[PBL] 알레르기 환자의 기타 혈액검사 수치

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 3  [PBL] 알레르기 환자의 기타 혈액검사 수치-3
 4  [PBL] 알레르기 환자의 기타 혈액검사 수치-4
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[PBL] 알레르기 환자의 기타 혈액검사 수치에 대한 자료입니다.
목차
Allergy 환자에서의 Routine Laboratory Studies
Allergic Disease
Assay Methods for Measurement of Mediators and Markers of Allergic Inflammation
AST, ALT가 증가하는 경우
Reference
본문내용
Allergic Disease
Increased serum total IgE is not a sensitive test and is of limited clinical value but extreme values may be helpful :
 Very low levels(900ug/L, atopic disease is likely but tests for specific allergens are needed.
 Very high levels (2000 to >60000ug/L) are found in asthma associated with severe atopic dermatitis, allergic bronchopulmonary aspergillosis, Buckley’s syndrome(staphylococcal infections with hyper-IgE), systemic parasitic infestations, IgE myeloma, immune deficiency.
 Principal value in infants is to alert the clinician to the possibility of allergic disease when this is not the presumptive diagnosis.
Radioallergosorbent test (serum IgE antibodies specific for various allergens) measures IgE specific for individual allergies. Useful when skin skin testing cannot be done. (e.g. in children, those at risk for anaphylaxis) or when skin testing is unreliable (e.g. in cases of generalized dermatitis, severe dermographism). Less sensitive than skin and bronchial provocation tests.
Blood eosinophil count of >450/cu mm in adults and >750/cu mm in children suggest allergic disorders. Significant number of false-positive and false-negative results occur.
Nasal cytology smears stained with Wright’s-Giemsa showing >5% eosinophils, >1% basophils, and/or >50% goblet/epithelial cells suggest allergic disease of respiratory tract. Does not correlate with blood eosinophilia. Large numbers of neutrophils suggest infection. Both eosinophils and neutrophils suggest chronic allergy with superimposed infection. Significant number of false-positive and false-negative result occur.
Measurement of serum complement is not useful. 2)



>>> 위의 책을 포함한 여러 진단검사의학 전문 서적에서도 알레르기 반응에서의 혈액검사에 대해서는, 호산구와 IgE 수치에 대한 언급만 되어 있었다.



Assay Methods for Measurement of Mediators and Markers of Allergic Inflammation
A vast amount of knowledge concerning the detection and treatment of allergic disease is derived, in part, from numerous in vitro studies investigating the parameters, mechanisms, and pharmacologic control of the inflammatory mediators released from basophils and mast cells. ........
Although histamine is most commonly measured following this IgE-mediated reaction, it has become increasingly apparent that other mediators are also released from basophils and are important markers of allergic inflammation........................
Histamine
LCT4
Basophil cytokine generation
IL-4
IL-13
Non-basophil-secreted mediators
Tryptase
PGD2
MBP and ECP
NO 3)



>> allergy와 관련된 여러 전문 서적과 논문을 찾아 본 결과, 어디에서도 AST와 ALT 수치에 대해 찾아볼 수 없었고, 따라서 다른 가설에 대해 생각해 보기로 했다. 우선 AST, ALT가 높아지는 경우에 대해 공부해 보았다.


참고문헌
Reference
1) ROY PATTERSON, LESLIE C. GRAMMER, PAUL A. GREENBERGER, C. RAYMOND ZEISS, Allergic Disease – Diagnosis and Management, 4th Edition, J.B. LIPPINCOTT COMPANY, page 205, Routine Laboratory Studies
2) JACQUES WALLACH, M.D., Interpretation of Diagnostic Tests, 7th Edition, LIPPINCOTT WILLIAMS&WILKINS, page 922, Allergic Disease
3) Noel R. Rose, Robert G. Hamilton, Barbara Detrick, Mannual of Clinical Laboratory Immunology, 6th Edition, page899, JOHN T. SCHROEDER, ANNE KAGEY SOBOTKA, Assay Methods for Measurement of Mediators and Markers of Allergic Inflammation
4) 이귀녕, 김진규, 임상화학, 의학문화사, page301-309
5) Burtist CA, Ashwood ER, Tietz Textbook of Clinical Chemistry, 2nd Edition, Philadelphia: WB Saunders Company, page788-797


Allergy 환자에서의 Routine Laboratory Studies
Allergic Disease
Assay Methods for Measurement of Mediators and Markers of Allergic Inflammation
AST, ALT가 증가하는 경우
Reference