Discussion comment
These are 2 discussion initial posts, can you please comment on both of them separately and include at least 2 references in each post? apa format please with in-text citations.
B. R.
Initial Discussion Post
In this case scenario, the 22-year-old male is having a type 1 hypersensitivity reaction or anaphylactic response to the allergy shot he received. This is a severe allergic reaction as evidenced by his difficulty breathing (sitting in tripod position), nausea, and weakness. This is an IgE mediated process. Antibodies (IgE) bind to mast cells and basophils which contain histamines. The mast cells suddenly release a large amount of histamine which causes inflammation. Severe cases may include bronchospasm, laryngeal edema, cyanosis, hypotension, and shock. Anaphylaxis is a medical emergency as it can lead to life threatening respiratory failure (Justiz-Vaillant & Zito, 2019).
In type 1 hypersensitivity reactions after a previous exposure (sensitization) immunoglobulin (Ig) E is produced by the body which bind to the mast cells and basophils. Subsequent exposures to the allergen triggers cross-linking of mast-cell cytophilic IgE, causing mast cells and their degranulation mediators to become activated which in turn cause the allergic reaction. The histamine and lipid mediators cause vascular leak, bronchoconstriction, inflammation and gastrointestinal hyper-motility (McCance & Huether, 2019). This process aligns with the patient’s clinical symptoms of weakness, difficulty breathing, and nausea.
Certain people are genetically predisposed to develop allergies, specifically type 1 allergies. These people are referred to as atopic. About 40% of offspring develop allergy in families when one parent has allergy, compared to an upward of 80% of offspring in families in which both parents have same allergy. Atopic people tend to make higher amounts of IgE and have more Fc receptors for IgE on their mast cells. The airways and skin of atopic people are more responsive to a big variety of stimuli than people who are not atopic (McCance & Huether, 2019).
Resources
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513315/
Links to an external site.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier
Second post
Violetta Zheleznova
Initial Post.
The patient is presenting with the specific symptoms described due to anaphylaxis, a severe allergic reaction, in response to the allergy shot. The physiologic response to the stimulus presented in the scenario occurs when the body’s immune system overreacts to a perceived threat, in this case, the allergy antigen in the shot, triggering the rapid release of chemicals that can cause dangerous symptoms throughout the body (Daya &Toit 2022). I think this response occurred due to immunoglobulin E (IgE) IgE antibodies on mast cells detecting an allergen, after which they trigger the release of these mediators, which act systemically to dilate blood vessels and cause bronchoconstriction and fluid leakage.
The patient is exhibiting classic symptoms of anaphylaxis, including difficulty swallowing and nausea due to pharyngeal edema and gastrointestinal effects. Tachycardia, hypotension, and shortness of breath can occur from vasodilation and bronchoconstriction (Cardona et al., 2020). Treatment with epinephrine can counteract the effects by inducing vasoconstriction to increase blood pressure and relax bronchial smooth muscle (Bilò, et al., 2020). The role genetics plays in the disease is that the genetic predisposition of the patient is directly connected to the development of this hypersensitivity. Defects in IgE regulation can make someone more prone to anaphylaxis. The antigen exposure from the injection, along with the patient’s sensitization from prior allergy shots, created the perfect conditions for triggering this life-threatening reaction.
The cells that are involved in this process are mast cells, basophils, and helper T cells. The mast cell is a type of white blood cell which contains granules of chemical mediators like histamine. Basophil and Mast cells release inflammatory chemicals when activated by allergens (Daya &Toit, 2022). T cells play a coordinating role in the allergic cascade. Another characteristic, such as the patient’s gender, would not change the physiologic response, as anaphylaxis can occur in both males and females. However, research suggests females may be at higher risk during high estrogen phases of the menstrual cycle (De Martinis et al., 2020). Recognizing the altered cellular processes enables rapid treatment of this life-threatening allergic reaction.
References
Bilò, M., Martini, M., Tontini, C., Corsi, A., & Antonicelli, L. (2020). Anaphylaxis. European Annals of Allergy and Clinical Immunology, 53(01), 4. https://doi.org/10.23822/eurannaci.1764-1489.158
Links to an external site.
Cardona, V., Ansotegui, I. J., Ebisawa, M., El-Gamal, Y., Fernandez Rivas, M., Fineman, S., Geller, M., Gonzalez-Estrada, A., Greenberger, P. A., Sanchez Borges, M., Senna, G., Sheikh, A., Tanno, L. K., Thong, B. Y., Turner, P. J., & Worm, M. (2020). World allergy organization anaphylaxis guidance 2020. World Allergy Organization Journal, 13(10), 100472. https://doi.org/10.1016/j.waojou.2020.100472
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