Reacción de Hipersensibilidad Tipo II

Descripción General

• Reacción de hipersensibilidad
  • Una respuesta “hiper” o exagerada a lo que deberían considerarse antígenos ambientales inofensivos
  • Los LOS Neisseria tipos I, II y III son reacciones inmediatas que se producen en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un plazo de 24 horas.
  • La reacción de tipo IV se desarrolla durante varios días.
• Reacción de hipersensibilidad tipo II
  • Reacción de hipersensibilidad mediada por anticuerpos de inmunoglobulina M ( IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions) e IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis que se unen a:
    • Antígenos intrínsecos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las superficies celulares (e.g., eritrocitos) o materiales extracelulares (e.g., membrana basal)
    • Antígenos extrínsecos (e.g., hemoderivados, medicamentos)
  • El complejo anticuerpo-antígeno conduce a procesos que resultan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum lisis celular, daño y/o disfunción tisular.

Fisiopatología

Activación del sistema del complemento

Los LOS Neisseria siguientes mecanismos se desencadenan por la unión de los LOS Neisseria complejos anticuerpo-antígeno:

• Complemento: proteínas grandes y distintas que participan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una cascada enzimática secuencial para la defensa del huésped
• Los LOS Neisseria números de complemento (C1-4) no indican el orden de activación, sino que reflejan el orden en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el que fueron descubiertos.
• Las vías a partir de C1 son movilizadas por complejos anticuerpo-antígeno → C3 → escindido a C3a y C3b → C3b escinde C5 a C5a y C5b
• C3a, C4a, y C5a:
  • Mediadores de la inflamación = anafilatoxinas
  • Degranulación de mastocitos y basófilos
  • El C5a también provoca quimiotaxis de neutrófilos.
• C5b y C6, C7, C8, C9:
  • Complejo de ataque de membrana
  • Se adhiere a la membrana celular y crea canales permeables a los LOS Neisseria iones que provocan cambios osmóticos y lisis celular
• C3b:
  • Una opsonina (marca los LOS Neisseria antígenos para su eliminación por los LOS Neisseria fagocitos = opsonización) que media la fagocitosis de las células diana
• Ejemplos: reacción transfusional, anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune

Citotoxicidad mediada por células dependientes de anticuerpos

• Los LOS Neisseria anticuerpos, u opsoninas, unen sus sitios de unión a antígeno a los LOS Neisseria antígenos y los LOS Neisseria marcan para su fagocitosis.
• Si los LOS Neisseria complejos antígeno-anticuerpo son demasiado grandes para ser fagocitados, se reclutan células efectoras portadoras de receptores Fc Fc Crystallizable fragments composed of the carboxy-terminal halves of both immunoglobulin heavy chains linked to each other by disulfide bonds. Fc fragments contain the carboxy-terminal parts of the heavy chain constant regions that are responsible for the effector functions of an immunoglobulin (complement fixation, binding to the cell membrane via fc receptors, and placental transport). This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme papain. Immunoglobulins: Types and Functions, principalmente linfocitos asesinos naturales.
• Los LOS Neisseria linfocitos asesinos naturales se unen al AL Amyloidosis receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors Fc Fc Crystallizable fragments composed of the carboxy-terminal halves of both immunoglobulin heavy chains linked to each other by disulfide bonds. Fc fragments contain the carboxy-terminal parts of the heavy chain constant regions that are responsible for the effector functions of an immunoglobulin (complement fixation, binding to the cell membrane via fc receptors, and placental transport). This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme papain. Immunoglobulins: Types and Functions del anticuerpo → liberan gránulos tóxicos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células → perforina y granzimas perforan la membrana → lisis celular
  • Ejemplos: rechazo de trasplante, reacción inmune contra una neoplasia

Disfunción celular mediada por anticuerpos

• No citotóxica; la función celular se ve VE Ventilation: Mechanics of Breathing afectada sin que se produzca una lesión o inflamación celular
• Los LOS Neisseria autoanticuerpos se unen a receptores de superficie celular para producir una activación/bloqueo anormal del proceso de señalización.
• Ejemplos:
  • Miastenia gravis ( los LOS Neisseria anticuerpos provocan el bloqueo del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de acetilcolina)
  • Enfermedad de Graves ( los LOS Neisseria anticuerpos provocan la estimulación del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de la hormona estimulante de la tiroides (TSH, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés))
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types perniciosa (anticuerpos contra el factor intrínseco)

