Hereditaryangioedema B
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This document discusses different types of chronic urticaria and angioedema, including their causes, characteristics, and treatments. It describes the difference between urticaria and angioedema, as well as chronic, physical, hereditary, and acquired forms. Diagnostic tests and treatments are covered for various conditions like cholinergic urticaria and hereditary angioedema. Antihistamines are recommended as first-line treatment for most acute cases, with steroids and immunosuppressants reserved for more severe situations.
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Physical urticaria
This document provides an overview of physical urticarias. It defines physical urticarias as urticarias induced by physical stimuli like pressure, vibration, heat, cold, etc. It describes several types of physical urticarias in detail, including dermographism (pressure urticaria), delayed pressure urticaria, and vibratory angioedema. For each type, it covers epidemiology, clinical features, pathogenesis, diagnostic testing, and treatment approaches. The document is a comprehensive review and classification of physical urticaria subtypes.
Chronic idiopathic urticaria; background & clinical presentation
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August 2, 2013Chronic idiopathic urticaria part 2: investigation and management
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Presented by Wat Mitthamsiri, M.D.
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Diagnosis and treatment of physical urticariaChulalongkorn Allergy and Clinical Immunology Research Group
Physical urticaria is a heterogeneous group of inducible conditions that includes symptomatic dermographism, cold contact urticaria, heat contact urticaria, delayed pressure urticaria, and others. Symptomatic dermographism is the most common subtype, where mechanical stroking of the skin causes a wheal and flare reaction with itch. Cold contact urticaria is triggered by skin contact with cold stimuli and can be diagnosed using an ice cube test. Treatment involves avoidance of physical triggers as well as antihistamines. For severe cases that are resistant to antihistamines, immunosuppressants or intravenous immunoglobulins may be considered.Urticaria
This case series describes 18 patients diagnosed with urticaria multiforme, an acute urticarial hypersensitivity syndrome characterized by annular, arcuate, and polycyclic urticarial lesions. Urticaria multiforme is often mistaken for erythema multiforme or serum sickness-like reactions due to similar presentations. However, urticaria multiforme lacks true target lesions or skin necrosis and responds well to antihistamines. The case series aims to distinguish the clinical features of urticaria multiforme from erythema multiforme and serum sickness-like reactions to aid accurate diagnosis.
chronic urticaria
This document discusses updates in the management of chronic urticaria. It begins with definitions of acute and chronic urticaria, noting that chronic urticaria is defined as symptoms lasting more than 6 weeks. It then discusses the classification of urticaria as either spontaneous or inducible. Mast cell activation and degranulation are identified as the key pathological mechanisms involved in urticaria symptoms. Autoimmune processes involving immunoglobulins such as IgG and IgE autoantibodies are also discussed as potential pathological factors in chronic urticaria. Guidelines for the treatment of urticaria have been updated.
Urticaria
This case involves a 25-year-old woman who presented to the emergency department with shortness of breath and an expanding rash. She has a history of asthma and allergies to aspirin and shellfish. On exam, she was tachypnic, hypertensive, and had periorbital edema and scattered wheals. Her symptoms and history are concerning for anaphylaxis.
Urticaria anaphylaxis
The document describes several studies related to chronic urticaria and solar urticaria. It summarizes:
1. A study that found increasing doses of levocetirizine and desloratadine up to 4 times the conventional dose improved symptoms in patients with difficult-to-treat chronic urticaria.
2. The case of a 16-year-old boy with solar urticaria that was refractory to oral antihistamines but partially improved with omalizumab treatment.
3. A study that treated 6 patients with severe chronic spontaneous urticaria resistant to other treatments with high-dose intravenous immunoglobulin, which improved symptoms.
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Physical urticaria
This document provides an overview of physical urticarias. It defines physical urticarias as urticarias induced by physical stimuli like pressure, vibration, heat, cold, etc. It describes several types of physical urticarias in detail, including dermographism (pressure urticaria), delayed pressure urticaria, and vibratory angioedema. For each type, it covers epidemiology, clinical features, pathogenesis, diagnostic testing, and treatment approaches. The document is a comprehensive review and classification of physical urticaria subtypes.
Chronic idiopathic urticaria; background & clinical presentation
Chronic idiopathic urticaria; background & clinical presentationChulalongkorn Allergy and Clinical Immunology Research Group
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Presented by Watt Mitthansiri, MD.
