•-Melinda,a 17-years old girl, received a heart transplantation six months ago•-underwent immunosupression therapy all the time.•-Be sensitive to penicillin,bee stings and peanut.

Case:

Symptoms:

●large hives on her skin , angioedema(血管性水肿 ) sets in

●Within seconds, she is wheezing

and having difficulty breathing

●Spasm

penicilin allergy!

1.RIST test indicate the increase of lgE concentration in her serum.

2. Strongly positive lgE-specific Ab to penicillin were present on RAST test(allergic history: to penicillin, bee stings, and peanuts )

3. CT test,myocardium biopsy,blood test exclude heart failure.

• CT-----brain injury

• Cardiac biopsy-----rejection reaction

• Blood test -----infection

• MRI----- stroke ; aneurysm

Epinephrine can cure allergies .

Belong to type hypersensitivityⅠ A life-threatening allergic response that occurs within seconds to minutes of exposure to an antigen. early phase reaction ,mainly caused by histamine

Systemic anaphylaxis:

Mechanism of type I hypersensitivity

1. Allergy-induced period 2.  allergy-stimulated period 3. effect period

 

Type hypersensitivityⅠ

Therapy for allergy

• 1. Eliminate allergen (penicillin):stop using drug tie tourniquet on near heart direct.

• 2. reducing the quantity of IgE present :use anti-lgE antibody to prevent IgE binds to FcR I on mast cells and basophils . 超级连接

• 3. Epinephrine • 4. Prevent mast cell degranulation

Ca influx inhibitor (chromolyn sodium)Phosphodiesterase (theophylline)

anti-lgE antibody

Mast cell

anti-lgE antibody

Epinephrine ： first choice!

Mechanism:• α receptor excitation:收缩血管，血压升高，保证重要脏器血液供应

• β receptor excitation :Bronchodialat

• cAMP excitation :inhibit the release of mediators such as histamine.

plasma exchange

Find tick!!!