Allergic and Immunologic Diseases

A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic Diseases

1st Edition - October 14, 2022
Imprint: Academic Press
Editor: Christopher Chang
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 9 5 0 6 1 - 9
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 5 3 2 3 - 8

**Selected for Doody’s Core Titles® 2024 in Allergy/Clinical Immunology**Allergic and Immunologic Diseases: A Practical Guide to the Evaluation, Diagnosis and Management of Aller… Read more

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**Selected for Doody’s Core Titles® 2024 in Allergy/Clinical Immunology**

Allergic and Immunologic Diseases: A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic Diseases is a valuable resource for researchers and others involved in the day-to-day practice of allergy and immunology, with specific information, protocols and algorithms to guide their thinking. The book provides practical information and an explanation of why and how we do things, while also addressing the limitations of testing and treatment. Other sections focus on scientific based practices and the known pathophysiology of allergic and immunologic diseases, along with mechanisms of action in various treatment modalities.

This book is unique in that it explains the rationale behind everything we do in allergy and immunology, hence it offers readers specific information on procedures and how to order tests and treat allergic and immunologic diseases.

Cover image
Title page
Table of Contents
Copyright
Dedication
List of contributors
Preface
Section A: Background
Chapter 1. Introduction
Abstract
Chapter outline
The origin of allergy and immunology as a specialty
The role of allergy and immunology in the world of medicine
The allergy and immunology workforce in the United States
Training of allergy and immunology specialists
Professional organizations
Allergy and immunology journals
Summary
References
Chapter 2. A brief history of allergy and immunology
Abstract
Chapter outline
Introduction
An early history of immunology
A modern history of allergy and immunology
The 21st century—a brave new world
Conclusion
References
Chapter 3. Basic immunology
Abstract
Chapter outline
Introduction
Primary and secondary lymphoid organs
Innate and adaptive immunity
Characteristics and attributes of the human immune system
Immunological concepts
Immune paradigms
Cellular immunity—cells of the immune system
Mononuclear cells
Ontogeny of immune cells and antibodies
Humoral immunity—immunoglobulins and other molecules
Computational immunology
Summary and conclusions
References
Chapter 4. The allergy and immunology history and physical
Abstract
Chapter outline
Introduction
The allergy and immunology chief complaint and its relevance
The main elements of history taking
Essentials of the clinical history and physical exam approach in a patient with ocular complaints
Essentials of the clinical history and physical exam approach in a patient with upper respiratory complaints
Essentials of the clinical history and physical exam approach in a patient with lower respiratory complaints
Essentials of the clinical history and physical exam approach in a patient with skin complaints
Essentials of the clinical history and physical exam approach in a patient with gastrointestinal complaints
Essentials of the clinical history and physical exam approach in a patient with recurrent infections
Conclusions
Acknowledgments
References
Chapter 5. Basic genetics and epigenetics for the immunologist and allergist
Abstract
Chapter outline
Introduction
Diagnostic tools
Genetic and epigenetic basis of allergic disease
Genetic and epigenetic basis of immunologic diseases
Applications of genetics and epigenetics
Challenges and limitations of genetic testing
Conclusions
References
Chapter 6. Laboratory skills for immunologists: utility and limitations with emphasis on allergy research
Abstract
Chapter outline
Abbreviations
Introduction
Section 1: Western blotting
Section 2: Enzyme-linked immunosorbent assay
Section 3: Flow cytometry
Section 4: Basophil activation test
Section 5: Microarray
Section 6: Animal models
Conclusion
Future directions and challenges
References
Chapter 7. Developments and emerging technologies in allergic and immunologic disease management
Abstract
Chapter outline
Abbreviations
Introduction
Section 1: Diagnosis of allergic diseases
Section 2: Latest development of allergen-specific immunotherapy
Section 3: Omics in the management of allergic diseases