August 2, 2013Chronic idiopathic urticaria part 2: investigation and management
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Presented by Wat Mitthamsiri, M.D.
August23, 2013Diagnosis and treatment of physical urticaria
Diagnosis and treatment of physical urticariaChulalongkorn Allergy and Clinical Immunology Research Group
Physical urticaria is a heterogeneous group of inducible conditions that includes symptomatic dermographism, cold contact urticaria, heat contact urticaria, delayed pressure urticaria, and others. Symptomatic dermographism is the most common subtype, where mechanical stroking of the skin causes a wheal and flare reaction with itch. Cold contact urticaria is triggered by skin contact with cold stimuli and can be diagnosed using an ice cube test. Treatment involves avoidance of physical triggers as well as antihistamines. For severe cases that are resistant to antihistamines, immunosuppressants or intravenous immunoglobulins may be considered.Urticaria
This case series describes 18 patients diagnosed with urticaria multiforme, an acute urticarial hypersensitivity syndrome characterized by annular, arcuate, and polycyclic urticarial lesions. Urticaria multiforme is often mistaken for erythema multiforme or serum sickness-like reactions due to similar presentations. However, urticaria multiforme lacks true target lesions or skin necrosis and responds well to antihistamines. The case series aims to distinguish the clinical features of urticaria multiforme from erythema multiforme and serum sickness-like reactions to aid accurate diagnosis.
chronic urticaria
This document discusses updates in the management of chronic urticaria. It begins with definitions of acute and chronic urticaria, noting that chronic urticaria is defined as symptoms lasting more than 6 weeks. It then discusses the classification of urticaria as either spontaneous or inducible. Mast cell activation and degranulation are identified as the key pathological mechanisms involved in urticaria symptoms. Autoimmune processes involving immunoglobulins such as IgG and IgE autoantibodies are also discussed as potential pathological factors in chronic urticaria. Guidelines for the treatment of urticaria have been updated.
Urticaria
This case involves a 25-year-old woman who presented to the emergency department with shortness of breath and an expanding rash. She has a history of asthma and allergies to aspirin and shellfish. On exam, she was tachypnic, hypertensive, and had periorbital edema and scattered wheals. Her symptoms and history are concerning for anaphylaxis.
Urticaria anaphylaxis
The document describes several studies related to chronic urticaria and solar urticaria. It summarizes:
1. A study that found increasing doses of levocetirizine and desloratadine up to 4 times the conventional dose improved symptoms in patients with difficult-to-treat chronic urticaria.
2. The case of a 16-year-old boy with solar urticaria that was refractory to oral antihistamines but partially improved with omalizumab treatment.
3. A study that treated 6 patients with severe chronic spontaneous urticaria resistant to other treatments with high-dose intravenous immunoglobulin, which improved symptoms.
clinical approach to Urticaria AND ANGIODEMA
This document provides information on urticaria (hives), including its definition, classification, clinical presentation, pathophysiology, diagnosis and management. Some key points:
- Urticaria is defined as a raised, itchy skin lesion consisting of wheals (swellings) and flares caused by localized swelling in the skin. Individual hives can last 30 minutes to 36 hours.
- Urticaria is classified as acute (lasting less than 6 weeks) or chronic (daily or almost daily for over 6 weeks). Common types include ordinary, physical, cholinergic, urticarial vasculitis, and angioedema.
- Diagnosis is based on history and physical
URTICARIA AND CONTACT DERMATITS-MEDICAL-BIOMEDICAL-MATHANKUMAR S
Urticaria, commonly known as hives, is a skin rash characterized by itchy, raised bumps that can appear anywhere on the body. It is often caused by allergic reactions. Chronic hives persist for over six weeks, while acute hives resolve within six weeks. Treatment involves identifying and avoiding triggers as well as using antihistamines to reduce symptoms. More severe cases may require stronger medications like corticosteroids. Contact dermatitis is skin irritation or rash caused by contact with an allergen or irritant and can be classified as allergic, irritant, or photocontact dermatitis.
Approach to chronic urticaria
Chronic urticaria lasts longer than 6 weeks and presents as recurrent hives and angioedema occurring more than 3 days a week. It can be classified as inducible or spontaneous. Inducible types are triggered by specific physical stimuli like pressure, cold, heat, or vibration. Chronic urticaria is considered after ruling out look-alike conditions such as urticarial vasculitis and other autoinflammatory syndromes. Its evaluation involves considering potential systemic triggers or underlying causes.
