Definition of Anaphylaxis:
Anaphylaxis is a serious allergic reaction that must be treated immediately, as it manifests progressively and can quickly become lethal, as it blocks the airways and closes the glottis.
If you have an anaphylactic reaction, you will need an injection of epinephrine (adrenaline) as soon as possible. At the same time, someone must call 911 so that you can receive emergency medical help. If left untreated, it can be deadly.
Epinephrine can reverse symptoms in a matter of minutes. If this does not happen, you may need a second injection within half an hour. You should not take antihistamines for an anaphylactic reaction. It is also a good idea to wear a medical alert bracelet or a pendant or carry a card with information about your allergy.
If you have had an anaphylactic reaction before, you have a greater risk of having another. You have a higher risk if you have a history of anaphylaxis or have asthma.
Symptoms of anaphylaxis
The first signs of an anaphylaxis may resemble typical allergy symptoms: runny nose or rash. But within about 30 minutes, more serious signs appear.
Generally there are more than one of these:
- Cough; wheezing and pain, itching or tightness in the chest
- Fainting, dizziness, confusion or weakness
- Urticaria; rash and itching, swelling or red skin
- Congestion or stuffy nose and sneezing
- Shortness of breath or shortness of breath and rapid heartbeat
- Swollen or itchy lips or tongue
- Swelling or itching in the throat, hoarseness, difficulty swallowing, tightness in the throat
- Vomiting, diarrhea or cramps
- Weak pulse, pallor
Some people also remember feeling the “sense of fatality” just before the attack.
Up to 1 in 5 people can have a second anaphylactic reaction within the first 12 hours of having one. This is called biphasic anaphylaxis.
Treatment of anaphylaxis
Epinephrine is the most effective treatment for anaphylaxis, and the injection should be given immediately (usually in the mucus). If you have had an anaphylaxis reaction before, you should take at least two doses of epinephrine with you at all times.
Epinephrine expires after about a year, so make sure your prescription is up to date. If you have an anaphylactic reaction and the dose has expired, inject yourself anyway.
When medical personnel arrive, they can administer more epinephrine in a timely manner. If you are not able to breathe, you can put a tube in your mouth or nose to help you. If this does not work, they could do a surgery called a tracheotomy that places the tube directly in the trachea.
Whether in the ambulance or in the hospital, you may need fluids and medications to help you breathe. You will probably have to stay in the emergency room for several hours to make sure you do not have a second reaction.
After the initial emergency is over, consult an allergy specialist, especially if you do not know what caused the reaction.
Causes of anaphylaxis
Anaphylaxis occurs when you have an antibody, something that usually fights any infection that may be present in your body, which overreacts to something harmless like food.
It may not happen the first time you come in contact with the food that may detonate it, but it may develop over time.
In children, the most common cause is food. For adults, the main cause is medication.
The typical detonators among foods in children are:
- The common detonators present in adult foods are:
- Tree nuts (walnuts, hazelnuts, cashews, pistachios, pine nuts and almonds)
- Some people are so sensitive that even the smell of food can cause a reaction. Some are also allergic to certain preservatives in food.
The common detonators present in medicines are:
- Penicillin (more injections followed instead of a pill)
- Muscle relaxants such as those used for anesthesia
- Aspirin, ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs)
- Drugs against seizures
Anaphylaxis can also be triggered by some other things. But they are not so common, as for example:
- Pollen, such as ambrosia, grass and pollen from trees
- Stings of bees, wasps and ants.
- Latex, found in hospital gloves, balloons and rubber bands
- Some people may have an anaphylactic reaction if they breathe latex.
- Some may have a reaction to a combination of things:
- If they breathe the pollen of the birch and eat apple, raw potatoes, carrots, celery or hazelnut
- If they breathe sagebrush pollen and eat celery, apples, peanuts or kiwi
- If they breathe ambrosia pollen and eat melons or bananas
- If you touch the latex and eat papaya, chestnuts or kiwi.
- In rare cases, it can be triggered by 2 to 4 hours of exercise after eating certain foods or by exercise itself.
Anaphylactic reactions usually begin in a matter of minutes after contact with what detonates it, but may also occur an hour or more later.
Some people never realize what caused their reactions.
Factors that influence the severity of this disease
The severity of allergic reactions to food can vary, based on the amount of food eaten, whether the food is cooked, raw or processed and the co-ingestion of other foods.
In addition, severity may be influenced by: the age of the patient, the degree of sensitization, whether the food is taken on an empty stomach or ingested during exercise or if the patient has other co-morbid conditions (eg, eczema, asthma or severe allergic rhinitis)