This doctor has a system

Chapter 522 585. Strange Allergies
"Hello, Director Gao, you are having dinner here too." Liu Benmao responded.

"I just got here too." Gao Feng replied, "Why are you all wet?"

"There's something wrong with the umbrella." Liu Benmao made up an excuse.

Gao Feng was not very familiar with him, so he didn't want to ask too much. The three of them had a simple meal and parted ways as soon as the rain stopped.

At night, Li Youliang, who was sleeping with his girlfriend in his arms, was woken up by a phone call. He picked up the phone and saw that it was an unfamiliar number.

Who is this? Disturbing my sleep in the middle of the night. So annoying!
"Hey?"

"Is that Xiao Li?" A middle-aged female voice came over, "I'm your second aunt!"

"Second Aunt?" Li Youliang thought about it and didn't seem to have any special impression.

In rural areas, the term "second aunt" has been overused, and people always call you "second aunt" or "second aunt" at any time.

"How can you forget your relatives now that you have become capable?" The second aunt on the other end of the phone was a little dissatisfied, "Have you forgotten that when you were a child, I beat you... and hugged you."

Li Youliang thought for a long time and finally remembered who the other person was.

Second Aunt lives at the west end of the village. She is a very enthusiastic person and likes to meddle in other people’s business.

He was naughty when he was a child. For a period of time, he liked to go to the river to take a bath and refused to listen to his parents' teachings.

That day he was having fun in the water and was seen by his second aunt who was passing by.

"Several children have drowned recently. Why are you so stubborn?"

The other party just picked him up and beat him up.

Whenever Li Youliang thinks about this now, he feels a pain in his butt.

"Second Aunt, what's the matter with you calling in the middle of the night?"

"Don't you work at the Provincial Hospital?" Second Aunt said, "My son is not feeling well and has been sent to your hospital. I would like to ask you what is going on."

"What happened to Sandanzi?" Li Youliang asked.

Second Aunt has two sons. The elder one has already married and had children, and the younger one is a few years younger than him and seems to be attending college in State Z.

Li Youliang only remembered the other person's nickname.

"He said he suddenly couldn't breathe." Second Aunt was very worried, "We are rushing over there."

Li Youliang was very sleepy, but he still forced himself to get up.

It was past two in the morning, a great time to sleep, and there was not a soul on Jing Er Road, but the emergency department was a completely different scene.

From time to time, hurried footsteps could be heard in the hall, and the sirens of ambulances tore through the tranquility of the night, bringing endangered lives here one after another.

The doors keep opening and closing, as if it is the cycle of fate, bringing people from life to death, and then from death back to life.

This is the ferry of life, everyone is holding on to the rope of life with their last strength, and those angels in white are their most solid support. In this busy and heavy atmosphere, the meaning of life is given new weight at every moment.

"Li Xiangyu?" The triage nurse checked him out and said, "He went for a CT scan."

Li Youliang quickly ran to the imaging department, and when he arrived and asked, he found out that the person had already gone back.

He ran back panting and finally found the real owner.

"Three eggs!"

Li Xiangyu was receiving an IV drip when he heard his nickname. He turned around subconsciously and asked, "Is it Brother Youliang?"

"What's wrong with you?" Li Youliang looked at him and asked. He didn't seem to have any serious problems.

"It may be an allergy." Li Xiangyu replied. He lifted up his clothes and his chest and back were covered with large patches of rashes, which looked scary.

He had a barbecue with his friends at around 10pm and then went to the playground to play basketball. About 10 minutes after the exercise, he developed such severe allergic symptoms.

"Is this the first time?"

"No." Li Xiangyu replied. There had been such a situation before, but it was not as serious as this time.

This time, he not only had rashes all over his body, but also had obvious breathing difficulties. His roommates saw his condition and thought it was not good, so they called 120.
At this time, a doctor named Gou from the emergency room also came over.

"Brother Gou." Li Youliang said.

"Hey, don't call me that." Doctor Gou frowned in disdain, "Call me Brother Chengcai."

"Okay, Brother Gou, what's going on with my brother? Is he allergic to food?"

"That should be it." Gou Chengcai said after thinking for a while, "But according to his description, it seems that he didn't eat anything special."

The patient's description is definitely not very accurate, and he may not know what he has taken.