Resistant urticaria tutorial ppt.
This document summarizes information on chronic urticaria, including its prevalence, causes, impact on quality of life, and treatment options. It notes that chronic urticaria affects approximately 1% of people with acute urticaria and has a significant negative impact on quality of life. First-line treatment includes non-sedating antihistamines, sometimes at higher off-label doses. If patients do not respond sufficiently to antihistamines alone, second-line options include doxepin, leukotriene antagonists, short-term corticosteroids, dapsone, sulfasalazine, and narrowband UVB phototherapy. The document reviews evidence on the efficacy and safety of these second-
Urticaria part I
This document provides information on urticaria (hives), including definitions, epidemiology, pathogenesis, classification, and specific types. Some key points:
- Wheals are central swellings surrounded by erythema that itch or burn and resolve within 24 hours. Angioedema causes swelling below the skin that takes longer to resolve.
- Urticaria prevalence is 15-25% lifetime and chronic urticaria affects 1% annually, more common in adults and women.
- Pathogenesis involves skin mast cell degranulation in response to triggers like allergens, autoantibodies, neuropeptides.
- Classification includes acute (<6 weeks), chronic (>6 weeks),
Angioedema
Angioedema is swelling under the skin or mucus membranes that is similar to hives. It can affect different parts of the body including the face, throat, and intestines. There are three main types - types I and II are hereditary and involve a deficiency or dysfunction of the C1 inhibitor protein, while type III has no clear cause. Symptoms range from swelling of the skin to potentially life-threatening swelling of the throat. Treatment depends on the underlying cause, but may include antihistamines, corticosteroids, C1 inhibitor concentrate for hereditary types, or epinephrine in emergencies threatening the airway.
Urticaria
This document summarizes different types of urticaria (hives). It describes urticaria as pink, itchy swellings (wheals) that can occur anywhere on the body and last less than 24 hours. It divides urticaria into acute (<6 weeks) and chronic (>6 weeks) forms. It discusses physical urticarias like cold, solar, heat, cholinergic, aquagenic, dermographism, and delayed pressure urticaria. It also covers hypersensitivity, autoimmune, pharmacological, contact, and latex allergy urticaria. The document provides details on presentation, course, complications, differential diagnosis, investigations, and management of different types of urticaria.
Angioedema
To download my ANIMATED presenation VISIT
https://www.dropbox.com/s/5rfb35jcq45uexa/ANIAngioedema.pptx?m
To watch my ANIMATED vedio presentation VISIT
www.youtube.com/watch?v=hlqNGUGphuk
Thank you
Vaccini
- The risk of anaphylaxis following vaccination is rare, affecting less than 1 in 100,000 people. However, it can occur in any patient.
- A retrospective study found that only 3 of 135 patients who experienced allergic-like events after vaccination were referred for suspected anaphylaxis, suggesting that guidelines may overestimate the risk.
- Most allergic-like events that occur more than 1 hour after vaccination are not likely IgE-mediated reactions and should not be managed as such. Skin testing in these patients can be misleading.
Journal club: Chronic urticaria and autoimmunity
Journal club: Chronic urticaria and autoimmunityChulalongkorn Allergy and Clinical Immunology Research Group
The study evaluated 195 patients with chronic idiopathic urticaria to determine the correlation between biomarkers of autoimmunity like ANA, ATA, and disease severity. It found that 46% of refractory patients tested positive for the CU Index compared to 30% of controlled patients. Combinations of biomarkers had slightly better sensitivity and negative predictive value than individual biomarkers for identifying refractory cases. The CU Index alone had the best specificity and positive predictive value.Common ocular allergy
This document summarizes common ocular allergies and their treatment. It discusses the anatomy of the eye and approaches to diagnosing itchy eyes. Common allergic diseases include allergic conjunctivitis, vernal keratoconjunctivitis, atopic dermatitis, and giant papillae conjunctivitis. Allergic conjunctivitis is caused by an IgE-mediated inflammatory response and accounts for many seasonal cases related to pollen. Treatment includes cold compresses, artificial tears, topical antihistamines, mast cell stabilizers, topical corticosteroids, and immunomodulators for severe cases.