Section 4: Artificial intelligence in the management of allergic diseases
Section 5: Omics and AI in the management of immunodeficiency diseases and autoimmune diseases
Concluding remarks—implications of novel technologies in allergy and immunology research and care
References
Chapter 8. Genomics technologies and bioinformatics in allergy and immunology
Abstract
Chapter outline
Introduction
Types of genetic diseases and variants
High throughput methods
Data science and big data analytics
Importance of scalable infrastructure and data standardization
Conclusion
Acknowledgment
References
Section B: Diagnosis of allergic diseases
Chapter 9. Epicutaneous and intradermal skin testing
Abstract
Chapter outline
Introduction
Mechanism of skin response
Indications of skin testing
Factors affecting skin testing
Number of skin test
Selection of allergens
Cross-reactivity
Methods of skin testing
False-positive and false-negative skin test results
The use of skin tests for nondiagnostic purposes
Correlation with other diagnostic tests for diagnosing allergic diseases
Conclusion
References
Chapter 10. Skin prick testing for foods
Abstract
Chapter outline
Introduction
Approach to food allergy diagnosis
Pathophysiology of immunoglobulin E-mediated food allergy and rationale for skin prick testing to foods
Skin prick testing procedure
Skin prick test measurement
Skin prick test interpretation
Skin prick testing variability
Limitations of skin prick testing
Safety
Conclusions
References
Chapter 11. In vitro methods to assess allergy
Abstract
Chapter outline
Introduction
Total IgE levels
Allergen-specific IgE
In vitro testing for environmental allergens
In vitro testing for food allergens
In vitro testing for venom allergy
In vitro testing for latex
In vitro testing for drugs
In vitro testing for occupational protein allergens
Tryptase
In vitro tests primarily used in research—basophil tests and eosinophil cationic protein
Unvalidated in vitro tests
Conclusion
References
Chapter 12. Oral food challenges
Abstract
Chapter outline
Introduction
Epidemiology of food allergies
The heterogeneity of adverse food reactions
Oral food challenges
Preparing the patient for an oral food challenge
Oral food challenge procedure
Postchallenge management
Discharge instructions
Special populations
Specific foods
Variations on oral food challenges
Frequently asked questions
Conclusions
References
Chapter 13. Physical urticarias: diagnosis and testing
Abstract
Chapter outline
Introduction
General recommendations for provocation testing
Symptomatic dermographism
Delayed pressure–induced urticaria
Cold-contact urticaria
Heat-contact urticaria
Solar urticaria
Vibratory urticaria
Conclusion
Conflict of interest
References
Chapter 14. Techniques to evaluate asthma
Abstract
Chapter outline
Introduction
Subjective evaluations
Physiologic evaluations
Mechanistic evaluations
Conclusion
References
Chapter 15. Drug allergy testing
Abstract
Chapter outline
Introduction
Types of adverse drug reactions
Evaluation of immediate drug reactions
Skin testing other drug classes
Laboratory studies and in vitro testing
Direct oral challenge
Evaluation of delayed hypersensitivity reactions
Discussion/Conclusion
References
Chapter 16. Diagnosis and management of rhinitis and rhinosinusitis
Abstract
Chapter outline
Introduction
Clinical presentation
Medical management and outcomes
Surgical management and outcomes
Conclusion
References
Chapter 17. Approach to the rash from an allergy and immunology perspective
Abstract
Chapter outline
Introduction
Eczematous rashes
Atopic dermatitis
Contact dermatitis
Seborrheic dermatitis
Nummular eczema
Lichen simplex chronicus/prurigo nodularis
Mycosis fungoides
Urticarial rashes
Chronic urticaria
Physical urticaria
Urticarial vasculitis
Cutaneous mastocytosis
Papulosquamous disorders
Drug eruptions
Stevens–Johnson syndrome/toxic epidermal necrolysis
Drug reaction with eosinophilia and systemic symptoms
Acute generalized exanthematous pustulosis
Fixed drug eruption
Bullous disorders
Pemphigus vulgaris
Conclusion
References
Chapter 18. Patch testing and the evaluation of contact allergy
Abstract
Chapter outline
Abbreviations
Introduction
Pathophysiology
Clinical history
Physical examination
Histologic findings
Site-specific considerations
Other important considerations
Allergens causing allergic contact dermatitis
Nickel sulfate
Fragrances
Balsam of Peru
Preservatives
Methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone
Paraben
p-Phenylenediamine
Lanolin
Cocamidopropyl betaine
Rubber
Medications
