Allergy: An Atlas of Investigation and Management (2006) PDF
Preview Allergy: An Atlas of Investigation and Management (2006)
An Atlas of Investigation and Management ALLERGY ALLERGY S Hasan Arshad North Staffordshire University Hospital Stoke-on-Trent, Staffordshire, UK Stephen T Holgate Southampton General Hospital Southampton, UK N Franklin Adkinson, Jr John Hopkins Asthma and Allergy Centre Baltimore, MD, USA K Suresh Babu Southampton General Hospital Southampton, UK CLINICAL PUBLISHING OXFORD Distributed worldwide by Taylor & Francis Ltd Boca Raton London New York Washington D.C. Clinical Publishing An imprint of Atlas Medical Publishing Ltd Oxford Centre for Innovation Mill Street, Oxford OX2 0JX, UK Tel: +44 1865 811116 Fax: +44 1865 251550 Web: http://www.clinicalpublishing.co.uk/ Distributed by: Taylor & Francis Ltd 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487, USA E-mail: [email protected] Taylor & Francis Ltd 23–25 Blades Court Deodar Road London SW15 2NU, UK E-mail: [email protected] © Atlas Medical Publishing Ltd 2005 First published 2005 This edition published in the Taylor & Francis e-Library, 2006. “ To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to http://www.ebookstore.tandf.co.uk/.” All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Clinical Publishing or Atlas Medical Publishing Ltd. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A catalogue record for this book is available from the British Library ISBN 0-203-49280-3 Master e-book ISBN ISBN 0-203-62586-2 (Adobe e-Reader Format) ISBN 1 904392 24 5 (Print Edition) The publisher makes no representation, express or implied, that the dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publisher do not accept any liability for any errors in the text or for the misuse or misapplication of material in this work. Contents Preface vi Acknowledgements vii Abbreviations viiI 1 Introduction 1 2 Assessment 30 3 Asthma 50 4 Allergic rhinitis 79 5 Atopic dermatitis 95 6 Contact dermatitis 107 7 Urticaria and angioedema 115 8 Food allergy 125 9 Insect allergy 138 10 Drug allergy 152 11 Anaphylaxis 162 Index 170 Preface The last 30 years have witnessed an unprecedented increase in the prevalence of all allergic disease that includes asthma, allergic rhinoconjunctivitis, drug and food allergy, anaphylaxis, occupational allergy, and allergic skin disease manifesting as atopic eczema and urticaria. While there is much debate about why this ‘epidemic’ has occurred, the highest prevalence and greatest change in demography appears to be linked to aspects of the Western lifestyle that not only includes altered exposure to micro-organisms, which is frequently cited as the cause for the changing trends, but also changes in housing, drug use, and diet, as well as indoor and outdoor air pollutants. It is most likely that more than one factor is involved in driving the trends. Irrespective of the underlying cause(s), allergic disease has now assumed public health proportions affecting all age groups and often manifesting as multiple organ disease. Indeed, complex allergy often presents a diagnostic and therapeutic challenge. Since allergy has such protean manifestations it often falls not only within the domain of organ- based specialists, but also general practitioners, immunologists, and those specializing in allergy. All such professionals will find this Atlas an aid to the diagnosis and management of allergy. With the aid of clear diagrams and ample clinical and pathological illustrations, this Atlas describes the mechanisms, epidemiology, diagnosis, and treatment of all of the common allergies. Great care has been taken to draw out the most salient features of each of the disorders and to present them in a way that will enhance learning and recall memory. While there are many books on allergy, both small and large, this Atlas fills a unique niche in providing an accessible source of up-to-date information. This book is of special value to medical students and those in post-graduate training, as well as to practitioners who wish for an easy-to-use, illustrated reference source. We are extremely grateful to our patients who co-operated in this effort and it is their interest that has made this unique book possible. We hope you find its content valuable. We are always pleased to receive comments, especially if you have any useful suggestions for future revisions. SH Arshad ST Holgate NF Adkinson, Jr KS Babu Acknowledgements The authors would like to express their gratitude to patients attending the David Hide Asthma and Allergy Centre for agreeing to have their photographs published in this Atlas. The authors are also indebted to Mrs Sharon Matthews and the nursing staff of the Centre for their invaluable help in the collection of many of the photographs. Abbreviations ACD allergic contact dematitis AD atopic dermatitis ADR adverse drug reaction AHR airway hyper-responsiveness AIDS aquired immunodeficiency syndrome ALL acute lymphoblastic leukaemia APC antigen-presenting cell ARDS adult respiratory distress syndrome ARIA Allergic Rhinitis and its Impact on Asthma (Study) BALF bronchoalveolar lavage fluid BHR bronchial hyper-responsiveness BPT bronchial provocation test CD contact dermatitis CLA cutaneous lymphocyte-associated antigen CLL chronic lymphocytic leukaemia CS corticosteroids DBPCFC double blind, placebo controlled food challenge DH dermatitis herpetiformis DNA deoxyribonucleic acid DPI dry powder inhaler ECP eosinophil cationic protein ECRHS European Community Respiratory Health Survey EDN eosinophil-derived neurotoxin ELISA enzyme linked immunosorbent assay EPO eosinophil peroxidase FEV forced expiratory volume in 1 second 1 FGF fibroblast growth factor FVC forced vital capacity GALT gut associated lymphoid tissue GI gastrointestinal GM-CSF granulocytic monocyte colony stimulating factor HDM house dust mite HIV human immunodeficiency virus HLA human leucocyte antigen H/O history of HPA hypothalamopituitary axis ICAM intercellular adhesion molecule ID intradermal (test) Ig immunoglobulin IL interleukin i.m. intramuscular IMN infectious mononucleosis INF interferon ISAAC International Study of Asthma and Allergies in Childhood i.v. intravenous LABA long-acting beta agonist LT leukotriene MBP major basic protein MCP monocyte chemotactic protein MCT mast cell tryptase MCTC mast cell tryptase, chymase MDI metered-dose inhaler MHC major histocompatibility complex MIP 1α macrophage inflammatory protein 1 alpha NARES non-allergic rhinitis with eosinophilic syndrome NK natural killer (-cell) NO nitric oxide (i)NOS (inducible) nitric oxide synthase NSAID non-steroidal anti-inflammatory drug OCP oral contraceptive pill PAF platelet activating factor PAR perennial allergic rhinitis PC provocation concentration (20% decrease in FEV1) 20 PD provocation dose (20% decrease in FEV1) 20 PDE phosphodiesterase PEF peak expiratory flow PEFR peak expiratory flow rate PG prostaglandin
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