Angioedema
The document discusses angioedema, including its definition as transient swelling in deep dermis or subcutaneous tissue resulting from vascular leakage. It outlines the pathophysiology of angioedema involving mast cell activation and the kallikrein-kinin and renin-angiotensin systems. It specifically examines ACE inhibitor-induced angioedema, noting its incidence, risk factors, types based on drug structure and pharmacokinetics, and mechanisms of action related to inhibition of angiotensin-converting enzyme. The diagnosis of ACE inhibitor-induced angioedema is described based on its characteristic symptoms and sites of involvement.
Case presentation on toxic epidermal necrolysis
Here are the potential acute and chronic complications of toxic epidermal necrolysis (TEN):
Acute complications:
- Similar to burns, depends on extent of involvement
- Massive fluid and electrolyte loss
- Prerenal failure
- Hypercatabolism
- Mucous membrane involvement
- Bacterial infection, sepsis
Chronic complications:
- Ocular complications (up to 30%), including conjunctivitis, ectropion, entropion, corneal scarring
- Wound infection
- Nail dystrophy
- Scarring alopecia
- Esophageal stricture
Ocular allergy
Allergic conjunctivitis is a common bilateral inflammatory condition of the conjunctiva caused by an IgE-mediated allergic response. It can be seasonal due to pollen allergens or perennial due to indoor allergens like dust mites. Symptoms include itching, redness, tearing and blurred vision. Treatment involves avoidance of allergens, artificial tears, oral antihistamines and topical mast cell stabilizers and antihistamines. Atopic keratoconjunctivitis is a chronic inflammation of the conjunctiva and eyelids associated with atopic dermatitis. It presents with itching, mucus discharge, and papillae on the tarsal conjunctiva.
Chronic spontaneous urticaria (part 1)
1) The document outlines an overview of chronic spontaneous urticaria (CSU), including its epidemiology, clinical presentation, natural history, and pathogenesis.
2) CSU affects approximately 0.5-1% of the general population and is more common in adults than children, with a peak age of onset between 20-40 years.
3) The pathogenesis of CSU is not fully understood but is believed to involve inappropriate activation of mast cells and basophils by autoantibodies, leading to the release of inflammatory mediators that cause wheals and angioedema.
Stevens Johnson syndrome and laboratory diagnostic tools
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This case study describes a 7-year-old Thai boy who presented with a rash, fever, and seizures. He was initially diagnosed with epilepsy and treated with phenytoin, cef-3, and azithromycin. His condition worsened with the development of Steven Johnson Syndrome. Testing found he was positive for phenytoin on an ELISPOT test. The document discusses SJS pathogenesis, definitions, investigations including the ALDEN algorithm and ELISPOT test, and management of the patient's condition.Adult onset stills disease
This case report describes an adult female patient presenting with fever, cough, joint pain, and skin rash. Laboratory tests revealed elevated white blood cell count with neutrophilia. Imaging showed pulmonary nodules. She fulfilled criteria for adult onset Still's disease (AOSD), which can involve the lungs in 50% of cases. AOSD is diagnosed based on Yamaguchi or Fautrel criteria, which this patient met. Treatment involves corticosteroids and immunosuppressants to control the abnormal cytokine levels caused by AOSD. Pulmonary involvement requires close monitoring for serious complications like acute respiratory distress syndrome.
Toxic shock syndrome
Toxic shock syndrome is a life-threatening illness caused by toxins from Staphylococcus aureus or Streptococcus pyogenes bacteria. It causes high fever, low blood pressure, rash, and problems affecting multiple organ systems. While often associated with tampon use, it can result from other infections as well. Prompt treatment includes antibiotics, IV fluids, and organ support. Nurses closely monitor patients and management includes infection control, fluid resuscitation, and prevention of recurrence.
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My Urticaria In December
The document discusses urticaria (hives), including its definition, classification as acute or chronic, pathophysiology involving histamine release from mast cells, causes such as allergies, infections, and physical stimuli, associated conditions like angioedema, evaluation through patient history and physical exam, and treatment focusing on identification and avoidance of triggers as well as antihistamines.
Urticaria
Urticaria and angioedema are conditions characterized by wheals (hives) and swelling in the skin. Urticaria involves superficial swelling in the upper dermis, while angioedema involves deeper swelling in the dermis and subcutaneous tissue. They can be acute, recurrent, or chronic. Causes include allergic reactions, physical stimuli, infections, medications, foods, emotional stress, and autoimmune factors. Diagnosis involves taking a thorough history regarding triggers, medications, and associated symptoms.
