Allergy & Asthma a slide show

Dr Asha Pherwani

Consultant

PD Hinduja National Hospital

Allergy – a multi-headed monster

Up to the 19th century

Few cases of allergic cold

Increasing rapidly

More in the westernized countries

Allergic diseases

• Disturbing to the patient

• Occassionally fatal

• Alarming facts * observation of new allergies

* nuts, soya, latex, gelatin and other

• What is allergy?

When the body encountes an allergen

An allergen is a protein different from the body

The body reacts

Favourable result ---immunity

If the body over-reacts----harmful

allergy

Serum IgE levels are high in allergies

IgE attaches itself to mast cells

Atopic dermatitis

The one airway theory

Tell tale signs of allergy

Rhinitis

Very common

AR in children

May predicit asthma

Allergic cold

Eye lid allergy

Drug allergyDrug allerg: Isonex (SJ) / methotrexate

Insulin allergy

Pressure urticaria

Contact dermatitis

Nickel allergy

Nicke / copper allergy

Insect allergy

What does this slide project ?

House dust mite

Pollen allergy

pollens

Rage weedChrysanthemum

POLLENS

Food Reactions

A diverse spectrum

Food reactions

Immunological

IgE

Non-IgET cells, macrophages

Non-immunological

Drugsdose dependent

Enzyme deficiencies

Food poisoning- Toxic

Prevalence of food allergy

• IgE mediated allergy

• 1-2.5% of adults

• 6-8% of children

Systems not only restricted to GIT

• Gastrointestinal

• Respiratory

• Skin

• Cardiovascular

• General-Anaphylaxis

• General• Itching, tingling,

swelling lips, mouth• Tongue & Throat

swelling• Angio-oedema

(swelling, puffiness)• Nausea• Vomiting• Diarrhoea• Abdominal pain,

cramps• Colic , reflux

RrespiratoryThroat tightnessWheezing, asthmaShortness of breathRepetitive coughingCyanosis- turning blue

Nasal congestion

Runny nose

Cough

• Skin reactions

• Pruritus – itching

• Flushing

• Urticaria – rash

• Angio-oedema- tissue swelling

• Eczema/dermatitis• Itchy eyes and ears

• Hypotension

• Shock

• Syncope- fainting

• Arrhythmia

• Chest pain

Most common allergenic foods• Milk

• Wheat

• Egg

• Soy

• Peanut

• Tree nuts

• Fish & shellfish

• Any foods can theoretically trigger allergies

Cross-reactions may occur

• Wheat and other grains• Soy and other legumes• Cow’s milk & horse, sheep, goat’s milk• Different tree nuts• Nuts and peanuts• Pollen & some fruit• Latex and avocado, kiwi, chestnut, banana

• Otal allergy syndrome

Anaphylaxis –food inducedFoods most commonly implicated

• Eggs• Wheat• Milk • Peanuts• Fish

• Shellfish

• Nuts

Celery

Seeds

Legumes

Guar gum

Rice

Many others

pets

Pet allergy

Exercise induced Anaphylaxis

• Anaphylaxis occurring after exercise, when certain foods are eaten prior or after exercising

• Common culprits: Wheat,cereals, celery, fruit,vegetables, shellfish

• Watch out for: “may contain”• It only takes a minute grain to react• Nuts/egg/ sea food life time allergies• Cold. Ice• Food addtives & preservatives• Caffeined in foods, medication, tea,

coffee Coca-Cola, nausea and tremors.• Salicylates • Induce urticaria, asthma and nasal

polyps to develop• Curry powder, dried herbs, vegetable

and fruit skins, tea and almonds

Food Intolerances

• Enzyme deficiencies• Food poisoning• Intestinal fermentation• Food aversions

• Pharmacological reactions- reactions to chemicals in foods or additives. Reactions are dose dependent and can be cumulative.

Do the right thing

• Don’t just restrict your freedom of eating a wide variety of foods

• Do seek professional help to investigate the symptoms you have

• The cause may not always be what you think!

• Remember- it can take up to 36-48 hours for some reactions to develop – even longer in some conditions

Hoarse voice - anaphylaxis

Epipen (Inj adrenaline)

FIRES IN THE GARBAGE

• 1. DECOMPOSING WASTE MATTER

• 2. MAN MADE

FOR RECYCLABLE MATERIAL

(30% OF GARBAGE IN CAIRO)

environment

genes pregnancy

smoking viral infections in infancy

small baby

The skin Prick test

SPTs / patch tests

Skin prick tests

COLD URTICARIACold urticaria – 2 cases

Deficiency of C1 estarse inhibiyor deficincy

Patients

Angioed

Neck swelling

Died of meningitis at 1ge 15-16 y

Life span 40-45 y

2 causes

*Muslces

*inflammation

Asthma – hyper-reactive air ways

Chronic wheeze

SPTs

IgE / AEC

Growth in asthma

No

Inhalers

Without

spacers

Spacers

A wiff of air

Thank you