Elena Resnick
speaker
130 appearances
2 recordings
1 series
first heard Jan 2025
last heard 17 Jul
Elena Resnick’s voice in public audio — every appearance, attributed to the second.
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Appearances
Obviously, we don't want to put a pregnant woman into anaphylaxis.
So we're sort of stuck with that label, which is hard for the OB because then their patient gets a simple infection.
They can't use a penicillin.
So a lot of the OBs will say to their patients, before you get pregnant again, better go get cleared of your
Penicillin allergy.
Huh. This patient told me they were allergic to penicillin. Oh, it's that your mom told you when you were a kid. Well, what happened? Oh, you don't even know what happened?
Elena Resnick. I'm an allergist and immunologist.
I always knew I wanted to be a doctor. My dad's a doctor, and there was never any doubt about that. I was lucky to have a lot of great mentors along the way. My mentor in college, Jerry Groupman, who's up at Harvard, was very instrumental in my choices. I worked in his lab for four years. applied to medical school, thought I wanted to be a hematologist oncologist like him, explored that field.
And later into my residency, I explored allergy immunology, which has fascinating medicine and amazing potential to make people feel better.
The immune system in particular is fascinating because we know so little about it. It's so important, right? We need our immune system to protect us from disease and to fight things off. When it goes haywire, we can end up with autoimmune disease, which is where our own antibodies attack us.
Or we can end up with allergic disease, which is when different types of antibodies, IgE antibodies, react against substances that are harmless. But if we make antibodies against them, we can run into big trouble. Define IgE for me. IgE is immunoglobulin E. It's an immunoglobulin that's made by B cells.
It probably had more of a function evolutionarily in terms of fighting off parasitic disease, etc., It certainly was not evolutionarily made to react to peanuts and pollens, but we don't know why in some people those types of antibodies are made that are specific against harmless substances.
It's the most serious type of IgE-mediated allergic reaction where the allergy cells explode, they release all sorts of mediators, histamines, tryptase, etc., and that causes your vessels to vasodilate. Fluid runs in, people get hives, people get swelling, people's throat closes up, or you have difficulty breathing.
Your airways constrict. And because the vessels all over the body are dilating, your blood pressure drops. You can't get blood back up to your heart and you have a cardiac arrest.
The studies show that 90 percent of people who believe that they are allergic to penicillin actually can tolerate it.
Oh, my gosh. I don't know that I can think of any. I think that the vast majority of people either have or were told that they had some sort of reaction in childhood. So that is the most common history.
I think you are 100% wrong, I'm sorry to say. The other drugs, we're so lucky to have them, but many of them have much more severe side effect profiles than penicillin does. They can have more serious complications. They're much more expensive. And in certain cases, for example, vancomycin, they can actually increase the risk of drug-resistant bacteria.
How do we do that? So every good experiment has a control. And the controls that we use are saline, which is salt water. Nobody is allergic to that. And histamine, which is the body's allergic chemical. So we prick you. And when I say prick, I mean we clean off the forearm. And then we use tiny needles to introduce just under the surface of the skin saline, histamine, and our penicillin reagents.
So it's four small pricks under the surface of the skin.
If you are allergic, we would expect that where we pricked you with the saline, nothing would happen. Where we pricked you with the histamine, you'll get a red itchy bump. And where we prick you with the penicillin, you will also get a red itchy bump. That's considered a positive test. We say you've tested positive for penicillin allergy. That's it. Go home. Continue to avoid penicillins.
Showing 101–120 of 130 · page 6 of 7
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