investigations.

Main Results:

  • A broad differential diagnosis exists for hyper-IgE, necessitating a systematic approach.
  • The proposed algorithm aids in distinguishing common conditions from IEI or other rare causes.
  • Increased awareness and a structured approach can improve diagnostic accuracy and reduce morbidity.

Conclusions:

  • A systematic diagnostic strategy is critical for managing hyper-IgE in children.
  • Early identification of IEI or rare conditions through a structured approach leads to better outcomes.
  • Further research is needed to refine diagnostic strategies and long-term follow-up protocols.