Anaphylaxis

Anaphylaxis is a severe allergic reaction that can affect the entire body and escalate rapidly, posing a life-threatening risk. This reaction occurs when the immune system mistakenly identifies a harmless substance, such as certain foods, as a threat, triggering an exaggerated immune response. The body's immune cells release large amounts of inflammatory chemicals like histamines, often within minutes. The onset can be unpredictable, even in individuals who have never reacted to a particular substance before. People with allergies to peanuts, tree nuts, bee stings, and certain medications are most commonly affected, especially those who have previously experienced anaphylaxis.

Causes

Anaphylaxis can be triggered by various factors, often allergens, but not always. Common causes include:

• Genetic Predisposition: More frequent in families with a history of allergies or asthma. Previous severe reactions increase the risk.

• Foods: Common allergens are peanuts, tree nuts, fish, shellfish, cow’s milk, and eggs.

• Insect Stings: Stings from bees, wasps, hornets, yellow jackets, and fire ants.

• Medications: Includes penicillin, Aspirin, muscle relaxants, and anesthesia.

• Latex: Found in disposable gloves, intravenous tubes, syringes, adhesive tapes, and catheters.

• Contrast Dye: Occasionally used in medical imaging.

• Non-Allergen Triggers: Exercise, extreme temperatures, or idiopathic anaphylaxis, where the cause is unidentified.

Symptoms

Symptoms of anaphylaxis can appear rapidly, often within minutes, though sometimes they may be delayed. Common symptoms include:

• Tightness in the throat: Difficulty swallowing or breathing.

• Swelling: Face, lips, tongue, or throat.

• Breathing difficulties: A critical symptom.

• Hives and itching: Early signs.

• Runny nose: Accompanies other symptoms.

• Rapid heartbeat: Noticeably faster pulse.

• Gastrointestinal issues: Nausea, vomiting, abdominal pain, or diarrhea.

• Dizziness or lightheadedness: Due to blood pressure changes.

• Feeling of impending doom: Anxiety or confusion.

Severe cases can lead to respiratory and cardiovascular system involvement, causing airway closure and a dangerous drop in blood pressure, resulting in anaphylactic shock. It's vital to seek emergency medical attention immediately if these symptoms occur.

Diagnosis

Anaphylaxis is typically diagnosed in emergencies based on visible symptoms and signs, not through a single test. Blood tests may occasionally show elevated inflammatory chemicals like tryptase and histamine during a reaction, but these are not essential for diagnosis. Consulting an allergist can be beneficial if you have known allergies, as they can help identify specific triggers and plan appropriate treatments. However, allergy tests do not predict the severity of future reactions, meaning anyone can be at risk of anaphylaxis.

Treatments

Immediate emergency medical help is critical during anaphylaxis due to its life-threatening potential. The primary treatment is Epinephrine, delivered through a single-use auto-injector. Those with severe allergies should always carry an auto-injector and know its use. Brands like EpiPen, EpiPen Jr, Adrenaclick, Symjepi, and Auvi-Q are available by prescription.

In the event of witnessing anaphylaxis, administer epinephrine promptly, then call 911 rather than driving to the emergency room. Medical personnel can provide necessary care during transit. The person should lie down with legs elevated to enhance blood flow unless breathing is easier while sitting upright. Even after symptom improvement, hospital care is essential since symptoms could worsen or recur.

Medications

• Seek emergency medical care immediately for anaphylaxis.

• Administer Epinephrine using an auto-injector for quick treatment.

• Auto-injectors include EpiPen, EpiPen Jr, Adrenaclick, Symjepi, and Auvi-Q, available by prescription.

• Follow these steps during an anaphylactic reaction:

• Administer epinephrine promptly.

• Call 911 for emergency medical assistance.

• Have the person lie down with legs elevated to improve blood flow.

• Medical evaluation is critical even if symptoms improve after epinephrine, as symptoms may reoccur.