Melissa D - A Bad Reaction: A Case Study in Immunology

Lesson Plan for High School Biology

Duration: 45 minutes

Case Studies found at:

Principle(s) Investigated:

Students will be able to illustrate the various roles of immune cells, the physiology of anaphylaxis, and the function of antibodies in immune physiology. The case involves concepts related to histocompatibilities, organ donation, and organ rejection.

California Content Standards Addressed:

10. Organisms have a variety of mechanisms to combat disease. As a basis for understanding the human immune response:

            b.  Students know the role of antibodies in the body’s response to infection.

e.  Students know why an individual with a compromised immune system (for example, a person with AIDS) may be unable to fight off and survive infections by microorganisms that are usually benign.

f.  Students know the roles of phagocytes, B-lymphocytes, and T-lymphocytes in the immune system


  • Copies of the patient records  (enough copies to supply each group with every record)
  • File Folders (Patient #1, Patient #2, Patient #3)
  • Play money (enough to supply each group with $1200); or “credit”
  • Data recording sheets (each group needs a set of data recording sheets)
  • Record description sheets (each group needs a sheet describing each record)


Part I: "Medical Mystery"

  1. Divide class into 6 groups.
  2. Explain to the class that you, the instructor, is the Director of Grants and Research at a local hospital who has hired them as teams of researchers (the groups) to examine the records of the patients in an attempt to uncover the connections.
  3. Provide a brief introduction that includes a review of (this is all the information they get before strategically selecting the case files) :
    1. Project Goals:
        1. You have been awarded a grant in the amount of $1200.
        2. Your research team is to use this grant to cover the costs of examining the case histories of three patients.
        3. Your goal is to make a diagnosis from these records and design a testable experiment that can be used to obtain future funding.
    2. Case Presentations:
        1. Case #1: November 18, 1989 (22-year--old male)                                                            The patient presented to the ER with complaints of nausea, diarrhea, dizziness, and abdominal cramps. Three hours after being admitted, the patient suffered a cardiorespiratory arrest which resulted in cerebral anoxia, coma, and brain death. Multiple organs were procured for transplant and no autopsy was performed.
        2. Case #2: March 2, 1990 (35-year-old male)                                                                  Patient is a recipient of a liver and right kidney transplant from the patient in case #1. Three months after the transplant, the patient presented in the ER with complaints of dizziness, shortness of breath, nausea, and skin rashes. The patient was interviewed (transcripts available). Several tests were run to determine the general health of the patient and the condition of the transplanted organs. NO DIAGNOSIS AT THIS TIME.
        3. Case #3: March 15, 1990 (27-year-old woman)                                                            Patient #3 was called into the ER for assessment in response to the clinical observations made in case #2. Patient #3 is a recipient of a left kidney and pancreas from Patient #1. The patient was interviewed (transcripts available) and a complete physical was done along with assessment of the transplanted organs. There is no apparent manifestations of any illness or disease in this patient at this time.
    3. Diagnosis: (on hand-out)
    4. Experiment Proposal: (on hand-out)
    5. Contents and Cost of Individual Records: (on hand-out)
    6. Evaluation Criteria: (on hand-out)
    7. Time Limitation for Completion: (on hand-out)
  4. Students will begin to organize and develop a strategy for purchasing the records.
  5. Collect the student work at the given time.

Student Prior Knowledge:

Students have the basic understanding of the various components of the immune system, including the various types of immune cells, the concept of antigen and antibody, and the difference between specific and non-specific defenses.


  • Patient #1 has food allergies and consumed a meal that contained all of those foods (medical history and transcript).
  • Patient #1 has many signs and symptoms of anaphylaxis (vitals and blood tests).
  • Patient #2 had a meal with peanuts prior to presenting in the ER (transcript).
  • Patient #2 has some signs of hypersensitivity reaction.
  • Patient #2, who received a combination liver and kidney transplant, probably received the peanut allergy through the liver because Patient #3 also received a kidney and does not show signs of this allergy (she eats peanut butter and jelly sandwiches).
  • Organ rejection does not seem probable since the organ assessments for Patients #2 and #3 are normal.
Norman Herr,
Mar 16, 2011, 9:35 PM