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A Bad Reaction

A Case Study in Immunology


James A. Hewlett
Science and Technology Department
Finger Lakes Community College


This case involves the transfer of a food allergy to a patient who received a combined kidney and liver transplant from a donor who died as the result of an allergic reaction. In addition to learning about the various roles of immune cells, the physiology of anaphylaxis, and the function of antibodies in immune physiology, students explore concepts related to histocompatibilities, organ donation, and organ rejection. The case is appropriate for use in a course in human physiology, a combined course in human anatomy and physiology, or an introductory course in immunology.

  • Understand the physiology related to the sensitization to an allergen.
  • Understand physiology related to the allergic response that is produced during a secondary exposure to an antigen that an immune system is sensitized to.
  • Learn the difference between immediate, subacute, or delayed hypersensitivity.
  • Know the symptoms of anaphylaxis and the systemic manifestations of an immediate hypersensitivity reaction.
  • Learn about the various classes of immunoglobulins and the role of IgE in an allergic response.
  • Understand the role of T and B cells in the specific immune response.
  • Understand how an allergen, helper T cells, B cells, IgE, and basophils interact during an allergic response.
  • Understand the role of HLA (MHC) in organ compatibility, donation, and rejection.
  • Understand the difference between antigen and allergen.
Keywords: Allergic reaction; allergen; peanut allergy; anaphylaxis; antigen; antibody; major histocompatibility complex; MHC; human leukocyte antigen; HLA; immune response; organ donation; tissue donation; liver transplant; kidney transplant; organ rejection
Topical Area: N/A
Educational Level: Undergraduate lower division, Undergraduate upper division
Formats: PDF
Type/Method: Directed, Jig-Saw
Language: English
Subject Headings: Physiology   Medicine (General)  
Date Posted: 02/27/02
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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I have finished the course of WBCs and immunity to my students and I will try this activity in my lectures. Thank you.

Noha Abdelaziz Nassef
Faculty of Medicine, Ainshams University
Cairo, Egypt
I used this case study for an A&P class. The students got a lot out of the case study and enjoyed competing in teams. One of the best lessons that came out of this case was the importance of listening to the information that the patients communicated to their health professionals! Pretty important lesson for future health care professionals.

Kathy Eubanks
Cardiovascular Sonography
Sanford Brown College
Dearborn, Michigan
I used this case twice in an upper level undergraduate immunology course when teaching at Bates College. I presented it after we had covered the mechanisms of immune reactions and transplants but gave the student no clue what might be happening. I grouped the students into groups of 4, each group from a different institution.

The students loved this activity. It would often take them about between 30–45 minutes to begin to make sense of the information, and most arrived at the proper conclusion by 90 minutes. On occasion some groups would set up “collaborations” with other institutions/groups and pool their resources (with no encouragement from me, making for a great teaching moment on the power of collaboration and the difficulties).

I would use this activity again in a heartbeat, as it makes the students really think about data and dig deep into what they know about.

The students generally didn’t have time to come up with an experimental approach to confirm their hypothesis while in class. This might be a good exam question to follow the exercise.

Stephanie Richards
Biology Department
Bowdoin College
Brunswick, Maine 04011

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