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Anaphylaxis

HIGHLIGHTS:

  • Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction
  • Anaphylaxis occurs due to the immune systems of the patient reacting to allergens more vigorously than those in the general population, with potentially fatal consequences.
  • If a patient or family member or a caregiver is experiencing an anaphylactic reaction, that person should be taken to the hospital immediately as such symptoms require emergency medical treatment.

 

Anaphylaxis refers to the body’s immediate and vigorous reaction to certain allergens, such as medication, food, insect stings or other various substances. It occurs as a result of the body’s resistance to that substance, which is higher than in those who do not suffer from the condition. This resistance causes symptoms that affect various bodily organs. However, what’s even more disturbing is that such a reaction is potentially life-threatening.

Symptoms

  • Symptoms affecting the skin: Flushing hives, swelling around the mouth, swelling around the eyes and itchy rash.
  • Symptoms affecting the respiratory system: Difficulty breathing, feels like throat obstruction, breathlessness, and wheezing sound.
  • Symptoms affecting the digestive system: Nausea, vomiting, abdominal pain and diarrhea.
  • Low blood pressure (hypotension), dizziness and feeling faint.
  • Some patients may also experience a headache, tightness at chest, seizures, confusion and even a loss of consciousness.

Anaphylactic reactions can vary in severity and rate of progression. They may progress rapidly (over a few minutes) or occasionally in a biphasic manner.

Substances that can cause allergic reactions

  • Foodssuch as cow milk, nuts, seafood, gluten and egg white.
  • Medications such as antibiotics, aspirin and anticonvulsants.
  • Insect stings such as bees, wasps, hornets and fire ants.
  • Products made from latex for example rubber gloves.

Diagnosis

Doctors will carry out a diagnosis that includes an inspection of the patient’s medical history, the symptoms they previously have suffered, the duration of time the patient has been exposed to the substances suspected of causing the allergic reactions, their history of allergic reactions, any underlying disease, and a physical examination.

For patients who wish to confirm whether or not their symptoms are being caused by other health disorders, a blood test to identify Tryptase enzyme levels may be carried out, as the presence of this enzyme may increase during an allergic reaction. The patient may be requested to undergo the skin prick test later on.

Treatment for anaphylaxis reaction

  • If it is suspected that a patient is experiencing an anaphylactic reaction, he or she should be taken to hospital immediately as such symptoms require emergency medical treatment.
  • Intramuscular injection of Epinephrine into thigh, giving antihistamine medication, saline solution. In some cases, a bronchodilator with oxygen inhaler was given to open up the airways.
  • The patient must remain in hospital to be closely monitored for a period of at least 24 hours depending on the severity of the reaction, and how they respond to the treatment.

Prevention

Avoid coming into contact with the substance that causes the anaphylactic reaction, for example:

  • In cases of food allergies, patients or care giver should read any food labels carefully. When eating out, ask how each disk is prepared, and find out what ingredients it contains.
  • In cases of allergies to insect stings, wear long-sleeved shirt and pants, and try to avoid walking barefoot outside the house.
  • People with a history of allergies should carry a special Allergy ID Card, necklace or bracelet that informs others about which substances they are allergic to.
  • For a person with severe allergic reactions, keep an emergency kit with prescribed medication, Epinephrine, available at all times.
  • A patient or parents or caregivers must alert doctors of a patient’s allergic reaction, and learn how to use Epinephrine medication for any emergency situation.
  • People with a history of anaphylactic reactions should carry an epinephrine auto-injector with them at all times.
  • Patients and their guardians should get to know more about the symptoms of an allergic reaction, including the correct way to inject epinephrine in emergency situations.

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Buntita Bamrungchaowkasem, M.D. Summary: Pediatrics Pediatric Allergy And Immunology