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clinical approach to Urticaria AND ANGIODEMA
This document provides information on urticaria (hives), including its definition, classification, clinical presentation, pathophysiology, diagnosis and management. Some key points:
- Urticaria is defined as a raised, itchy skin lesion consisting of wheals (swellings) and flares caused by localized swelling in the skin. Individual hives can last 30 minutes to 36 hours.
- Urticaria is classified as acute (lasting less than 6 weeks) or chronic (daily or almost daily for over 6 weeks). Common types include ordinary, physical, cholinergic, urticarial vasculitis, and angioedema.
- Diagnosis is based on history and physical
URTICARIA AND CONTACT DERMATITS-MEDICAL-BIOMEDICAL-MATHANKUMAR S
Urticaria, commonly known as hives, is a skin rash characterized by itchy, raised bumps that can appear anywhere on the body. It is often caused by allergic reactions. Chronic hives persist for over six weeks, while acute hives resolve within six weeks. Treatment involves identifying and avoiding triggers as well as using antihistamines to reduce symptoms. More severe cases may require stronger medications like corticosteroids. Contact dermatitis is skin irritation or rash caused by contact with an allergen or irritant and can be classified as allergic, irritant, or photocontact dermatitis.
Approach to chronic urticaria
Chronic urticaria lasts longer than 6 weeks and presents as recurrent hives and angioedema occurring more than 3 days a week. It can be classified as inducible or spontaneous. Inducible types are triggered by specific physical stimuli like pressure, cold, heat, or vibration. Chronic urticaria is considered after ruling out look-alike conditions such as urticarial vasculitis and other autoinflammatory syndromes. Its evaluation involves considering potential systemic triggers or underlying causes.
Resistant urticaria tutorial ppt.
This document summarizes information on chronic urticaria, including its prevalence, causes, impact on quality of life, and treatment options. It notes that chronic urticaria affects approximately 1% of people with acute urticaria and has a significant negative impact on quality of life. First-line treatment includes non-sedating antihistamines, sometimes at higher off-label doses. If patients do not respond sufficiently to antihistamines alone, second-line options include doxepin, leukotriene antagonists, short-term corticosteroids, dapsone, sulfasalazine, and narrowband UVB phototherapy. The document reviews evidence on the efficacy and safety of these second-
Urticaria part I
This document provides information on urticaria (hives), including definitions, epidemiology, pathogenesis, classification, and specific types. Some key points:
- Wheals are central swellings surrounded by erythema that itch or burn and resolve within 24 hours. Angioedema causes swelling below the skin that takes longer to resolve.
- Urticaria prevalence is 15-25% lifetime and chronic urticaria affects 1% annually, more common in adults and women.
- Pathogenesis involves skin mast cell degranulation in response to triggers like allergens, autoantibodies, neuropeptides.
- Classification includes acute (<6 weeks), chronic (>6 weeks),
Angioedema
Angioedema is swelling under the skin or mucus membranes that is similar to hives. It can affect different parts of the body including the face, throat, and intestines. There are three main types - types I and II are hereditary and involve a deficiency or dysfunction of the C1 inhibitor protein, while type III has no clear cause. Symptoms range from swelling of the skin to potentially life-threatening swelling of the throat. Treatment depends on the underlying cause, but may include antihistamines, corticosteroids, C1 inhibitor concentrate for hereditary types, or epinephrine in emergencies threatening the airway.
Urticaria
This document summarizes different types of urticaria (hives). It describes urticaria as pink, itchy swellings (wheals) that can occur anywhere on the body and last less than 24 hours. It divides urticaria into acute (<6 weeks) and chronic (>6 weeks) forms. It discusses physical urticarias like cold, solar, heat, cholinergic, aquagenic, dermographism, and delayed pressure urticaria. It also covers hypersensitivity, autoimmune, pharmacological, contact, and latex allergy urticaria. The document provides details on presentation, course, complications, differential diagnosis, investigations, and management of different types of urticaria.
Angioedema
To download my ANIMATED presenation VISIT
https://www.dropbox.com/s/5rfb35jcq45uexa/ANIAngioedema.pptx?m
To watch my ANIMATED vedio presentation VISIT
www.youtube.com/watch?v=hlqNGUGphuk
Thank you
Vaccini
- The risk of anaphylaxis following vaccination is rare, affecting less than 1 in 100,000 people. However, it can occur in any patient.
