Allergy
The word
allergy derives from the Greek words allos meaning
"other" and ergon meaning "work".
An allergy is a reaction to a substance that occurs through a change in the
immune system caused by the production of antibodies, and is usually experienced
by only a small number of people exposed to a substance.
Allergic reactions in
the workplace tend to affect the skin.
History of Allergy
The earliest report of allergic disease is that of King Menses of
Egypt, who was killed by the sting of a wasp at some time between 3640 and 3300
BC. Another report from ancient history is that of Britannicus, the son of the
Roman Emperor Claudius. He was
allergic to horses and "would develop a rash and
his eyes swelled to the extent that he could not see where he was going".
Accordingly, the honour of riding at the head of the young patricians fell to
Nero who was Claudiuss adopted son. Nero allegedly threw Christians to the
lions and killed Britannicus. Sir Thomas More gives the next authoritative
account of allergy: King Richard III used his
allergy to strawberries to good
effect in arranging the judicial murder of Lord William Hastings. The King
surreptitiously ate some strawberries just prior to giving an audience to
Hastings and promptly developed acute urticaria. He then accused Hastings of
putting a curse on him, an action that demanded the head of Hastings on a plate.
The Roman philosopher, Lucretius observing exaggerated responses to commonly
occurring substances said "what is food for some may be fierce poisons for
others". However, The term and concept of "allergy" was coined by a Viennese
pediatrician named Clemens von Pirquet in 1906.
Allergy Signs and Symptoms
Allergy symptoms vary depending on what is causing the reaction
and the part of the body where the reaction occurs. Symptoms can include:
runny nose
tearing eyes, burning or itching eyes
red eyes, conjunctivitis
swollen eyes
itching nose, mouth, throat, skin, or any other area
wheezing
coughing
difficulty breathing
hives (skin wheals)
skin rashes
stomach cramps
vomiting
diarrhea
headache
Methods for the Diagnosis Allergy
There are several methods for the diagnosis and assessment of allergies
Skin testing -- the most common method of allergy testing. This may include
intradermal, scratch, patch, or other tests. Skin testing may even be an option
for young children and infants, depending on the circumstances.
Blood test -- also called RAST (radioallergosorbent), this measures the levels
of allergy antibody, IgE, produced when your blood is mixed with a series of
allergens in a laboratory. If you are allergic to a substance, the IgE levels
may increase in the blood sample. The blood test may be used if you have
existing skin problems like eczema, if you're on medications that are
long-acting or you cannot stop taking, if you have a history of anaphylaxis, or
if you prefer not to have a skin test.
"Use" or "elimination" tests -- suspected items are eliminated and/or
introduced while the person is observed for response to the substance. This is
often used to check for food or medication allergies.
Eyelid -- Occasionally, the suspected allergen is dissolved and dropped onto
the lining of the lower eyelid (conjunctiva) as a means of testing for allergies. (This test should only be done by a physician, never the patient,
since it can be harmful if done improperly.)
Reaction to physical stimuli -- application of heat, cold, or other
stimulation, and then look for an allergic response.
Treatment of Allergy
The best treatment is to avoid what causes your allergies in the first place. It
may be impossible to completely avoid everything you are allergic to, but you
can often take steps to reduce your exposure. This is especially important for
food and drug allergies.
Medications that can be used to treat allergies
include the following:
Short-acting antihistamines, which are generally
non-prescription, often relieve mild to moderate symptoms but can cause
drowsiness. In addition, these antihistamines can blunt learning in children
(even in the absence of drowsiness). An example is diphenhydramine. One formerly
prescription medication, loratadine (Claritin), is now available over the
counter. It does NOT tend to cause drowsiness or affect learning in children.
Longer-acting antihistamines cause less drowsiness and can be equally
effective, and usually do not interfere with learning. These medications, which
require a prescription, include fexofenadine (Allegra) and cetirizine (Zyrtec).
Nasal corticosteroid sprays are very effective and safe for people with
symptoms not relieved by antihistamines alone. These prescription medications
include fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort
AQ).
Decongestants may also be helpful in reducing symptoms such as nasal
congestion. Nasal spray decongestants should not be used for more than several
days, because they can cause a "rebound" effect and make the congestion worse.
Decongestants in pill form do not cause this effect.
Leukotriene inhibitors -- montelukast (Singulair) is a prescription medicine
approved to help control asthma and to help relieve the symptoms of seasonal allergies.
Allergy Prevention
Children who have been breastfed are less likely to have allergies. In addition, a mother who avoids cow's milk, eggs, nuts, and peanuts
while breastfeeding can prevent allergy-related conditions, including eczema, in
some children.
If there is a family history of eczema and allergies it is wise to discuss the
implications for infant feeding with your child's doctor. The timing of
introduction of solid foods in general, as well as of several specific foods,
can help prevent some allergies.
There is also evidence that infants exposed to certain airborne allergens
(such as dust mites and cat dander) may be less likely to develop related
allergies. This is called the "hygiene hypothesis" and sprang from observations
that infants on farms tend to have fewer allergies than those who grow up in
environments that are more sterile.
Once allergies have developed,
treating the allergies and carefully avoiding those things that cause reactions
can prevent allergies in the future.
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Allergies
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