Li Xiangyu said that he ate grilled lamb skewers outside, but if the lamb skewers that cost 1 yuan a skewer were real, then the boss must be crazy.

"It's probably pork."

"Oh, no, pork is expensive, it might be chicken, with the sheep fat soaked on it."

This is a common practice, and people who go to eat there sometimes know about this situation.

But who cares, as long as it tastes good, that’s all.

"Anyway, no matter what he eats, it's most likely a food allergy." Gou said, "I gave him two vials of methylprednisolone sodium succinate. Let's send him to the dermatology department or the allergy department tomorrow morning."

The emergency room is only responsible for saving lives, not treating patients.

Li Xiangyu's imaging examination and electrocardiogram showed nothing wrong, and his vital signs were stable, so this treatment was appropriate.

"Sandanzi, just lie here and observe for one night." Li Youliang instructed, "I'll come back tomorrow.

"Okay, Youliang brother."

Before leaving, Li Youliang put some money into his account as a reward for his second aunt beating him when he was a child.

22 hours after Li Youliang left, Second Aunt and her husband arrived.

"How disgusting!" She couldn't stand looking at the large patches of hives on her son's body, "eryue"

Li Xiangyu

"Mom, aren't you just causing trouble?"

"Son, what happened to you?" The father was very worried, "Will this thing leave a scar?"

"No, the doctor said it will slowly subside." Li Xiangyu said quickly, "It has already subsided a lot."

He also told her about Li Youliang's visit, and Second Aunt was moved.

"That kid has been smart since he was young. As expected, he is now a famous doctor in a big hospital." She envied him for a while, then turned around and said with a little regret, "I wish you had studied medicine."

I can’t get such a high score, Li Xiangyu thought.

After a short break, it was soon morning. After the shift change, the nurse in charge of triage contacted the dermatology department and took Li Xiangyu over. "Has this happened several times before?" Bao Xiaoli from the dermatology department asked carefully.

"Yes, I came to see you before." Li Xiangyu said, "I think it was you who showed it to me."

"Did you come to see us? Or was I the one who treated the patient?" Bao Xiaoli quickly pulled out the last medical record, which showed that Li Xiangyu came to see a doctor one year ago because of multiple urticaria all over his body.

The signature at the bottom of the medical record is indeed hers.

The patient underwent a number of tests during his last visit, and serum-specific IgE testing showed that wheat, gluten, and omega-5 collagen were negative, and pork, beef, dog and cat dander, pork albumin, and cat albumin were all positive.

Skin prick tests showed positive reactions to raw pork, pork sausage, and cat hair allergen scratch extracts.

At that time, Li Xiangyu scoffed at this result. He often ate pork and beef, not to mention wheat. As for cats and dogs, he had come into contact with them a lot when he was a child.

"Have you come into contact with cats recently?" Bao Xiaoli asked
"He's in college, how would he get involved in this?" Second Aunt answered quickly.

"There is a coffee shop at the school gate that has cats. I'll go there and pet them when I have nothing to do," said Li Xiangyu.

Petting cats does make people feel happy, and everyone likes soft and cute things.

However, Li Xiangyu has been in contact with cats for many years. His hometown has one and it has always slept on his bed. He didn't show any allergies at that time.

"Did you eat pork or beef yesterday?" Bao Xiaoli continued to ask.

"I don't have beef, but I eat pork every day." Li Xiangyu replied. He couldn't get up in the morning, so he would eat two sausages to fill his stomach.

Bao Xiaoli felt very strange. Since the patient often ate pork and was in contact with cat dander, could it be that these two factors were the cause?

So what was the culprit that caused his allergic reaction?

While I was thinking about it, Li Youliang came over with Gao Feng.

"Hello, Director Gao." Bao Xiaoli quickly stood up and greeted him.

"Hello." Gao Feng looked at her name tag and said, "Doctor Bao."

Li Youliang walked up to greet his second aunt and the other two.

Bao Xiaoli reported the patient's condition and then called the department director.

"Director Gao, your visit is a great honor to our dermatology department." Director Xi said cheerfully. He and Gao Feng were only familiar faces but had never dealt with each other.

"A relative, I came to see him." Gao Feng responded with a smile.

Upon hearing what he said, Director Xi was very concerned and immediately asked about the details again.