- A retrospective study found that only 3 of 135 patients who experienced allergic-like events after vaccination were referred for suspected anaphylaxis, suggesting that guidelines may overestimate the risk.
- Most allergic-like events that occur more than 1 hour after vaccination are not likely IgE-mediated reactions and should not be managed as such. Skin testing in these patients can be misleading.
Journal club: Chronic urticaria and autoimmunity
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The study evaluated 195 patients with chronic idiopathic urticaria to determine the correlation between biomarkers of autoimmunity like ANA, ATA, and disease severity. It found that 46% of refractory patients tested positive for the CU Index compared to 30% of controlled patients. Combinations of biomarkers had slightly better sensitivity and negative predictive value than individual biomarkers for identifying refractory cases. The CU Index alone had the best specificity and positive predictive value.Common ocular allergy
This document summarizes common ocular allergies and their treatment. It discusses the anatomy of the eye and approaches to diagnosing itchy eyes. Common allergic diseases include allergic conjunctivitis, vernal keratoconjunctivitis, atopic dermatitis, and giant papillae conjunctivitis. Allergic conjunctivitis is caused by an IgE-mediated inflammatory response and accounts for many seasonal cases related to pollen. Treatment includes cold compresses, artificial tears, topical antihistamines, mast cell stabilizers, topical corticosteroids, and immunomodulators for severe cases.
Angioedema
The document discusses angioedema, including its definition as transient swelling in deep dermis or subcutaneous tissue resulting from vascular leakage. It outlines the pathophysiology of angioedema involving mast cell activation and the kallikrein-kinin and renin-angiotensin systems. It specifically examines ACE inhibitor-induced angioedema, noting its incidence, risk factors, types based on drug structure and pharmacokinetics, and mechanisms of action related to inhibition of angiotensin-converting enzyme. The diagnosis of ACE inhibitor-induced angioedema is described based on its characteristic symptoms and sites of involvement.
Case presentation on toxic epidermal necrolysis
Here are the potential acute and chronic complications of toxic epidermal necrolysis (TEN):
Acute complications:
- Similar to burns, depends on extent of involvement
- Massive fluid and electrolyte loss
- Prerenal failure
- Hypercatabolism
- Mucous membrane involvement
- Bacterial infection, sepsis
Chronic complications:
- Ocular complications (up to 30%), including conjunctivitis, ectropion, entropion, corneal scarring
- Wound infection
- Nail dystrophy
- Scarring alopecia
- Esophageal stricture
Ocular allergy
Allergic conjunctivitis is a common bilateral inflammatory condition of the conjunctiva caused by an IgE-mediated allergic response. It can be seasonal due to pollen allergens or perennial due to indoor allergens like dust mites. Symptoms include itching, redness, tearing and blurred vision. Treatment involves avoidance of allergens, artificial tears, oral antihistamines and topical mast cell stabilizers and antihistamines. Atopic keratoconjunctivitis is a chronic inflammation of the conjunctiva and eyelids associated with atopic dermatitis. It presents with itching, mucus discharge, and papillae on the tarsal conjunctiva.
Chronic spontaneous urticaria (part 1)
1) The document outlines an overview of chronic spontaneous urticaria (CSU), including its epidemiology, clinical presentation, natural history, and pathogenesis.
2) CSU affects approximately 0.5-1% of the general population and is more common in adults than children, with a peak age of onset between 20-40 years.
3) The pathogenesis of CSU is not fully understood but is believed to involve inappropriate activation of mast cells and basophils by autoantibodies, leading to the release of inflammatory mediators that cause wheals and angioedema.
Stevens Johnson syndrome and laboratory diagnostic tools
Stevens Johnson syndrome and laboratory diagnostic toolsChulalongkorn Allergy and Clinical Immunology Research Group
This case study describes a 7-year-old Thai boy who presented with a rash, fever, and seizures. He was initially diagnosed with epilepsy and treated with phenytoin, cef-3, and azithromycin. His condition worsened with the development of Steven Johnson Syndrome. Testing found he was positive for phenytoin on an ELISPOT test. The document discusses SJS pathogenesis, definitions, investigations including the ALDEN algorithm and ELISPOT test, and management of the patient's condition.Adult onset stills disease
This case report describes an adult female patient presenting with fever, cough, joint pain, and skin rash. Laboratory tests revealed elevated white blood cell count with neutrophilia. Imaging showed pulmonary nodules. She fulfilled criteria for adult onset Still's disease (AOSD), which can involve the lungs in 50% of cases. AOSD is diagnosed based on Yamaguchi or Fautrel criteria, which this patient met. Treatment involves corticosteroids and immunosuppressants to control the abnormal cytokine levels caused by AOSD. Pulmonary involvement requires close monitoring for serious complications like acute respiratory distress syndrome.
