Anaphylaxis is a severe allergic reaction that needs to be treated right away. It can lead to a potentially fatal condition known as anaphylactic shock. It is a severe allergic reaction to venom, food, or medication. Most cases are caused by a bee sting or eating foods that are known to cause allergies, such as peanuts or tree nuts. It can occur within seconds or minutes of exposure to something you’re allergic to.
Anaphylaxis usually begins with severe itchiness in the eyes or face. Within a few minutes, you may start experiencing more severe symptoms, including:
• Swelling, which may cause swallowing and breathing difficulties.
• Shortness of breath.
• Difficulty swallowing.
• Red rash.
• Abdominal (belly) pain.
• Chest tightness.
• Feeling of doom or dread.
If you notice symptoms, get medical help right away or use your allergy medication. Without treatment, more severe, life-threatening anaphylaxis symptoms may occur:
• Drop in blood pressure, with a weak pulse or confusion.
• Increased heart rate.
• Sudden weakness.
Any substance that causes an allergic reaction is called an allergen. For some people, even minimal exposure to traces of an allergen can cause a severe reaction.
In its reaction to an allergen, the body produces large amounts of histamine — a signaling molecule that can trigger an inflammatory response.
This response can lead to:
• dilation of the blood vessels
• a sudden drop in blood pressure
• loss of consciousness
In a person experiencing anaphylaxis, the airways often become narrow, making breathing difficult. In addition, the blood vessels may leak, causing edema, a type of swelling that results from the accumulation of fluid.The reaction may happen immediately after contact with the allergen or within hours of contact.
In children, the most common cause is food. For adults, the main cause is medication.
Typical food triggers for children are:
Common food triggers for adults are:
• Tree nuts (walnuts, hazel nuts, cashews, pistachios, pine nuts, and almonds)
Some people are so sensitive that even the smell of the food can trigger a reaction. Some are also allergic to certain preservatives in food.
Common medication triggers are:
• Penicillin (more often following a shot rather than a pill)
• Muscle relaxants like the ones used for anesthesia
• Aspirin, ibuprofen, and other NSAIDs (nonsteroidal anti-inflammatory drugs)
• Anti-seizure medications
Some people never figure out what caused their reactions. That’s known as idiopathic anaphylaxis. If you don’t know your triggers, you can’t avoid them. So it’s especially important to carry epinephrine injectors, make sure you and people close to you know how to use them, and wear medical alert jewelry.
Risk Factors –
There aren’t many known risk factors for anaphylaxis, but some things that might increase the risk include –
• Previous anaphylaxis.
If you’ve had anaphylaxis once, your risk of having this serious reaction increases. Future reactions might be more severe than the first reaction.
• Allergies or asthma.
People who have either condition are at increased risk of having anaphylaxis.
• Certain other conditions.
These include heart disease and an irregular accumulation of a certain type of white blood cell (mastocytosis).
Some people may go into anaphylactic shock. It’s also possible to stop breathing or experience airway blockage due to the inflammation of the airways. Sometimes, it can cause a heart attack. All of these complications are potentially fatal.
You will most likely be diagnosed with anaphylaxis if the following symptoms are present:
• mental confusion
• throat swelling
• weakness or dizziness
• blue skin
• rapid or abnormal heart rate
• facial swelling
• low blood pressure
While you are in the emergency room, the healthcare provider will use a stethoscope to listen for crackling sounds when you breathe. Crackling sounds could indicate fluid in the lungs.
After treatment is administered, your healthcare provider will ask questions to determine if you’ve had allergies before.
To help confirm the diagnosis:
• You might be given a blood test to measure the amount of a certain enzyme (tryptase) that can be elevated up to three hours after anaphylaxis
• You might be tested for allergies with skin tests or blood tests to help determine your trigger
During an anaphylactic attack, you might receive cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating.
You might also be given medications, including:
• Epinephrine (adrenaline) to reduce the body’s allergic response.
Epinephrine is the most effective treatment for anaphylaxis, and the shot should be given right away (usually in the thigh).
• Oxygen, to help you breathe
• Intravenous (IV) antihistamines and cortisone to reduce inflammation of the air passages and improve breathing
• A beta-agonist (such as albuterol) to relieve breathing symptoms
You carry around the injector, about the size of a larger marker, wherever you go. If you experience an anaphylactic reaction, you inject yourself with the medication, usually in your thigh. These shots work quickly to reverse symptoms.
If symptoms don’t improve after five to 15 minutes, give yourself a second injection, if you have one available. After injecting yourself, get medical help or call 911. You need a medical evaluation after having an anaphylactic reaction.
The best way to prevent anaphylaxis is to stay away from substances that cause this severe reaction. Also:
• Wear a medical alert necklace or bracelet to indicate you have an allergy to specific drugs or other substances.
• Keep an emergency kit with prescribed medications available at all times. Your provider can advise you on the contents. If you have an epinephrine autoinjector, check the expiration date and be sure to refill the prescription before it expires.
• Be sure to alert all your providers to medication reactions you’ve had.
• If you’re allergic to stinging insects, use caution around them. Wear long-sleeved shirts and pants; don’t walk barefoot on grass; don’t wear bright colors; don’t wear perfumes, colognes or scented lotions; and don’t drink from open soda cans outdoors.
• If you have food allergies, carefully read the labels of all the foods you buy and eat. Manufacturing processes can change, so it’s important to periodically recheck the labels of foods you commonly eat.
When people don’t get treatment in time, anaphylaxis may lead to unconsciousness and even death. But if you get prompt treatment with epinephrine, the prognosis is good. You’ll likely make a full recovery.
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