Presentación Clínica

La hipersensibilidad tipo II puede ser resultado de las siguientes afecciones:

Reacciones transfusionales (incompatibilidad ABO o de grupo sanguíneo)

• Un receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de grupo sanguíneo A u O reaccionaría con un donante tipo AB o B (debido a la presencia de anticuerpos anti-B)
• Un receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de grupo sanguíneo B u O reaccionaría con un donante tipo A o AB (debido a la presencia de anticuerpos anti-A)
• Síntomas: fiebre, picor, urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives); una reacción grave provoca dificultad respiratoria e hipotensión

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune (contra los LOS Neisseria eritrocitos)

• Puede ser mediada por IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune caliente) o por IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune fría)
• Se manifiesta por debilidad, dificultad respiratoria, palidez por anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hasta ictericia y orina oscura por hemólisis

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types perniciosa (contra el factor intrínseco)

1. El anticuerpo impide la absorción de la vitamina B₁₂, causando anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types por deficiencia de B₁₂.
2. La deficiencia de B₁₂ puede provocar síntomas generales de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types, glositis, parestesias, problemas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la marcha.

Enfermedad hemolítica del feto y del recién nacido (contra los LOS Neisseria eritrocitos; incompatibilidad RhD)

• Primer embarazo: Una mujer rhesus-negativa concibe un feto rhesus-positivo.
• Parto: Durante el parto, los LOS Neisseria eritrocitos del feto se filtran a la madre.
• Posparto: Los LOS Neisseria eritrocitos fetales sobreviven el tiempo suficiente para provocar una respuesta IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis.
• Segundo embarazo: Los LOS Neisseria anticuerpos anti-D maternos atraviesan la placenta Placenta A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (chorionic villi) derived from trophoblasts and a maternal portion (decidua) derived from the uterine endometrium. The placenta produces an array of steroid, protein and peptide hormones (placental hormones). Placenta, Umbilical Cord, and Amniotic Cavity y atacan los LOS Neisseria eritrocitos fetales del segundo feto rhesus-positivo.
• Los LOS Neisseria recién nacidos pueden presentar desde anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autolimitada hasta hidropesía fetal ( anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types severa, edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema cutáneo, ascitis, derrame pulmonar/pericárdico).

Púrpura trombocitopénica autoinmune

• Fagocitos destruyen plaquetas sensibilizadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre.
• Mayor riesgo de hemorragia: < 20 000/μL
• Puede presentar petequias, púrpura, epistaxis Epistaxis Bleeding from the nose. Granulomatosis with Polyangiitis hasta hemorragia severa

Fiebre reumática aguda

• Anticuerpos contra la pared celular del Streptococcus Streptococcus Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci. Streptococcus también reaccionan con el miocardio.
• Principales manifestaciones: artritis, carditis Carditis Rheumatic Fever, corea de Sydenham, nódulos subcutáneos, eritema marginado

Síndrome de Goodpasture

• Anticuerpos atacan a antígenos de la membrana basal de los LOS Neisseria alvéolos (hemorragia pulmonar) y riñones (nefritis).
• Inicialmente se presenta con quejas sistémicas, seguidas de síntomas renales ( hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma) y pulmonares (disnea, hemoptisis, tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome)

Enfermedad de Graves

• Anticuerpos receptores de TSH estimulan la glándula tiroides para producir T4 T4 The major hormone derived from the thyroid gland. Thyroxine is synthesized via the iodination of tyrosines (monoiodotyrosine) and the coupling of iodotyrosines (diiodotyrosine) in the thyroglobulin. Thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. Thyroxine is peripherally deiodinated to form triiodothyronine which exerts a broad spectrum of stimulatory effects on cell metabolism. Thyroid Hormones y T3 T3 A T3 thyroid hormone normally synthesized and secreted by the thyroid gland in much smaller quantities than thyroxine (T4). Most T3 is derived from peripheral monodeiodination of T4 at the 5′ position of the outer ring of the iodothyronine nucleus. The hormone finally delivered and used by the tissues is mainly t3. Thyroid Hormones libres sin TSH.
• Bocio, exoftalmos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el examen con síntomas como intolerancia al AL Amyloidosis calor Calor Inflammation, ansiedad, temblores, palpitaciones, pérdida de peso.