Toxic shock syndrome
Toxic shock syndrome is a life-threatening illness caused by toxins from Staphylococcus aureus or Streptococcus pyogenes bacteria. It causes high fever, low blood pressure, rash, and problems affecting multiple organ systems. While often associated with tampon use, it can result from other infections as well. Prompt treatment includes antibiotics, IV fluids, and organ support. Nurses closely monitor patients and management includes infection control, fluid resuscitation, and prevention of recurrence.
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My Urticaria In December
The document discusses urticaria (hives), including its definition, classification as acute or chronic, pathophysiology involving histamine release from mast cells, causes such as allergies, infections, and physical stimuli, associated conditions like angioedema, evaluation through patient history and physical exam, and treatment focusing on identification and avoidance of triggers as well as antihistamines.
Urticaria
Urticaria and angioedema are conditions characterized by wheals (hives) and swelling in the skin. Urticaria involves superficial swelling in the upper dermis, while angioedema involves deeper swelling in the dermis and subcutaneous tissue. They can be acute, recurrent, or chronic. Causes include allergic reactions, physical stimuli, infections, medications, foods, emotional stress, and autoimmune factors. Diagnosis involves taking a thorough history regarding triggers, medications, and associated symptoms.
Urticaria&angioedema(copiedsenior)
1. Urticaria and angioedema can be caused by allergic triggers like foods, drugs, infections, insect bites, or physical factors. Chronic urticaria lasts longer than 6 weeks.
2. Chronic urticaria is difficult to determine the cause of and may last for years. Physical urticarias are triggered by environmental stimuli and are often resistant to corticosteroids.
3. Angioedema causes swelling in the deep layers of the skin and tissues. It can be caused by allergic, pseudoallergic, or nonallergic mechanisms. Treatment depends on the mechanism but may include antihistamines, corticosteroids, or epinephrine to prevent air
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The document summarizes different types of hypersensitivity and allergic reactions. It describes Type I reactions as rapid hypersensitivity reactions mediated by IgE antibodies, including seasonal allergies, food allergies, and anaphylaxis. Type II reactions are cytotoxic and involve autoantibodies against self cells. Type III reactions occur when immune complexes form in blood vessels and cause tissue damage. Type IV reactions are delayed hypersensitivity responses mediated by T cells without antibodies or complement involvement, like contact dermatitis. Type V reactions involve inappropriate stimulation of cell receptors by autoantibodies. The document also discusses specific conditions like latex allergy, allergic rhinitis, Sjogren's syndrome, and Goodpasture's syndrome
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- Anaphylaxis can involve cutaneous, respiratory, or cardiovascular symptoms alone or in combination. Symptoms may not always include rash.
- Patients at risk of severe or biphasic anaphylaxis may require overnight observation after treatment.
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This document provides an overview of urticaria, angioedema, and anaphylaxis. It defines the conditions, describes their pathophysiology as being related to mast cell degranulation and mediator release, and classifies them as acute, chronic, physical, or hereditary. Epidemiology, clinical manifestations, diagnostic approach, differential diagnosis, treatment involving antihistamines and epinephrine, and prevention are discussed. Anaphylaxis is emphasized as a medical emergency requiring immediate epinephrine injection and supportive care.
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1. Acute post-streptococcal glomerulonephritis (APSGN) is a type of acute nephritic syndrome that occurs after a streptococcal infection.
2. It is characterized by edema, hematuria, proteinuria, and decreased kidney function.
3. The infection triggers an immune response where antibodies form complexes that deposit along the glomerular basement membrane, causing inflammation and kidney damage.
lecture notes
Based on the information provided, the most likely diagnosis is idiopathic nephrotic syndrome. Some key points:
- The child is 5 years old, which is a common age for nephrotic syndrome to present.
- There is generalized body swelling (edema), hypoalbuminemia (serum albumin 17), heavy proteinuria (4+ on urine dipstick), and hyperlipidemia (cholesterol 12), meeting the criteria for nephrotic syndrome.
