Response # 1: Carefully read the initial posts made by the other students in your small group.

• Respond to the initial post of one of your peers in your discussion group. Identify 1 differential diagnosis for the case study presented. Identify the underlying pathophysiology and clinical presentation of the Differential Diagnosis you identified in your response to your peers. Please Note: you may not duplicate a differential diagnosis posted by another peer in the discussion thread.

 Response of one peer

1. Evidence indicating the absence of an acute severe infection
2. One of the main evidences indicating that Anna does not have an acute severe infection is because of the normality of all her vital signs. This means that all symptoms that Anna is displaying and experiencing are within the normal range. If there was an infection, Anna would be experiencing wheezing, watery eyes, running nose, itchy eyes, and difficulty breathing. Therefore, there is no evidence that Anna has a severe infection.
3. Type of hypersensitivity action involved
4. Hay fever or allergic rhinitis is a common condition, often caused by exposure to pollen (Baghlaf & Eid, 2021). Therefore, individuals sensitive to pollen can experience immediate and sometimes severe effects or reactions. Therefore, if Anna has allergic rhinitis, the type of hypersensitivity action involved would be immediate hypersensitivity. The main reason is that during the examination, Anna states that she often gets colds whenever the fall and spring seasons arrive when flowers are sprouting and blooming. Hence, once the flowers release pollen and Anna gets exposed to the pollen, she reacts immediately, resulting in coughs.
5. Reasons why Anna’s symptoms did not start immediately
6. Anna has been living a normal life and never displayed symptoms of being allergic to cat dander. The main reason for the delay of symptoms is because Anna was probably at the symptom-free period. During this period, the body is exposed to the offending allergen and is determining how to react (Biermé et al., 2017). Besides, during this stage, the B lymphocytes were releasing a significant number of antibodies to fight the allergens, resulting in a delay in symptoms. Therefore, it is vital for Anna to get further tests to determine her level of sensitivity to cat dander and whether she might be allergic to other allergens that she might be aware of.
7. Class of antibodies that bind to mast cells
8. Antibodies help the body to fight and eliminate foreign matter that could potentially harm the body, affecting one’s health and wellness (Anvari et al., 2018). Immunoglobulin E is a class of antibodies that bind to mast cells, providing a safety barrier that protects the body and keeps it healthy. Oftentimes, Immunoglobulin E attaches themselves to receptors on the surface of blood basophils and mast cells. A unique feature of mast cells that have Immunoglobulin E on the surfaces is that all are sensitized. Moreover, the link between Immunoglobulin E and sensitized cells strengthens, causing a release of mediators that prevent allergic reactions from worsening and protect the body from harm.
9. Psychological mechanisms causing the redness of Anna’s nasal mucosa
10. Usually, allergens attach themselves to the useful and reliable immunoglobulin E antibodies, resulting in the degranulation and the release of inflammatory mediators (Biermé et al., 2017). In Anna’s case, it is likely that some mediators could have promoted the occurrence of vasodilation, resulting in the redness of Anna’s nasal mucosa. If this is the case, the best strategy for Anna would be avoiding the exposure and contact with cat dander to prevent further reaction because of the offending allergen. Alternatively, the physician can prescribe effective drugs like antihistamine drugs to reduce the redness of Anna’s nose and offer much-needed temporary relief.
11. Mechanisms that caused Anna’s clear postnasal drainage
12. One of the symptoms that Anna is displaying is a clear postnasal discharge. The discharge could be the result of the cold Anna experienced during spring and fall, meaning that the discharge can disappear on its own after the two seasons end. The increase of vasodilation and vascular permeabilities are other possible reasons or contributors of the clear postnasal discharge. Therefore, Anna can avoid cats, or the physician can administer drugs to stop the discharge and prevent further reactions to cat dander.
    References 
    Anvari, S., Miller, J., Yeh, C.-Y., & Davis, C. M. (2018). IgE-mediated food allergy. Clinical
    Reviews in Allergy & Immunology, 57(2), 244–260. https://doi.org/10.1007/s12016-018-8710-3
    Baghlaf, M. A., & Eid, N. M. S. (2021). Prevalence, risk factors, clinical manifestation,
    diagnosis aspects and nutrition therapy in relation to both IgE and IgG cow’s milk protein allergies among a population of Saudi Arabia: A literature review. Current Research in Nutrition and Food Science Journal, 9(2), 375–389. https://www.foodandnutritionjournal.org/volume9number2/prevalence-risk-factors-clinical-manifestation-diagnosis-aspects-and-nutrition-therapy-in-relation-to-both-ige-and-igg-cows-milk-protein-allergies-among-a-population-of-saudi-arabia-a-lit/
    Biermé, P., Nowak-Wegrzyn, A., & Caubet, J.-C. (2017). Non-IgE-mediated gastrointestinal
    food allergies. Current Opinion in Pediatrics, 29(6), 697–703. https://doi.org/10.1097/mop.0000000000000554
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