What are the most likely type and mechanism of the urticarial hypersensitivity reaction? What are the most likely type and cause of the anaphylactic reaction?
This 35-year-old woman reported that she had experienced three bouts of urticaria of unknown origin about 10 years ago. The urticaria affected her mucous membranes and skin. She had experienced similar symptoms after repair of a fractured femur caused by a skiing accident. These symptoms were attributed to an antibiotic reaction.
As an emergency room nurse, she observed occasional localized hives after the use of latex gloves. Even when she used hypoallergenic latex gloves, she continued to have hives every few months. Increased urticaria, at times generalized, continued to occur.
Within 30 minutes of having a routine vaginal examination performed by a health care provider wearing latex gloves, she had an anaphylactic reaction that required resuscitation and hospitalization. A vaginal biopsy 1 week later required a latex-free environment for her safety.
A short time later, she was forced to retire from nursing because of symptoms of asthma. She had also developed food allergies to shellfish.
- What are the most likely type and mechanism of the urticarial hypersensitivity reaction?
- What are the most likely type and cause of the anaphylactic reaction?
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