- No obvious underlying cause is identified, so it is likely primary/idiopathic in nature.
The main possible etiologies/causes of nephrotic syndrome include minimal change disease, focal segment
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Urticaria - Dr Maryam K Alnajem
Haya is a 47-year-old woman presenting with a 3-day history of widespread, pruritic skin rash with individual lesions lasting around 8 hours. Khalid is a 28-year-old man with a 6-month history of periodic swelling on his body accompanied by itching and raised lesions that disappear within minutes to hours and are worse with exercise or embarrassment. Urticaria is characterized by transient skin or mucosal swellings due to plasma leakage and can be caused by allergies, autoimmunity, drugs, dietary factors, or infections. Treatment involves antihistamines as first-line and corticosteroids, epinephrine, or monoclonal antibodies as later options for severe or
Nephrotic Syndrome
Patients with nephrotic syndrome have an increased risk of thromboembolic complications due to alterations in the coagulation system. They experience a loss of natural anticoagulants like antithrombin III and protein S, as well as an increase in procoagulants like fibrinogen. Platelets also become hyperactive due to these changes. Together, this shifts the balance towards a prothrombotic state. As a result, nephrotic patients commonly develop deep vein thromboses and pulmonary embolisms. Renal vein thrombosis also occurs in around 5-15% of cases. Timely treatment and management of coagulation abnormalities can help reduce these risks.
Parasitic lung diseases in India by Dr. S.K Jindal | Jindal Chest Clinic
Parasitic lung diseases are infections of the lung that are specific to different parasites and are brought on by either a state of the immune system or the parasites' transient presence in the lung. This presentation gives an overview on "Parasitic lung diseases in India" including risk factors, treatment, etc. For more information, please contact us: 9779030507.
ACUTE ILLNESS MANGEMENT nursing ambulatory care.pptx
The document discusses the management of acute abdominal pain and bradycardia in the emergency department. It provides details on the causes, signs, symptoms, diagnostic workup and treatment of common conditions that present with abdominal pain such as appendicitis, cholecystitis, pancreatitis, and diverticulitis. It also outlines the nursing role in assessing and managing patients with abdominal pain. Additionally, it covers the definition, criteria, causes, complications and treatment of anaphylaxis and bradycardia, with a focus on the importance of promptly administering epinephrine for anaphylaxis.
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Acute rheumatic fever is an inflammatory disease that can develop following a streptococcal infection such as strep throat or scarlet fever. It primarily affects the heart, joints, brain, and skin. Common symptoms include fever, joint pain, abnormal heart rhythms, involuntary movements, and rashes. It is most common in children ages 5-15. Treatment involves antibiotics to treat the initial infection, medications to reduce inflammation and symptoms, and long-term preventative antibiotics to avoid recurrence. Nursing care focuses on reducing fever, monitoring for cardiac complications, maintaining activity and rest, and educating patients and families.
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Parasitic lung diseases in India by Dr. S.K Jindal | Jindal Chest Clinic
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- 7. Chronic Urticaria and Angioedema by the Urticaria and Angioedema Committee © AAAAI 2006
- 9. Chronic Urticaria/Angioedema (Mast cell driven) Urticaria & Angioedema Urticaria Angioedema 40% 50% 10 %
- 11. Drug Induced Urticaria / Angioedema Bradykinin responsible for swelling in angioedema in patients with HAE Kaplan A et al J Allergy Clin Immunol 2002;109:195-209 Angiotensin converting enzyme (ACE) inhibitors interfere with metabolism of bradykinin via interference with kininase Ii Gavras I Kidney Int 1992; 42:1020-29 Patients on angiotensin converting enzyme blockers (ARBs) may not be at risk for angioedema Gavras I Arch Int Med 2003; 163: 240-1
- 17. (Ecalantide)
- 33. Vibratory angioedema Lawlor F et al Br J Dermatol 1989; 120: 93-99 Vortex to induce angioedema in a patient with swelling of hands while driving car
- 35. B Cell Lymphoma Associated with Symptomatic Dermatographism Patient’s dermatographism resistant to fexofenadine and cetirizine sent a clue that something else may be causing her itching and hives.
- 37. Antibodies associated with urticaria IgG auto ab to IgE receptor 35-40% Antithyroglobulin Ab 8% Antimicrosomal Ab 5%