Allergy & asthma
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Transcript of Allergy & asthma
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