Sumadiono

Pediatric Department
Faculty of Medicine
Gadjah Mada University
Yogyakarta1
Block 8 - 2003 school of medicine - gadjah mada 2
university
 Immune System

NONSPECIFIC

SPECIFIC

Block 8 - 2003
IMMUNOPATHOLOGY

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 Immunopathology

• Immunodeficiency

• Hypersensitivity
• Autoimmune

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Allergies Definition
 are abnormal reactions of the immune
system that occur in response to otherwise
harmless substances.

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 TERMINOLOGY

. Allergen — A substance that provokes an

allergic response.

• Allergist. A doctor who diagnoses and

treats allergy-related conditions

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• Anaphylaxis. A life-threatening allergic reaction
involving the entire body. Anaphylaxis requires
immediate medical attention.

• Antihistamines. These drugs block histamine –

a chemical the body releases during an allergic
reaction -- reducing symptoms such as itching,
sneezing, and runny nose.

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• Allergic rhinitis — Inflammation of the mucous
membranes of the nose and eyes in response to
an allergen.

• Anaphylaxis — Increased sensitivity caused by

previous exposure to an allergen that can result
in blood vessel dilation and smooth muscle
contraction.
Anaphylaxis can result in sharp blood pressure
drops and difficulty breathing.
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• Antibody — A specific protein produced by the
immune system in response to a specific foreign
protein or particle called an antigen.

• Antigen — A foreign protein to which the body

reacts by making antibodies.

• Asthma — A lung condition in which the

airways become narrow due to smooth muscle
contraction, causing wheezing, coughing, and
shortness of breath.
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• Conjunctivitis — Inflammation of the thin
lining of the eye called the conjunctiva.

• Contact dermatitis — Inflammation of the skin

as a result of contact with a substance.

(An allergic reaction that occurs after skin comes

in contact with an allergen such as poison ivy,
washing powders, perfumes, or other irritants)

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• Decongestants. Medications that shrink swollen
nasal membranes, decreasing congestion and
mucus, and making it easier to breathe.

• Eczema. Chronic inflammation that causes a skin

rash.
Symptoms include itching, crusting, blisters, and
scaling.

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• Mast cells — A type of immune system cell
that displays a type of antibody called
immunoglobulin type E (IgE) on its cell surface,

 participates in the allergic response by

releasing histamine from intracellular granules.

• T cells — Immune system cells or more

specifically, white blood cells, that stimulate
cells to create and release antibodies.
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• Epinephrine. A drug used to immediately treat
severe allergic reactions. Also known as
adrenaline.

• Allergic rhinitis. an inflammation of the mucus

membranes in the nose.

Symptoms include sneezing, itching, runny nose,

and nasal congestion.
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• Histamine. A chemical released by cell mast
after it's exposed to an allergen.
It causes tissues to become swollen, inflamed,
itchy, and red.

• Urticaria/Hives. An allergic reaction of the skin.

Symptoms include itchy, swollen, red bumps that
appear suddenly: lips, tongue, and ears.

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• Nasal spray. Over-the-counter or prescription
drugs that can treat and prevent nasal symptoms
such as congestion and runny nose.

• Pollen. a fine, powdery substance released by

trees, grasses, weeds, and flowering plants.

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Rising Prevalence
30

25

20

15 1979
10
1991

0
Asthma Rhinitis Eczema Total

• Aberg. Clin Exp Allergy.

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1995.95:815. Swedish Children
 ALLERGIC DISEASES :
• Impact on the quality of
life
• Impact on work and school
• Economic burden
• Fatal?

Worldwide Variation in 12-month (ISAAC)

Lancet 1998
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EPIDEMIOLOGY

Allergic Rhinitis : 7.8%

• Worldwide, 10% - 30 % of the population.

Drug Allergy
• Worldwide: 10% & 20% :hospitalized patients

Food Allergy: 8%
6%: 0-2 years , 9% : 3-5 y, 8%: 6-18y
• 38.7% : food allergic  severe reactions 19
EPIDEMIOLOGY

Skin Allergy: 13%

• Black children:17%, white:12%, Asian: 10%
children.1

Urticaria: above 20%

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 EPIDEMIOLOGY of Urticaria &
Angioedema

• ALL AGE
20% OF POPULATION
• URTICARIA + ANGIOEDEMA:
49%
• URTICARIA ONLY: 40%
• ANGIOEDEMA ONLY: 11%
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Epidemiology of Atopic Dermatits

• 10-20% : >> infant and children

• Can continue until adult
• Male : Female = 1: 1

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ASTHMA BRONCHIALE

SUSPECTED:
WHEEZY,
EPISODIC,
NIGHT,
POST
ACTIVITY
ATOPY

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Asthma prevalence, children and young
adults

Asthma
prevalence,
children and
young adults

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Prevalence of asthma, allergic rhinitis, and atopic
eczema in young Finnish men: 1966-2003

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Incidence of different types of allergic
diseases by age

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 Allergic March

ATOPY

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 Allergic March

ATOPY

FOOD ALLERGY

ATOPIC
DERMATITIS

ASTHMA

ALLERGIC
RHINITIS
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Causes and symptoms

Allergens enter the body through four main routes:

• Airways
• Skin
• Gastrointestinal tract
• Circulatory system.

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 DUST MITE

INHALANT ALLERGEN 34
INHALANT ALLERGEN
Correlation Between Exposure and
Sensitization to Cockroach
in Asthmatic Patients

• SPT positive to cockroach: 52 %

• Positive SPT result of American Cockroach in

American Cockroach exposure: 75 %

• Positive SPT result of German Cockroach in

German Cockroach exposure: 40 %

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 POLLEN
MOLD

INHALANT ALLERGENS 36
DOG?

CAT?

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 FOOD ALLERGENS
35 29
30
22
25 1818
20 15 16 15
12 13
15 8 9 87
10 6 4
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Prevention

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