Anaphylaxis Allergy: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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woman that treats himself against anaphylaxis allergy

1Overview

Many individuals experience allergic or hypersensitivity reactions to specific items including food, dust, cosmetics, or skin products. In some cases, people become allergic to climate change and pollution. These allergens cause mild allergic reactions. However, if the reactions progress into more severe symptoms, this may signal an anaphylactic reaction or anaphylaxis.

Anaphylaxis is a severe and life-threatening condition that needs prompt and urgent care. The immune system responds to an allergen by releasing chemicals that can cause a person to go into shock, which is characterized by a drop in blood pressure, narrowing of the airways and difficulty in breathing.

The most common triggers of an allergic reaction include certain foods, medications, latex and insect stings. Anaphylaxis requires immediate medical treatment, which includes the urgent injection of epinephrine and a trip to the emergency department of a hospital.
If the condition is left untreated, it may lead to anaphylactic shock, which is fatal.

According to the Food Allergy Research & Education, there are more than 170 foods that have been reported to cause anaphylaxis or allergic reactions. The major food allergens are milk, egg, tree nuts, peanuts, wheat, soy, crustacean shellfish, and fish.

In the United States, there are 15 million Americans who have food allergies, including 5.9 million children who are below 18 years old. An estimated 30 percent of children with food allergies are hypersensitive to more than one food.

About 200,000 people require medical care in the emergency room for food allergies. In fact, a food allergy causes an allergic reaction that needs a trip the emergency room for emergency medical care.

2Symptoms

Anaphylaxis usually develops abruptly and gets worse rapidly. In fact, the symptoms of anaphylaxis may occur within just minutes of exposure to an allergen or trigger. The signs and symptoms include:

  • Hives and itching
  • Flushed or pale skin
  • Low blood pressure
  • Feeling lightheaded
  • Fast and shallow breathing
  • Wheezing
  • Fast heartbeat
  • Cold and clammy skin
  • Confusion and anxiety
  • Construction of the airways (swollen tongue)
  • Nausea and vomiting

Seek medical help if the patient – either yourself, your child or someone else has a severe allergic reaction. Seek emergency help if the symptoms do not go away.

3Causes

The immune system produces antibodies that aid in the defense against microorganisms and foreign substances. This is just a normal reaction to protect the body against harmful substances like bacteria and viruses.

However, in some people, their immune systems overreact to these substances, causing an allergic reaction. There are known triggers that could stimulate the immune response against these chemicals and substances.

IgE-Mediated Reactions

Insect Bites

Insect bites can cause an allergic reaction. Hymenoptera venoms from wasps, bees, yellow-jacket, fire ants and Hornet have enzymes called hyaluronidases and phospholipases, which trigger an IgE antibody reaction.

Foods

Some foods may trigger an anaphylactic reaction. These include:

  • Peanut
  • Tree nuts including cashew, pistachio nut, Brazil nut, almond, pine nut and walnut
  • Shellfish
  • Fish
  • Chicken and its eggs
  • Seeds like sesame, cotton seeds, and mustard)
  • Shellfish including oysters, scallops, crab, lobster, and shrimp
  • Milk (goat and cow)

In some cases, the anaphylaxis can be so serious, a reaction can happen by just inhaling the food particle like opening a package of peanuts or smelling the odors of fish being cooked. In some cases, if the food particles come in contact with the skin, the person may also have an anaphylactic reaction.

An anaphylactic reaction may also occur when these allergens are inhaled in the air.

  • Mugwort pollen like peanut, kiwifruit, apple, and celery
  • Birch pollen including raw potato, celery, hazelnut, apple, and carrot
  • Latex including avocado, chestnut, kiwifruit, papaya, and banana
  • Ragweed pollen like melons and banana
  • Shellfish including crab, lobster, oysters, scallops, and shrimp
  • Milk (goat and cow)

Medicines

Antibiotics

Penicillin, Sulphonamide antibiotics, and Cephalosporin are drugs that may trigger an allergic reaction. Hence, doctors should make sure the medicines used are tested on the skin before administering them to the patient.

Muscle Relaxants

Some muscle relaxants like alcuronium, pancuronium, atracurium, vecuronium, and suxamethonium are utilized in general anesthesia. These drugs are responsible for about 70 to 80 percent of allergic reactions that happen during the administration general anesthesia.

