Clinical Allergy (eBook)

Clinical Allergy 2
Gerald W. Volcheck 4
Series Editor’s Introduction 7
Preface 8
Contents 9
Overview of the Human Immune Response 19
1.1 Introduction 19
1.2 Innate Immune System 20
1.3 Acquired Immune System 25
1.4 T- and B-Cells in the Acquired Immune Response 29
1.5 Lymphoid Tissues 38
1.6 Tolerance: Distinguishing Self from Nonself 39
1.7 Cytokines 40
1.8 Chemokines 44
1.9 Complement 46
1.10 Inflammatory Cells 46
1.11 Primary Mediators of Inflammation 48
1.12 Allergic Response to an Allergen: Summary 52
1.13 Immune-Modulating Medications in Allergic Disease 52
1.14 Summary 55
Suggested Reading 57
Environmental Allergens 58
2.1 Overview of Allergens 58
2.2 Pollens 59
2.3 Fungal Allergens 74
2.4 Indoor Allergens 80
2.5 Animal Allergens 84
2.6 Cockroach Allergen 89
2.7 Clinical Vignettes 91
Suggested Reading 94
Allergen Testing and Allergen Immunotherapy 95
3.1 Allergen Testing 95
3.2 Allergen Immunotherapy 107
3.3 Summary 125
3.4 Clinical Vignettes 125
Suggested Reading 131
Allergic Rhinitis and Rhinosinusitis 133
4.1 Overview 133
4.2 Nasal Anatomy and Function 134
4.3 Clinical Overview 137
4.4 Allergic Rhinitis 137
4.5 Nonallergic Rhinitis and Rhinosinusitis 151
4.6 Infectious-Acute Rhinosinusitis 151
4.7 Chronic Rhinosinusitis 156
4.8 Infectious Chronic Rhinosinusitis 157
4.9 Allergic Fungal Rhinosinusitis 160
4.10 Chronic Eosinophilic (Fungal or Hyperplastic) Rhinosinusitis 161
4.11 Systemic Disease 162
4.12 Noninfectious Structural Rhinosinusitis 162
4.13 Noninfectious Nonstructural Rhinitis and Rhinosinusitis 167
4.14 Clinical Vignettes 171
Suggested Reading 179
Allergic Eye Disease 181
5.1 Overview 181
5.2 Basic Eye Anatomy 181
5.3 Approach to the Patient 183
5.4 Allergic and Allergic-Like Eye Disease 185
5.5 Clinical Vignettes 200
Suggested Reading 203
Asthma 204
6.1 Overview 204
6.2 Epidemiology 205
6.3 Pathophysiology 205
6.4 Clinical Presentation and Differential Diagnosis 212
6.5 Classification of Asthma 232
6.6 Evaluation of Factors Contributing to Asthma Severity 239
6.7 Treatment 248
6.8 Clinical Vignettes 286
Suggested Reading 292
Urticaria and Angioedema 294
7.1 Description and Epidemiology 294
7.2 Pathophysiology 295
7.3 Acute Urticaria: Etiologies 296
7.4 Chronic Urticaria 297
7.5 Urticaria-Angioedema-Associated Disorders 306
7.6 Patient Evaluation 310
7.7 Medications Used in the Treatment of Acute and Chronic Urticaria 315
7.8 Therapy Recommendations 320
7.9 Clinical Vignettes 320
Suggested Reading 324
Atopic and Contact Dermatitis 326
8.1 Atopic Dermatitis 326
8.2 Contact Dermatitis 348
8.3 Clinical Vignettes 368
Suggested Reading 373
Drug Allergy 375
9.1 Epidemiology 375
9.2 Definitions 375
9.3 Pathophysiology and Clinical Manifestations 376
9.4 Clinical Evaluation of Suspected Drug Sensitivity 385
9.5 Therapy and Management 389
9.6 Special Medication Reactions 394
9.7 Clinical Vignettes 402
Suggested Reading 405
Food Allergy 406
10.1 Definitions 406
10.2 Epidemiology 406
10.3 Pathophysiology 407
10.4 Food Allergens 411
10.5 Approach to Patients 415
10.6 Clinical Disorders 417
10.7 Management 434
10.8 Food Additive Reactions 436
10.9 Summary 438
10.10 Clinical Vignettes 438
Suggested Reading 444
Anaphylaxis and Anaphylactoid Reactions 446
11.1 Definition and Epidemiology 446
11.2 Pathophysiology 447
11.3 History and Physical Examination 449
11.4 Risk Factors 450
11.5 Common Causes of Anaphylactic and Anaphylactoid Reactions 451
11.6 Idiopathic Anaphylaxis 461
11.7 Differential Diagnosis 462
11.8 Diagnosis and Diagnostic Testing 465
11.9 Management 468
11.10 Clinical Vignettes 472
Suggested Reading 475
Stinging Insect Allergy 477
12.1 Introduction 477
12.2 Identification of Stinging Insects 477
12.3 Reactions to Stinging Insects 480
12.4 Diagnostic Testing 482
12.5 Management 485
12.6 Conclusion 488
12.7 Clinical Vignettes 489
Suggested Reading 490
Index 492