Corticosteroids
Patch testing and patch test allergens
Patch testing technique
Patch test reading and interpretation
False-positive and false-negative patch testing results
Determining clinical relevance
Repeat open application test and use test
Management: allergen avoidance and treatment
Conclusion
References
Chapter 19. Skin biopsies: their utility to allergists and immunologists
Abstract
Chapter outline
Introduction
Biopsy types
Direct immunofluorescence testing
Eczematous reactions
Urticarial eruptions
Autoinflammatory syndromes
Immunodeficiency syndromes
Other inflammatory disorders of the skin
Acknowledgment
References
Chapter 20. Evaluation and diagnosis of mast cell–associated disorders
Abstract
Chapter outline
Introduction
Physiologic roles of mast cells
Mast cell activation and mediator release
Defining mast cell–associated disorders
Genetic disorders involving mast cells
Clinical testing modalities
Clinical evaluation for mast cell–associated disorders
Conclusion
Acknowledgments
Funding
References
Chapter 21. The evaluation of a patient with urticaria and angioedema
Abstract
Chapter outline
Urticaria
Recurrent angioedema in the absence of wheals
Discussion
References
Chapter 22. Evaluation of a patient with anaphylaxis
Abstract
Chapter outline
Introduction
History taking
Differential diagnosis
Mechanisms of anaphylaxis
Causes of anaphylaxis
Workup
Conclusions
References
Chapter 23. Evaluating patients with eosinophilia and eosinophilic disorders
Abstract
Chapter outline
Introduction
Eosinophil biology
What is eosinophilia?
Severity classification of eosinophilia
Mechanisms of eosinophilia
Target organs
Causes of eosinophilia
“Secondary” eosinophilia
Primary eosinophilia
Organ-specific eosinophilic disorders
Approach to the patient with eosinophilia
Summary
References
Chapter 24. Unproven and controversial tests and treatments in allergy and immunology
Abstract
Chapter outline
Introduction
Unconventional diagnostic methods
Unproven treatment methods
Concluding remarks
References
Section C: Evaluation of immune function
Chapter 25. Newborn screening for severe combined immunodeficiency and related issues
Abstract
Chapter outline
Introduction
Newborn screening for severe combined immunodeficiency and other immunodeficiencies
Severe combined immunodeficiency diagnosis
Nonsevere combined immunodeficiency lymphopenia
Clinical evaluation
Laboratory evaluation
Genetic testing
Management
Treatment
Discussion/conclusion
Acknowledgment
References
Chapter 26. Testing the innate immune system
Abstract
Chapter outline
Background
Testing techniques
Testing components of the innate immune system
Conclusions
References
Chapter 27. Testing the adaptive immune system
Abstract
Chapter outline
Background
Testing components of the adaptive immune system
Discussion and conclusion
References
Chapter 28. Infections in primary immunodeficiency
Abstract
Chapter outline
Immunodeficiencies affecting cellular and humoral immunity
Combined immunodeficiencies with syndromic features
Predominantly antibody deficiencies
Diseases of immune dysregulation
Congenital defects of phagocyte number or function
Defects in intrinsic and innate immunity
Autoinflammatory disorders
Complement deficiencies
Phenocopies and therapies
Conclusion
Acknowledgments
References
Chapter 29. Periodic fever syndromes and autoinflammatory diseases
Abstract
Chapter outline
Introduction
Familial Mediterranean fever
Mevalonate kinase deficiency
Tumor necrosis factor receptor-associated periodic syndrome
Cryopyrin associated autoinflammatory syndrome
Periodic fever with adenitis, pharyngitis, and aphthous stomatitis
Other autoinflammatory conditions
Conclusion
References
Chapter 30. Primary immune regulatory disorders
Abstract
Chapter outline
Background
ALPS/ALPS-like disorders
IPEX and IPEX-related disorders
CVID, CVID-like, and profound/late-onset combined immune deficiency disorders
Immune phenotype and genetic testing in PIRD
Hyperinflammatory disorders and immune dysregulation
Discussion and conclusion
References
Chapter 31. The history, diagnosis, and pathophysiology of human immunodeficiency virus and acquired immunodeficiency syndrome
Abstract
Chapter outline
Introduction
Pathophysiology and immune dysfunction
Atopy and human immunodeficiency virus
Diagnosis
Retroviral conversion syndrome
Diagnosis in asymptomatic persons and treatment as prevention
Human immunodeficiency virus testing
Human immunodeficiency virus testing in infants and children
Human immunodeficiency virus testing in breastfed infants