I have to say, old people are more experienced. Director Xi is indeed a veteran doctor who has been working for more than 30 years. He quickly discovered two very important situations.

"Have you had runny and stuffy noses after coming into contact with cats in the past two years?"

"Yes." Li Xiangyu replied, "But it's not serious. It will be fine in a while."

“Do allergy symptoms always occur after exercise?”

"Yes, twice I was running, and the rest were playing ball or something." Li Xiangyu replied. He just realized this situation when asked by Director Xi.

"Could it be FDEIA?"

FDEIA, also known as food-dependent exercise-induced allergy, is a unique allergic disease characterized by a systemic allergic reaction that is triggered by physical exercise after consuming specific foods.

Patients often do not have any symptoms when eating this food, and when allergic symptoms occur, the patients have not been exposed to the allergens.

In addition, the thresholds for food intake and exercise intensity that trigger allergic symptoms vary greatly, and it is usually difficult for doctors to diagnose based on a single occurrence of symptoms.

But this situation happened several times after Li Xiangyu appeared, which makes people have to doubt this aspect.

To be honest, it was the first time that Gao Feng heard of this disease. It can only be said that medical knowledge is profound.

But the next question is, Li Xiangyu obviously eats pork every day, but he is not allergic every time. And why was he fine before, but suddenly became allergic in the past two years?
Director Xi couldn't explain it either.

"Let's treat the symptoms first."

Gao Feng became interested in this situation. After returning, he carefully checked the relevant literature and made other discoveries.

In 1994, a scholar reported a disease called pig-cat syndrome, which is a peculiar disease in which patients are allergic to cats and eventually become allergic to pork. It is more common in Europe and other countries, and less common in Asia.

The general principle is that there is antigenic similarity between cat serum albumin and porcine serum albumin. When patients are allergic to cat serum albumin, they produce immunoglobulin E (IgE). Due to the cross-reaction between these two proteins, ingesting pork can also induce an allergic reaction.

The common characteristic manifestations are generalized urticaria, angioedema, dyspnea, and anaphylactic shock. For this disease, blood IgE levels specific for pork albumin and cat albumin are helpful for diagnosis.

Patients often have a history of cat dander allergy that has lasted for several years;
Allergic symptoms do not always occur after eating pork; eating raw or smoked pork is more likely to cause allergic symptoms, while eating pork cooked at high temperatures rarely causes symptoms;

Symptoms appear within a short period of time after consuming pork;

If patients avoid contact with cats in daily life, cat dander-specific IgE levels will gradually decrease, and pork can be safely consumed again.

Back to Li Xiangyu, everyone found that two points were completely consistent: first, the patient had long-term contact with cats, and in recent years he developed symptoms of cat allergy, and then he developed symptoms of pork allergy; second, when the allergic symptoms appeared, what he consumed was not cooked pork, but ham and sausage (equivalent to smoked pork).

In fact, at this point, even if everything seems clear, the person involved still has questions.

Because Director Xi told him that he could no longer pet cats.

"Do you want to give it a try?" Li Xiangyu insisted, "I don't think it's as mysterious as you say."

Oh, I had an allergic reaction after eating pork and exercising, and the reason was that I was allergic to cats???

Isn’t this too unreasonable?
"Are you stupid?" Second Aunt knocked his head. "Can you just try this?"

Having said that, Li Xiangyu still did it according to his own ideas.

After being discharged from the hospital, he didn't pet the cat for a month, then had a barbecued pork belly and played basketball, without any allergic reaction.

very good!

Two days later, he petted the cat for an hour, ate grilled pork belly, and then went to play basketball.

This time it's not so good.

In less than 20 minutes, an ambulance roared into the campus.

"Your relative is really a tough guy." Gao Feng shook his head helplessly. As expected, college students are all stupid.

But this also confirmed that his diagnosis was correct.

As the two were talking about this, they saw another acquaintance, Liu Benmao from the Department of Breast Surgery. He looked even more depressed than before.

"Director Liu!" Gao Feng shouted.

There were a lot of cars coming and going on this street, and the other person looked as if he was daydreaming. He might be thrown into the sky by the cars.

Liu Benmao saw Gao Feng stunned for a moment, then walked towards them.

(End of this chapter)