Latex

Some people are allergic to latex, a type of rubber used in rubber gloves and condoms.

Contrast Agents

Some people are hypersensitive to contrast agents or dyes used in imaging tests.

4Risk Factors

There are just a few known factors that may increase the risk of anaphylaxis. These include:

Previous Anaphylactic Reaction

If a person had a previous anaphylaxis, the risk of having another and more serious reaction increases. The future attacks might be worse than the previous bouts.

Family History of Anaphylaxis

A family history of allergies may increase the risk of anaphylactic shock.

Certain Conditions

People who have heart disease and mastocytosis, an abnormal accumulation of a type of white blood cell, may raise the risk of having an anaphylactic attack in the future.

Asthma and Allergies

People who have asthma or allergies are more likely to have anaphylaxis than others.

5Complications

Anaphylactic shock is a severe condition that may block the airways and hinder breathing, which can be fatal. The heart may stop beating too, as a result of the sudden drop in blood pressure.

An anaphylactic reaction or shock may lead to serious complications such as:

  • Brain damage
  • Cardiogenic shock ( A condition wherein the heart stops pumping enough blood for the body)
  • Kidney failure
  • Heart attack
  • Arrhythmia
  • Death

6Diagnosis

The doctor will conduct a complete physical examination and medical history to determine previous allergic reactions and certain triggers.

To confirm a diagnosis, the doctor may request a series of tests including:

Blood Test

The doctor may request for a blood test to measure the amount of a particular enzyme called tryptase that can increase up to three hours after an anaphylactic reaction.

Skin Prick or Scratch Testing

Skin prick or scratch testing involves the doctor putting a small amount of allergen on the skin and scratches, to trigger an allergic reaction.

Intradermal (Percutaneous testing)

The allergens are placed under the skin and the doctor will observe for signs of allergic reaction.

7Treatment

Anaphylaxis is considered a medical emergency that requires prompt medical assistance. The best way to treat anaphylaxis is avoiding the known triggers and allergens.

The most commonly-used treatment for anaphylaxis is an epinephrine auto-injector. Individuals with potentially serious allergies will be given an adrenaline auto-injector to carry at all times. This medicine is used to prevent the progression of the anaphylaxis into a more serious condition.

Other treatment options include the administration of oxygen to help the patient breathe and intravenous (IV) antihistamines and steroids to reduce the inflammation of the air passages. Sometimes, a beta-antagonist is also given to relieve breathing symptoms. A licensed doctor should prescribe these medicines.

The long-term treatment of the condition is to avoid allergens and triggers such as food, medicines, climate changes and insect bites.

In the event of an emergency, it is important to do the following steps:

  • Call 999 or an emergency response team immediately if someone is experiencing an anaphylactic attack.
  • If the person has his medicines and you know how to administer them, make sure you administer the medicine immediately.
  • If the person has stopped breathing, perform CPR if you know how to do it, until the paramedics arrive.
  • It is important to get first aid and basic life support training to be equipped as a first-aider in cases like emergencies.

8Prevention

The best way to prevent an anaphylactic shock is to avoid the substances that cause this hypersensitivity reaction.

Always carry the medicines at all times

If a person has an anaphylactic reaction to certain triggers, it is important to carry an emergency kit with all the prescribed medicines at all times.

Wear a medical bracelet or necklace

A person with anaphylaxis should always wear his or her medical alert band to indicate that they have the condition so medical responders know the illness right away.

Practice precautions for insect bites if the person is allergic to stinging insects

To avoid insect stings or bites, it is important to wear long-sleeved tops and pants. Also, do not walk barefoot on the grass and do not use perfumes or scented lotions because these can attract insects.

Carefully read food labels

It is vital to read food labels to make sure you’re not buying products that contain substances you’re allergic to such as peanuts.

Be prepared

Even if you’re careful enough, you might still be exposed to these allergens. However, in the event of an allergic reaction, you should be able to address the emergency properly. Carry your medicine at all times, particularly the auto-injector. Also, inform your doctor about your symptoms and allergy triggers so he or she knows how to manage the condition.

Avoid eating the food triggers

It is important to know which foods you are allergic to. Avoid eating them as much as possible to prevent any severe allergic reactions. Also, inform your family members or friends about your allergies so they would know what to do whenever an attack happens.