Josh Manning, a nine-year old boy from Wichita, Kansas, had been in relatively p
ID: 81420 • Letter: J
Question
Josh Manning, a nine-year old boy from Wichita, Kansas, had been in relatively perfect health throughout his life. One August afternoon, he and three other boys of the same age decided to play football. Being that it was a hot summer day in the Midwest, the boys decided to take their shoes off so that they could fed the grass between their toes as they played the game. Unfortunately, the grass they were playing on was heavily blanketed by white clover. As the dinner hour approached, Josh recalled later in the emergency room, he decided to head home because his parents had been nagging him about his incessant lateness for dinner. But before leaving the field he felt a sudden sharp stinging pain on the bottom of his foot. Once he realized that a honeybee had stung him. Josh told his friends that the last time he had been stung he experienced an excessive amount of itching and developed hives. After a 10-minute limp toward home, approximately 200 yards into his walk, he fen to the ground. The boys ran to Mm and realized quickly that he was not playing one of his usual practical jokes, but rather he was unconscious. One boy stayed with him while the other ran home to his mother, a registered nurse, for help. Although not experienced In matters such as this, she grabbed her personal version of a first aid kit and rushed to help Josh. After ascertaining the events that led up to his state, she felt for Josh's pulse. She documented later at the hospital that his pulse had been rapid and irregular. She administered epinephrine into his outer thigh directly through his light pants after placing a tourniquet on his upper thigh downstream from his heart. His consciousness returned almost immediately, and he was transported to the emergency room. On the way to the hospital, he complained that he felt shaky. Hospital personnel found that his pulse was rapid and pounding, consistent with epinephrine administration. After his pulse stabilized he was sent home with no further complications. What type of a reaction did Josh have? Why are severe responses to bee stings referred to as immediate hypersensitivity? What type of signs and symptoms would one associate with a systemic anaphylactic reaction due to a bee sting? How does a type-1 hypersensitivity response differ from a normal humoral response? What other types allergens other than insect stings also cause type I hypersensitivity reactions? Which of the primary principal mediators involved In type I hypersensitivity courses on increase in vascular permeability and smooth-muscle contraction? How ore immediate hypersensitivity reactions, such as those induced by on insect sting, treated and how does the treatment work? How would one prevent further recurrences of anophylaxis due to bee stings? How should a person that is susceptible to these types of hypersensitivities take precautions?Explanation / Answer
In immediate hypersensitivity or type 1 hypersensitivity, immune system responds to antigens such as insect venom, pollen , etc., mediated by IgE antibodies. Its a fast response and symptoms are manifested within minutes (or hours) of exposure. The response involves release of vsoactive mediators such as histamine, chemotactic factors, etc.. Thus, severe responses to bee stings are referred to as immediate hypersensitivity.
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