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Anaphylaxis

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The potentially fatal allergic reaction is called as anaphylaxis. This is a medical emergency and requires urgent and instant medical attention.

What is Anaphylaxis?

Many are allergic to certain substances, food as well as medications. Some are allergic to insect bites and pollen. When one develops a serious allergic reaction to these allergens that can lead to death, it is called as anaphylaxis.

Anaphylaxis is a potentially fatal, multiorgan reaction that occurs due to release of certain chemicals by the immune system. The organs involved in this serious reaction include the skin, respiratory, cardiovascular as well as the gastrointestinal systems. One suffers from severe hives,  vomiting, and low blood pressure. Most of the reactions are acute and appear seconds or minutes after exposure to the allergen. If left untreated, it could lead to death. Thus, prompt medical attention can help save lives.

Causes of Anaphylaxis

There are different causes of anaphylaxis. Some of these causes are as follows:

Food

Certain foods can trigger allergic reactions that can be as severe as anaphylaxis. Some of the foods that can lead to anaphylaxis shock include:

  • Peanuts
  • Almonds, hazelnuts, cashews, pistachio
  • Milk
  • Eggs
  • Shellfish
  • Mustard
  • Sulphites
  • Lobsters
  • Shrimp
  • Pineapple, banana, kiwi, chestnut, avocado

Medication

Medicines too can trigger anaphylaxis. Some of the medications that cause severe allergic reaction include:

  • Penicillin
  • Aspirin
  • NSAIDs
  • Certain herbal preparations
  • Vaccines
  • Chemotherapy drugs
  • Alternative medications

Venom

Insect bites or stings can trigger a severe anaphylactic reaction. Most common insect bites to invoke anaphylaxis include:

  • Bee stings
  • Wasp stings
  • Kissing bugs
  • Fire ants
  • Hornets
  • Yellow jacket

Latex

Latex allergies too cause anaphylaxis. Latex is material that is obtained from rubber trees. It is common in people who are exposed to rubber or latex. This includes people who work in rubber industry or people who use latex gloves often.

Exercise

One of the rare causes of anaphylaxis is exercise. Some people develop exercise-induced anaphylaxis (EIA) that can occur within 45 minutes to 1 hour of exercising. At times, eating certain foods after exercise can induce anaphylaxis.

Idiopathic

At times, idiopathic causes are considered to trigger anaphylaxis. Idiopathic means, the exact cause is unknown and the reaction has no known trigger.

Signs and Symptoms of Anaphylaxis

Anaphylaxis is an allergic reaction that involves multiple organs. The signs are observed within minutes of exposure to an allergen or at times after several hours. The symptoms thus, involve different systems like:

Skin:

The person develops a severe skin reaction leading to hives, intense itching, swelling, redness, rash, and warmth. The tongue and/or throat swells up in a few cases. One may even develop swollen conjunctiva and skin turning blue due to lack of oxygen.

Respiratory System:

The respiratory system affected caused runny nose, shortness of breath, stridor and wheezing. One may have problems swallowing, pain in throat, hoarseness and cough. Constriction of the airways causes breathing problems. Watery eyes, itchy nose as well as nasal congestion may occur.

Cardiovascular System:

One may develop a weak pulse, suffer from spells of dizziness, fainting, become pale or blue due to lack of oxygen and undergo shock.

Gastrointestinal System

In case of the stomach, a person develops severe nausea, vomiting, diarrhea and stomach cramps.

Other Symptoms

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Other signs of anaphylaxis include confusion, loss of bladder control, headaches, feeling of anxiety, fear of ‘impending doom’, uterine cramps, metallic taste in mouth, etc.

When one has problems breathing, especially severe asthma attack in case of asthma patient, it is a sign of warning bells. Also, people who suffer from low blood pressure, dizziness and fainting spells, should be immediately taken to a hospital. If left untreated, it could lead to death.

Diagnosis of Anaphylaxis Reaction

People who know they are allergic to certain allergens or suddenly develop allergic reactions, should see a doctor. Anaphylaxis is determined based on the clinical presentation of the condition. This includes the following points:

  • If any food eaten seems to be the trigger the reaction
  • If any insect bite or sting was involved
  • Medications that may have lead to the reaction
  • If there was involvement of any latex product

The doctor may also watch out for the following factors:

  • If the symptoms involve skin or mucosal tissue along with respiratory problems
  • If the respiratory system, gastrointestinal system is involved
  • The patient suffers from low blood pressure after exposure to a known allergen

Other tests include:

  • Skin allergy testing
  • Blood tests to determine specific IgE allergen

Management of Anaphylaxis

Anaphylaxis requires immediate medical attention. The first emergency medicine given to the patient is epinephrine  that helps in lowering the allergic response of the immune system. The patient is given oxygen to help maintain the body oxygen levels. Antihistamines and cortisones are given intravenously to reduce the inflammation that causes blockage of the air passages. Albuterol or similar beta agonist are given to help ease breathing.

The patient who has problems breathing should be kept in an upright position to ease breathing. Those who are vomiting should be made to sleep on their side with their head down. Those who faint or feel dizzy should be made to sleep on their backs with the legs raised above heart level. Keep this in mind on the way to the hospital.

Those who are aware of their allergies should always remain prepared. They should carry an epinephrine auto-injector and wear a medical alert bracelet at all times. Make sure parents inform teachers and schools about the allergies their children suffer from. This will help people around the patient know what to do in case of emergency.

Prognosis

Prognosis is good for patients who are given correct and prompt medical help on time. In case of respiratory and cardiovascular reactions, death may occur in about 20% of the cases. In some cases, death occurs within a few minutes of reaction.

One should take extreme care in case they are aware of their allergies. Read food packets, bottles and labels carefully before eating or drinking something. Tell the doctor all about your allergies before he prescribes you drugs and medications. Wear full sleeves and long boots when moving outdoors, especially around the woods or gardens to prevent an insect bite or sting. Never waste time, if you observe anyone around you suffers from an anaphylaxis reaction. Immediate medical attention can help save a life.

Written by: Saptakee sengupta
Date last updated: February 25, 2015