Trimethoprim-SulfamethoxazoleInducedRashFatalHematologicDisorders学习资料.pptVIP

Noura Al-Osaimi Fatima Al-Nefaei Questions Our System in a Balance Hypersensitivity reactions: Immune-mediated that cause tissue damage Unexpected Different types. Pseudoallergic (anaphylactoid) reactions Non-immune mediated. Direct release of mediators without prior sensitization period. Vancomycin Red man syndrome? pseudoallergic True IgE-mediated ?anaphylaxis. Drug idiosyncrasy/intolerance responses Mimic immune-mediated drug reactions Major drugs induce idiosyncrasy: ASA NSAIDs ACEIs Classification of hypersensitivity reactions Different types of hypersensitivity reactions are distinguished by: The time required for symptoms or skin test reactions to appear after exposure to an antigen On type of Ags Or on the nature of organ involvement. Type I: immediate or anaphylactic hypersensitivity Type II: antibody-dependent cytotoxic hypersensitivity Type III: complex-mediated hypersensitivity Type IV: cell-mediated hypersensitivity Type I: immediate (anaphylactic hypersensitivity) Most common (20% of population) IgE is made in response to allergen (drug). In allergic individuals, IgE those without allergies. Th2 cells Th1 cells How can type I hypersensitivity reactions occur? Type I: immediate (anaphylactic hypersensitivity) Type I: immediate (anaphylactic hypersensitivity) Diagnostic test for type I Hypersensitivity: skin (prick and intradermal) tests RAST (radioallergosorbent test) Serum tryptase Therapeutic consideration of type I hypersensitivity Discontinue drug. Consider epinephrine, antihistamines, systemic corticosteroids, bronchodilators. patient monitoring, if severe Type II: antibody-dependent cytotoxic hypersensitivity IgG or IgM is made against normal self Ags foreign Ag looks like cell-surface molecule stimulate Abs (IgG, IgM) response? Abs bind to foreign Ag ? attack cell surface. The results: opsonization of the host cells activation of the classical complement pathway causing MAC lysis of the cells ADCC destruction of the host