Acute allergic reactions
Acute allergic reactions are the pathological states arising owing to hypersensitivity of an organism to the allergens getting from the outside and which are characterized by sudden development of the localized or generalized allergic reactions. Carry urticaria to the localized forms, , a laryngospasm and a bronchospasm, to system – anaphylactic shock and widespread toksiko-allergic dermatitis. Manifestations of acute allergic reaction depend on its form, a condition of an organism, age and other factors. Medical actions include allergen elimination, restoration of the vital functions, introduction of antihistamines and glucocorticosteroids.
Acute allergic reactions
Acute allergic reactions are the diseases developing with hypersensibility of immune system to the allergens getting into an organism from the outside. Usually at the same time signs of allergic reaction of immediate type with the sudden sharp beginning, distribution of pathological process on various bodies and fabrics expressed by violation of the vital functions of an organism come to light. Statistically every tenth inhabitant of our planet ever transferred acute allergic reaction. Allocate the easy (localized) manifestations of hypersensitivity in the form of an aggravation of an allergic rinokonjyunktivit and a narrow small tortoiseshell, medium-weight – with development of a widespread small tortoiseshell, Quincke's hypostasis, a laryngospasm, bronchospasm and heavy – in the form of anaphylactic shock.
Reasons of acute allergic reactions
Development of acute allergic reactions is usually connected with influence of the alien substances getting into an organism with the inhaled air (the bacterial, pollen, contained in atmospheric air and house dust allergens), food, medicines owing to stings of insects, when using latex, drawing on skin and mucous various inorganic and organic substances.
Pathological process is most often characterized by development of acute allergic reaction of immediate type. At the same time the IgE-mediated hypersensitivity to the problem alien substance becoming an anti-gene is formed. The developing immune reaction proceeds in the presence of cages of three types – macrophages, T-and B-lymphocytes. The immunoglobulins of a class E synthesized by B-cages settle down on a surface of cages targets (corpulent cages, basophiles).
Repeated intake of allergen in an organism leads to development of acute allergic reaction with activation of cages targets and emission of a large number of mediators of an inflammation (it is, first of all, a histamine, and also serotonin, tsitokina, etc.). Such immune reaction is usually observed at intake of pollen, food, household allergens, medicines and serums, being shown by symptoms of a pollinoz, atopic dermatitis and bronchial asthma, anaphylactic reactions.
The mechanism of developing of sharp allergic diseases can be caused by formation of the cytotoxic, immunocomplex, cellular mediated immune reactions. As a result of the patokhimichesky and pathophysiological changes developing after a sensitization typical symptoms of a sharp allergy appear.
Symptoms of acute allergic reactions
The easy course of acute allergic reactions is most often shown by symptoms of allergic rhinitis (difficulty of breath through a nose, , sneezing attacks) and conjunctivitis (an itch and puffiness a century, reddening of eyes, a photophobia). Here it is possible to refer emergence of symptoms of urticaria on the limited site of skin (roundish bubbles, hyperaemia, an itch).
At the medium-weight course of acute allergic reactions defeat of integuments becomes more expressed and is characterized by development of a generalized small tortoiseshell with capture practically of all surface of skin and emergence of new bubbles within several days. Quite often at the same time symptoms of angioneurotic hypostasis of Quincke with emergence of a limited angiootek of skin, hypodermic cellulose, mucous membranes are noted. Pathological process is more often localized in a face, affecting lips and eyelids, sometimes meets on brushes, feet and a scrotum, can lead to hypostasis of a throat and mucous membrane of digestive tract. Acute allergic reaction with development of an inflammation of a mucous membrane of a throat and bronchial tubes can cause heavy complications up to a lethal outcome from asphyxia.
The most serious consequences of hypersensitivity of immune system are observed in case of development of anaphylactic shock. At the same time vitals and systems of an organism – cardiovascular and respiratory with developing of the expressed arterial hypotension, a kollaptoidny state and loss of consciousness, and also violations of breath owing to hypostasis of a throat or a bronchospasm are surprised. Clinical manifestations, as a rule, develop within several minutes after contact with allergen, in the absence of the qualified emergency aid quite often there comes death.
Diagnostics of acute allergic reactions
Diagnostics of acute allergic reactions provides the careful analysis of anamnestichesky data (tolerance of medicines and serums, the postponed earlier allergic diseases), clinical displays of an allergy (damage of skin, the top airways, symptoms of suffocation, a faint, existence of spasms, violation of warm activity etc.). Survey of the allergist-immunologist and other experts is necessary: dermatologist, otorhinolaryngologist, gastroenterologist, rheumatologist and so forth.
All-clinical laboratory trials (blood, urine), biochemical blood test, according to indications – definition of a rheumatoid factor and anti-nuclear antibodies, markers of viral hepatitis, existence of antibodies to other microorganisms, and also necessary tool diagnostic procedures in this concrete case are carried out. At an opportunity skin tests, definition of the general and specific immunoglobulins of a class E, and also other inspections used in allergology can be carried out.
Differential diagnostics of acute allergic reactions demands an exception of a wide range of various allergic, infectious and somatic diseases which are followed by skin manifestations, damage of mucous membranes of internals, malfunction of breath and blood circulation.
Treatment of acute allergic reactions
Medical actions at acute allergic reactions have to include the fastest elimination of allergen, performing antiallergic therapy, restoration of the broken functions of breath, blood circulation and other systems of an organism. To stop further intake of the substance which caused hypersensibility development it is necessary to stop introduction of medicine, serum or blood substitute (at intramuscular and intravenous injections, infusions), to reduce allergen absorption (imposing of a plait higher than the place of introduction of medicine or a sting of an insect, an obkalyvaniye of this site with adrenaline solution use).
Performing antiallergenic therapy provides use of antihistaminic medicines and glyukokortikosteroidny hormones locally, inside or parenterally. Concrete dosages of medicines and a way of their introduction depend on localization of pathological process, weight of acute allergic reaction and a condition of the patient. Symptomatic therapy is directed to correction of the broken functions of an organism and, first of all, breath and blood circulation. So at a bronchospasm it is inhalation bronkholitichesky and anti-inflammatory drugs (an ipratropiya bromide, salbutamol are injected, etc.), at the expressed arterial hypotension vazopressorny amines (a dopamine, noradrenaline) with simultaneous completion of volume of the circulating blood are appointed.
In hard cases emergency aid is given in conditions of intensive care unit of a hospital with use of the special equipment supporting function of blood circulation and breath. After knocking over of sharp manifestations of allergic reactions treatment is performed by the allergologist-immunologist with use of individually picked up scheme of medicamentous therapy, observance of an eliminative diet, if necessary – carrying out ASIT.