Missed opportunities and postexposure prophylaxis
Diagnosis of acquired immunodeficiency syndrome
Conclusion
References
Chapter 32. The evaluation and treatment of autoimmune diseases
Abstract
Chapter outline
Introduction
The history of present illness and physical examination in the evaluation of the rheumatologic patient
Laboratory testing for autoimmune diseases
Specific antibodies
Human leukocyte antigen associations in autoimmune diseases
Imaging in autoimmune diseases
Treatment of autoimmune diseases
Corticosteroids
Conclusions
References
Chapter 33. Neurologic autoimmune diseases
Abstract
Chapter outline
Introduction
Multiple sclerosis
Neuromyelitis optica
Guillain–Barré syndrome
Chronic inflammatory demyelinating polyneuropathy
Myasthenia gravis
Autoimmune encephalitis
Paraneoplastic neurological disorder
Summary
References
Section D: Treatment of allergic diseases
Chapter 34. Immunotherapy to environmental allergens
Abstract
Chapter outline
Background
Duration of immunotherapy
Monitoring of treatment
Reactions to allergen immunotherapy
Subcutaneous immunotherapy versus sublingual immunotherapy
Clinical efficacy
Other administration routes
New technologies
Conclusion
References
Chapter 35. Drug desensitization
Abstract
Chapter outline
Introduction
Mechanisms of drug hypersensitivity
Drug desensitization
Indications
Choosing desensitization protocols
Desensitization protocols
Conclusion
References
Chapter 36. Oral, sublingual, and dermatologic immunotherapy for food allergy
Abstract
Chapter outline
Introduction
Oral immunotherapy
Epicutaneous immunotherapy
Sublingual immunotherapy
Summary
References
Chapter 37. Conventional medications for the treatment of allergic rhinitis and conjunctivitis
Abstract
Chapter outline
Introduction
Medications used for allergic rhinitis and allergic conjunctivitis
Future directions/conclusion
Disclosure statement
References
Chapter 38. New biologics in allergy
Abstract
Chapter outline
Introduction
Currently available biologics for allergic diseases
Biologics currently in development
Non-Th2 biologics in atopic disease
Additional considerations when utilizing biological therapies
Conclusion
References
Chapter 39. Action plans and quality of life evaluations
Abstract
Chapter outline
Abbreviations
Introduction
Objectives of asthma action plans
Structure of asthma action plans
Asthma action plans and asthma outcome
Asthma action plans and quality of life of asthma patients and parents
Asthma action plans and adherence to medications
Barriers and facilitators of using asthma action plans
Quality of life measurement of asthma patients and caregivers
Tools to measure quality of life for adults with asthma
Tools to measure quality of life for children with asthma and their caregivers
Food allergy action plans
Quality of life tools for food allergy
Conclusion
References
Chapter 40. Treatment of atopic dermatitis
Abstract
Chapter outline
Introduction
Diagnosis and assessment of atopic dermatitis severity
Atopic dermatitis triggers
Current atopic dermatitis therapy
References
Further reading
Chapter 41. Recognition and treatment of anaphylaxis
Abstract
Chapter outline
Introduction
Recognition of anaphylaxis
Management of anaphylaxis
Fatal anaphylaxis
Biphasic reactions
Epinephrine autoinjector
Prevention of anaphylaxis
Outpatient management of anaphylaxis
Underuse of epinephrine for the treatment of anaphylaxis
Conclusion
References
Chapter 42. Venom allergy evaluation, diagnosis, and treatment
Abstract
Chapter outline
Epidemiology
Etiology
Reactions
Diagnosis
Treatment
Prevention
Risk factors
Biting insect allergy
Conclusions
References
Chapter 43. Treatment of itch in atopic dermatitis
Abstract
Chapter outline
Introduction
Pathophysiology of itch in atopic dermatitis
Current treatment options for the atopic itch
Emerging treatment options for atopic itch
Conclusion
Conflicts of interest
References
Chapter 44. Treatment of eosinophilic and hypereosinophilic disorders
Abstract
Chapter outline
General principles of management
Key definitions and concepts
Eosinopenia
Severity of hypereosinophilia
Excluding secondary causes
Deciding the focus of treatment—the underlying condition, eosinophilia, or both?
Risk assessment
Deciding when to treat
Hypereosinophilia of undetermined significance (asymptomatic hypereosinophilia)
General management of hypereosinophilic syndrome, complications of treatment, and acute life-threatening presentations
Medications
Biologic agents
Transplantation
Biologic drugs and other medications with potential for future use
