A15 - Allergy and Immunology 2025

5q23-35

Gene region implicated in allergic diseases and pathogenesis

• Allergen causing symptoms (etiological classification)

• Duration of symptoms (Intermittent or Persistent)

• Severity of clinical symptoms (depending on impact of disease on QOL)

Disease pathophysiology (limited use)

Criteria for classifying Allergic rhinitis

Seasonal

AR which occurs only during specific periods of the year: e.g. pollination, mold sporulation

Perennial

AR triggered by allergens formed in the patient's environment at concentrations sufficient to induce symptoms all year round: dust mites, pet fur, cockroach.

Episodic

AR after exposure to a specific airborne allergen on a sporadic and short-term basis

Intermittent

AR with symptoms less than 4 days/week or less than a month/year

Persistent

AR with symptoms ≥ 4 days/week or ≥ a month/year

Mild AR

AR which symptoms do not affect sleep, no impairment in ADLs, work, school, and no troublesome symptoms

6 y/o

Diagnosis of AR is generally established by what age?

Oral H1-antihistamine

OR

Intranasal H1-antihistamine

AND/ORDecongestantORLTRA

Treatment options for mild intermittent AW

Intranasal corticosteroids

Drug added for step up therapy among patients with moderate-severe intermittent and mild persistent AR

B cell Immunodeficiency (Bruton Disease)

An infant was born normal until when he reached 6 months old, he has recurrent ear infections, bronchitis, pneumonia, and dermatitis. Total Ig < 250 mg/dL. Impression?

SCID

A young infant came in with failure to thrive, chronic otitis media, chronic diarrhea, recurrent pneumonia, and candida infection. On xray, there was absent thymic shadow. Impression?

CATCH 22

• Cardiac defect

• Abnormal facies

• Thymic aplasia

• Cleft palate

• Hypocalcemia

22q11.2 chromosomal deletion

Features of Di George syndrome?

Wiskott-Aldrich syndrome

A child presenting with immunodeficiency signs but with Thrombocytopenia and Eczema. Impression?

Hyper IgM syndrome

A profoundly neutropenic 2 y/o child came in for recurrent pyogenic infections and was later diagnosed with P. jiroveci pneumonia. Lab test showed depressed IgA, IgE, and IgG but normal IgM. Impression?

Judicious use of antibiotics for infections

Regular IVIG/SubQ Ig

Primary B cell defect treatment

Bone marrow transplant

Management of SCID

Hyper IgE syndrome

A child came in for recurrent bacterial abscesses, aspergillosis, and mucocutaneous candidiasis.

Chediak-Higashi syndrome

This Neutrophil function disorder is characterized by recurrent pyogenic infections, mild bleeding diathesis, partial oculo-cutaneous albinism, progressive peripheral neuropathy, and photophobia.

Leukocyte adhesion deficiency

Infant with recurrent bacterial infection associated with a lack of pus formation, bleeding tendency; delayed umbilical cord separation with significant omphalitis.

Chronic granulomatous

disease

Infant presenting with recurrent pyogenic infections with catalase-positive microorganisms, lymphadenitis, and granuloma formation.