Care of Patients with Immune Function Excess: Hypersensitivity (Allergy) and Autoimmunity
Hypersensitivities/Allergies
Increased or excessive response to the presence of an antigen to which the patient has been exposed
Degree of reaction ranging from uncomfortable to life threatening
Classified into 5 basic types
Type 1- Rapid Hypersensitivity Reactions-Most Common
Type 2- Cytotoxic Reactions
Type 3- Immune Complex Reactions
Type 4- Delayed Hypersensitivity Reactions
Type 5- Stimulatory Reactions
Type I: Rapid Hypersensitivity Reactions MOST COMMON (Also called atopic allergy)
Allergens can be contacted in these ways:
Inhaled (plant pollens, fungal spores, animal dander, house dust, grass, ragweed)
Ingested (foods, food additives, drugs)
Injected (bee venom, drugs, biologic substances)
Contacted (pollens, foods, environmental proteins)
Systemic
Other reactions may involve all blood vessels and bronchiolar smooth muscle, causing widespread blood vessel dilation, decreased cardiac output, and bronchoconstriction, which is known as anaphylaxis
Local
Some reactions occur just in the areas exposed to the antigen.
Such as mucous membranes of the nose and eyes, causing symptoms of rhinorrhea, sneezing and itchy red watery eyes.
Type I - Allergic Rhinitis- “Hay Fever”
Triggered by reactions to airborne allergens
Acute episodes can be “seasonal”
Chronic
Pathophysiology
Allergen
Histamine
Patient-Centered Collaborative Care NEED TO GET A DETAILED HISTORY
History
Onset and duration
Relationship to work, school and home environment
Possible exposure through hobbies, leisure time or sports activities
Tendency of type I allergic responses can be inherited, ask about the presence of allergies among close relatives
Physical Assessment
Rhinorrhea
Stuffy nose
Itchy, watery eyes
Nasal mucosa-appears swollen and pink
Headache, pressure over frontal and maxillary sinuses
Nasal secretions- dry,