Anti-Siglec-8
Dexpramipexole
Anti-EMR1
Tyrosine kinase inhibitors
Therapies that are not efficacious in the management of hypereosinophilic syndrome
Supportive care and surgery
Conclusion
References
Further reading
Chapter 45. Treatment of urticaria and angioedema
Abstract
Chapter outline
Introduction
Urticaria
Angioedema
Summary
References
Chapter 46. Integrative medicine in allergy and immunology
Abstract
Chapter outline
Philosophy of integrative medicine in allergy and immunology
Approaches of integrative medicine in allergy and immunology
Evaluation of integrative medicine in allergy and immunology
Allergic rhinitis
Systemic lupus erythematosus
Rheumatoid arthritis
Inflammatory bowel disease
Overall summary
References
Section E: Treatment of immunological disorders
Chapter 47. Treatment of primary immunodeficiencies and inborn errors of immunity
Abstract
Chapter outline
Introduction
Nutrition
Treatment of antibody deficiencies
Treatment of combined immune deficiencies
Autoimmunity associated with primary immune deficiencies
Treatment of phagocytic disorders
Other considerations
Complement deficiencies
Vaccination in PIDD
Conclusion
References
Chapter 48. Management of autoinflammatory syndromes and periodic fevers
Abstract
Chapter outline
Introduction
Management of autoinflammatory diseases by condition
Pharmacological aspects of management
Nonpharmacological aspects of management
Conclusions and future directions
References
Chapter 49. Immunomodulatory pharmaceuticals for the treatment of immune dysfunction
Abstract
Chapter outline
Background
Immune modulation in primary immune deficiency disorder
Immune modulators safety profile
Immunomodulators and immunodeficiencies: special considerations
Immunomodulation in hemophagocytic lymphohistiocytosis
Immunomodulatory drugs and severe Coronavirus disease of 2019
Discussion
References
Chapter 50. Management and prophylaxis of infections in primary immunodeficiency
Abstract
Chapter outline
Introduction
Immunizations
Antimicrobial prophylaxis
Bacterial infections
Viral infections
Fungal infections
Protozoal infections
Conclusion
Acknowledgment
References
Chapter 51. Bone marrow transplant for the patient with primary immune deficiency disorder
Abstract
Chapter outline
History and indications
Indications for transplant
Special considerations in bone marrow transplantation for primary immunodeficiency
Long-term concerns in primary immune deficiency
Conclusion
References
Chapter 52. An immunologist’s guide to solid-organ transplantation
Abstract
Chapter outline
Introduction
The journey of clinical transplantation
Routine transplant maintenance therapy
Rejection and treatment
Tolerance and ABO-incompatible transplant
References
Chapter 53. The use of therapeutic apheresis in allergic and immunological diseases
Abstract
Chapter outline
Introduction
Definitions
American Society for Apheresis guidelines
Therapeutic plasma exchange
Immunoabsorption
Extracorporeal photopheresis
Adsorptive cytapheresis general overview
Conclusion
References
Chapter 54. Management and treatment of human immunodeficiency virus
Abstract
Chapter outline
Introduction
Pharmacotherapy
Prevention
Antiretroviral adherence and support
References
Chapter 55. Gene therapy in the treatment of primary immune deficiency diseases
Abstract
Chapter outline
Introduction
Setbacks and pitfalls for gene therapy
Gene editing
Future perspectives and ethics of gene editing
References
Section F: Supplements
Appendices
Appendix A Abbreviations
Appendix B Ordering allergen extracts for skin testing and immunotherapy ,
Appendix C Oral and parenteral steroid dosing chart
Appendix D Topical corticosteroid potency chart
Appendix E Nonirritating concentrations of drugs for purposes of skin testing
Appendix F Normal values of immune function tests
Appendix G Pneumococcal serotypes in vaccines and testing
Appendix H CD molecules and their function
Appendix I T-cell subsets and ontogeny
Appendix J Immunological check point inhibitors
Appendix K B-cell subsets and ontogeny
Appendix L Monoclonal antibodies and fusion proteins currently in use in allergy and immunology
Index

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Physical Sciences & Engineering

Social Sciences & Humanities

Health

Allergic and Immunologic Diseases

A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic Diseases

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Institutional subscription on ScienceDirect

Christopher Chang

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