Hypersensitivity and Allergic Fungal Manifestations: Diagnostic Approaches
Johan A. Maertens, Kieren A. Marr in Diagnosis of Fungal Infections, 2007
Sensitivity to a variety of fungi is known to be a factor in allergic rhinitis, allergic fungal sinusitis (AFS), allergic bronchopulmonary mycoses (ABPMs), hypersensitivity pneumonitis, and asthma. Currently prevalent diagnostic tools and novel diagnostic approaches being developed for hypersensitivity and allergic fungal manifestations are reviewed. Exposure to fungal antigens can elicit both humoral and cellular immune responses. Humoral response to allergenic fungi is polyclonal in nature and is characterized by type I and type III hypersensitivity reactions. AFS is an increasingly recognized form of hypersensitivity disease, reported throughout the world. Allergic syndromes to fungi, mainly A. fumigatus (ABPA) and rarer organisms, such as Penicillium, Candida, Curvularia, Helminthosporium spp., or, reported, Saccharomyces cerevisiae, occurring in asthmatic patients as eosinophilic pneumonia are termed ABPMs. ABPA is one of the well-studied ABPMs, which is an immunological disease and depicts the immune mechanisms similar to that of asthma.
Immunologically Mediated Diseases and Allergic Reactions
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
The immunological mechanisms that mediate allergic and autoimmune responses are identical to the responses to infectious agents, only the antigens are different. This chapter discusses the deleterious effects of “inappropriate” responses to self-constituents and overactive immune responses to environmental antigens. Autoimmune disease affects one to two percent of the United States population. The pathogenesis of most autoimmune diseases involves one or more of the mechanisms that mediate hypersensitivity reactions. The hypersensitivities are inappropriate or excessive immune responses that produce tissue injury upon secondary or subsequent contact with an agent that is not intrinsically harmful. Treatment with anti-IgE antibodies has also been shown to be effective in decreasing serum IgE levels and in blocking IgE-mediated allergic symptoms in humans. Type 1 hypersensitivity, exemplified by hay fever, is due to the formation of excessive amounts of IgE antibodies specific for an allergen.
Infestations, insect bites, and stings
Anupam Das, Sumit Sethi in Concise Dermatology, 2021
The skin reacts to the attacks of arthropods and small invertebrates and depends partly on the extent and severity of the attack and, particularly, on the immune status of the individual attacked. Unfortunately, it is all too common for patients to be suspected of having scabies and to be prescribed treatment by inexperienced clinicians when the underlying diagnosis is, in fact, eczema, and the patient's skin deteriorates further as a result. Treatment should be instituted as soon as the diagnosis has been made to prevent the infestation from spreading. The stings of wasps and bees are usually quite painful. The stung part may become very swollen a short time after the sting and when hypersensitivity is present, the individual may develop a widespread reaction. Papular urticaria is a term used to describe a recurrent, disseminated, itchy papular eruption due to either insect bites or hypersensitivity to them. A major problem with insect bites is their intense itchiness.
Type IV Hypersensitivity to Gold Weight Upper-Eyelid Implant: Case Report and Review of the Literature
Published in Ocular Immunology and Inflammation, 2018
Caroline L. S. Kilduff, Edward J. Casswell, Richard Imonikhe, Branka Marjanovic
Purpose: Complications associated with gold-weight insertion for lagophthalmos are uncommon, recent reports have provided evidence to suggest that type IV hypersensitivity to gold can cause a persistent inflammatory reaction. Methods: We present a case of a 46-year-old man who experienced persistent post-operative inflammation, and summarize previously documented cases. This patient underwent uncomplicated insertion of an upper eyelid gold weight for right-sided facial nerve palsy. He had no allergies or implanted metalwork. Post-operatively erythema was noted at seven-weeks and did not resolve. The weight was removed after six-months. Results: The histopathological findings were in keeping with type IV hypersensitivity and similar to previous cases. Conclusions: Although infrequent, this complication has poor outcomes. The definitive management is removal of the weight. Information regarding implanted gold, and previous reactions should be elicited pre-operatively. Type IV hypersensitivity should be considered in patients with persistent inflammation that do not respond to antibiotic or steroid therapy.
Future Directions for Understanding Adolescent Bipolar Spectrum Disorders: A Reward Hypersensitivity Perspective
Published in Journal of Clinical Child & Adolescent Psychology, 2019
Lauren B. Alloy, Robin Nusslock
The idea that bipolar spectrum disorders (BSDs) are characterized by enhanced sensitivity to rewarding stimuli is at the core of the reward hypersensitivity model, one of the most prominent and well-supported theories of BSDs. In this article, we present the reward hypersensitivity model of BSDs, review evidence supporting it, discuss its relevance to explaining why BSDs typically begin and consolidate during the period of adolescence, and consider three major unresolved issues for this model that provide important directions for future research. Finally, we present integrations of the reward hypersensitivity model with circadian rhythm and immune system models that should provide greater understanding of the mechanisms involved in BSDs, and then suggest additional directions for future research deriving from these integrated models.
Successful rapid oral desensitization for dual hypersensitivity to isoniazid and rifampin while treating central nervous system tuberculosis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Moni Roy, Sharjeel Ahmad, Ashish Kumar Roy
Tuberculosis of the central nervous system (CNS-TB) is a critical disease with poor prognosis if not diagnosed and treated early. A regimen of drugs with good CNS penetration is required for treatment. Treatment options are limited in case of hypersensitivity reaction of the recommended regimen. We are reporting a rare instance where a patient developed hypersensitivity to both first line agents (isoniazid and rifampin) for CNS-TB and was successfully desensitized against both these medications to complete the treatment course using the rapid desensitization process. There have been reported cases of desensitization to anti tuberculous medications in cases with pulmonary tuberculosis and hypersensitivity reaction. In this review article we discuss the prior used methods of slow and rapid desensitization in case on non-CNS tuberculosis infections. This is the first reported case to use similar method of rapid desensitization in treatment of central nervous system infection.
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