Miastenia gravis

• Los LOS Neisseria anticuerpos inhiben la unión de la acetilcolina al AL Amyloidosis receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors nicotínico de acetilcolina.
• Los LOS Neisseria anticuerpos también activan una destrucción de receptores mediada por complemento.
• Debilidad muscular fluctuante, que empeora al AL Amyloidosis final del día o después de ejercicio ( ptosis Ptosis Cranial Nerve Palsies, diplopía, masticación fatigante, debilidad de extremidades)
• La debilidad de los LOS Neisseria músculos respiratorios conduce a insuficiencia respiratoria (crisis miasténica).

Diagnóstico y Tratamiento

El diagnóstico y el tratamiento varían en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum función de las manifestaciones, el sistema orgánico implicado y la severidad del deterioro producido por la reacción.

Reacciones transfusionales

• Diagnóstico: clínico; prueba de Coombs
• Tratamiento: suspensión de la transfusión, repetir la determinación de grupo sanguíneo y de prueba cruzada, y cuidados de soporte (mayor evaluación de coagulación intravascular diseminada (CID) dependiendo de la severidad de la reacción)

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune

• Diagnóstico: análisis de hemólisis; prueba de Coombs
• Tratamiento (primera línea): glucocorticoides; tratar la afección subyacente
• Los LOS Neisseria casos refractarios pueden requerir medicamentos inmunosupresores, esplenectomía.

Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types perniciosa

• Diagnóstico: Hemograma, B₁₂, nivel de folato con pruebas confirmatorias si presenta niveles limítrofes
• Tratamiento: Suplemento de B₁₂

Enfermedad hemolítica del feto y del recién nacido

• Diagnóstico: antecedentes de embarazos, anticuerpos maternos, ultrasonido, pruebas de laboratorio fetales
• Prevención: anti-RhD a las 28 semanas de gestación y dentro de las 72 horas posteriores al AL Amyloidosis nacimiento

Púrpura trombocitopénica autoinmune

• Diagnóstico: clínico con hemograma, frotis periférico, virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de inmunodeficiencia humana (VIH), hepatitis C Hepatitis C Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). The infection can be transmitted through infectious blood or body fluids and may be transmitted during childbirth or through IV drug use or sexual intercourse. Hepatitis C virus can cause both acute and chronic hepatitis, ranging from a mild to a serious, lifelong illness including liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis C Virus y otras pruebas basadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria antecedentes
• Objetivo del tratamiento: prevenir hemorragias clínicamente importantes
• Si hay hemorragia, el tratamiento puede incluir: transfusión de plaquetas, inmunoglobulina intravenosa, glucocorticoides

Fiebre reumática aguda

• Diagnóstico: pruebas de laboratorio (proteína C reactiva ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)), velocidad de eritrosedimentación (VES), antiestreptolisina O) con criterios de Jones, ecocardiograma
• Tratamiento: antibióticos para el Streptococcus Streptococcus Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci. Streptococcus y cuidados de soporte

Síndrome de Goodpasture

• Diagnóstico: clínico junto con exámenes de laboratorio (anticuerpos citoplasmáticos antineutrófilos, anticuerpos anti-membrana basal glomerular), biopsia renal
• Tratamiento: plasmaféresis y terapia inmunosupresora

Enfermedad de Graves

• Diagnóstico: El anticuerpo de receptores de TSH confirma el diagnóstico; pruebas de función tiroidea
• Tratamiento: control sintomático (betabloqueadores) y reducción de la síntesis de hormonas tiroideas (medicamentos antitiroideos, radioyodo o tiroidectomía)

Miastenia gravis

• Diagnóstico: electromiografía de fibra única (más sensible) y estudios inmunológicos
• Tratamiento: piridostigmina, inmunoterapias y timectomía