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Rinitis Alergica

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Rinitis Alergica

  1. 1. ALIAGA MACHA, Carlos
  2. 2. RINITIS ALÉRGICA La rinitis alérgica es una enfermedad inflamatoria desencadenada por la exposición a alergenos ambientales normalmente tolerados por la población en general. Es mediada por un mecanismo de hipersensibilidad tipo I, en el cual los mastocitos se encuentran sensibilizados por IgE específica a antígenos ambientales. ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA. 2007
  3. 3. ALGUNOS DATOS ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA. 2007
  4. 4. Patient perceptions of allergic rhinitis and quality of life.WAO journal september 2008; 138 - 144 The voice of the patient: Allergic rhinitis is not a trivial disease. Current opionion in allergy and clinicla immunology 2008: 1- 9
  5. 5. FACTORES DE RIESGO <ul><li>FAMILIAR-HERENCIA :capacidad de producir gran cantidad de anticuerposcontra sustancias extrañas. </li></ul><ul><li>Atopia: es la condicion mediante la cual la persona hereda esta predisposicion.Mediado por IGE. </li></ul><ul><li>Enfermedades Virales: Gatillan o acentúan una rinitis alérgica presente . </li></ul>
  6. 6. MECANISMO The voice of the patient: Allergic rhinitis is not a trivial disease. Current opionion in allergy and clinicla immunology 2008: 1- 9
  7. 7. FISIOPATOLOGIA <ul><li>FASE DE SENSI BILIZACION </li></ul><ul><ul><li>El alergeno sobrepasa la barrera mucosa,es fagocitada por los Macrófagos, Liberándose linfoquinas que activan a los Linfocitos T , ellos estimulan la Formacion de Linfocitos B que produciran IGE .Se deposita en gran cantidad en la superficie de los vasos sanguíneos y en la superficie de los Mastocitos, a nivel de mucosa y submucosa de la nariz. </li></ul></ul>
  8. 8. FASE DE PRODUCCIÓN ALERGICA <ul><li>Fase Temprana: </li></ul><ul><ul><li>El alergeno se pone en contacto con la IgE en la superficie del Mastocito, con lo cual se produce un aumento de la permeabilidad de la membrana celular </li></ul></ul><ul><ul><li>Liberación de Mediadores preformados: Histamina, SRS-A , ECF, PAF. </li></ul></ul><ul><ul><li>Liberación de mediadores Neoformados apartir del Acido araquidónico : Prostaglandinas, Tromboxanos , Leucotirenos . </li></ul></ul>
  9. 9. Fase de Produccion Tardía : <ul><li>En ausencia de ALERGENO, se produce la llegada de células inflamatorias como Eosinofilos y Basófilos que mantienen la enfermedad en forma crónica. </li></ul>
  10. 10. CLASIFICACIÓN ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA. 2007
  11. 11. DIAGNOSTICO <ul><li>1) Historia Clínica </li></ul><ul><li>2) Antecedentes Familiares </li></ul><ul><li>3) Pruebas cutáneas </li></ul><ul><li>4) IgE sanguineo </li></ul><ul><li>5) Recuento celular de Secreción Nasal . </li></ul>
  12. 12. HISTORIA CLÍNICA <ul><li>Inicio de la enfermedad antes de los 20 años. </li></ul><ul><li>Inicio frente a AG específicos e irritantes no específicos </li></ul><ul><li>Frecuentemente asociado a Atopia, Asma o Dermatitis Alérgica. </li></ul><ul><li>Estacional o Perenne. </li></ul><ul><li>Frecuente asociación a Historia familiar de alergias . </li></ul>
  13. 13. SINTOMAS The voice of the patient: Allergic rhinitis is not a trivial disease. Current opionion in allergy and clinicla immunology 2008: 1- 9
  14. 14. PRUEBAS CUTÁNEAS Y OTROS EXÁMENES <ul><li>Prick Test: Ideal solicitarlo de acuerdo a historia del Paciente </li></ul><ul><li>Se compara control de Histamina con Alergeno. </li></ul><ul><li>Será positivo si la reaccion es mayor que el control de histamina. </li></ul><ul><li>Deteccion de Ige: S e cuantifica IgE específica para un alergeno . </li></ul><ul><li>Recuento celular de Eosinofilos: Se ha estipulado un valor mayor de 10-20% . </li></ul>
  15. 15. RESUMIENDO… ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA. 2007
  16. 16. DIAGNÓSTICO DIFERENCIAL
  17. 17. ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA. 2007 GUIDELINES PARA EL TRATAMIENTO DE LA RINITIS ALÉRGICA
  18. 18. Treatment of allergic rhinitis (ARIA) Allergic Rhinitis and its Impact on Asthma mild intermittent mild persistent moderate severe intermittent moderate severe persistent allergen and irritant avoidance immunotherapy intra-nasal decongestant (<10 days) or oral decongestant local chromone intra-nasal steroid oral or local non-sedative H1-blocker
  19. 19. COMPLICACIONES DE LA RA

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