IDIOSYNCRASY

From Big Medical Encyclopedia

IDIOSYNCRASY (grech, idios own, special + synkrasis mixing) — the reactions of an organism similar on the clinical manifestations on allergic and arising at the people having hereditarily the caused hypersensitivity to a nek-eye to foodstuff and drugs.

The concept «idiosyncrasy» evolved from ideas of Ancient Greek and ancient Roman doctors of the correct mixing of four liquids of an organism defining the state of health. They considered that disturbance of mixing of liquids — the dyscrasia — leads to a course of a disease, and special, individual, mixing — the idiosyncrasy — defines unusual reaction to some ordinary, well transferable environmental factors. In the first half of 20 century with development of ideas of an allergy And. began to identify with allergic reactions of immediate type to exogenous allergens (drugs, serums, foodstuff, pollen of plants) and even on action physical. and mental factors. The last found the expression in the term «mental idiosyncrasy». In the middle of the 20th century, and especially in 60 — the 70th, the main mechanisms of development of allergic reactions were opened and it is formulated, classification of types of allergic (immunological) mechanisms of damage of fabrics (see. Allergic diseases ). At the same time allergic reactions to medicines began to call medicinal allergy (see), and reactions to foodstuff — food allergy (see). The analysis of mechanisms of hypersensitivity to drugs and foodstuff showed that not all these reactions are connected with antibody formation or sensibilized lymphocytes (specific allergic reaction). In large part cases these reactions (shocklike states, hemorrhagic vasculites, trombo-and leukopenias, hemolysis of erythrocytes, dyskinesia went. - kish. a path, diarrhea), on the manifestations similar to allergic, are caused by disturbance of activity of some enzymes, functional and other disturbances. According to a number of authors, only in a quarter of cases of intolerance of foodstuff specific allergic mechanisms play a role, the mechanisms connected with enzymatic disturbances, or diskineziya are the cornerstone of other cases. Among such mechanisms the big role belongs to deficit of the certain enzymes participating in metabolism of disaccharides, gluten substances of wheat, a galactose, etc. It resulted in need of division of the concept «idiosyncrasy» from food allergy. Refer intolerance of foodstuff, the mechanism to the first the cut is not connected with specific allergic reaction.

Hypersensitivity to medicines is also referred to And., if it is connected with nonspecific mechanisms, and to a medicinal allergy if it is connected with specific allergic reactions. In a number of the existing classifications (Sh. D. Moszkowski, 1947; the classification accepted on the I International symposium on side effect of drugs in Liege in 1957; classification of the Bulgarian authors, 1976) And. and a medicinal allergy are carried to different types of complications of medicinal therapy. Usually to And. carry cases hereditarily of the determined change of the typical effect of drugs. By data bolg, authors, medicinal And. it can be shown: 1) extreme sensitivity to small doses which can give the effect which is usually caused by much higher doses; 2) scarcely noticeable therapeutic effect of the doses surpassing therapeutic; 3) various changes in systems to which effect of drug is not directed. In a basis And. to drugs the caused lack of the certain enzymes which are taking part in metabolism of medicinal substances lies hereditarily. Example such And. is to a taga naz. the primakhinovy hemolitic anemia developing at reception of some antimalarial drugs (Primachinum, quinacrine), soothing and febrifugal drugs (acetphenetidiene, antipyrine, acetilsalicylic to - that), streptocides and other drugs. Such anemia is connected with a lack of erythrocytes glyukozo-6-fosfatdegid-rogeiazy that leads at reception of the specified drugs to insufficient formation of the recovered NADF and by that to a lack of the recovered glutathione which is necessary for maintenance of cellular integrity of erythrocytes. Hemolysis of erythrocytes results.

Reactions to serums and to pollen of plants do not carry to And., since these reactions are specific allergic. Studying And. to foodstuff and drugs showed that nonspecific mechanisms are very various and usually connected with genetically caused deficit of certain enzymes. In this regard the tendency to elimination of the concept «idiosyncrasy» was outlined. In classification of the drug disease offered E. M. Tareev (1970), the term «idiosyncrasy» is replaced with «genetic enzymopathies», and in classification Yu. K. Kupchinskas (1972) on «toxic metabolic complications».

At children And. can develop at drug intake, especially acting as liberator of a histamine (atropine, codeine, Pilocarpinum, polymyxin B, acetilsalicylic to - that), and various foodstuff. The small group of children has an intolerance to lactose (lactose) owing to inborn insufficiency of enzyme of lactase. Heavy reactions to transfusions of blood at children with inborn deficit of IgA which are connected with the content in the poured substrate of traces of this immunoglobulin are possible.

Each case And. demands the careful clinical laboratory analysis since a wedge, manifestations vary both on character, and on weight from children. Most often And. it is shown by kollaptoidny, leucio-and trombopenichesky reactions, hemolitic anemia, development of vasculites with various skin rashes is possible. Quite often the combination meets And. with allergic reactions.

Treatment

Treatment consists first of all in the immediate termination of administration of substance, to Krom is revealed And. Further assistance is directed to removal of the patient from serious condition — recovery of hemodynamic balance, reduction of vascular permeability and an itch. Cardiacs, drugs of adrenaline, and also antihistaminic drugs, calcium, Rutinum are for this purpose used. At heavy manifestations And. there can be a need of use of corticosteroid hormones.


Bibliography Ado A. D. General allergology, M., 1970, bibliogr.; Allergic diseases at children, under the editorship of M. Ya. Stu-denikina and T. S. Sokolova, M., 1971, bibliogr.; Kupchinskas Yu. K., In and with and l I at with to and with B. I. and Kemp and nanosecond to and with V. V. Side effect of drugs, M., 1972, bibliogr.; A drug disease, under the editorship of G. Mazhdrakov and Pop Christ's P., lane with bolg., Sofia, 1976; H about-galler A. M. Allergiya and chronic diseases of the digestive system, M., 1975, bibliogr.; Side effect of drugs, under the editorship of E. M. Tareev and E. Ya. Severova, page 3, M., 1970; S t i e li m E. R. a. F u 1 g i n i t i V. A. Immunologic disorders in infants and children, Philadelphia, 1973; Tuft L. Mueller H. L. Allergy in children, Philadelphia, 1970.

V. I. Pytsky, T. S. Sokolova.

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