Anaphylaxis

Anaphylaxis is a severe potentially life threatening allergic reaction that can be sudden in onset after exposure to an allergy causing substance.  Anaphylaxis is a medical emergency that requires immediate treatment in a medical facility. If you have a history of allergies or asthma and have previously had a severe reaction, you are at greater risk for anaphylaxis.  Millions of people are at risk for anaphylaxis but they can successfully manage this risk with proper diagnosis, avoidance, and treatment when needed.

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What is Anaphylaxis?

Symptoms

Symptoms of anaphylaxis usually begin within minutes of exposure to the triggering substance but in some cases can be delayed up to an hour or two.  Symptoms may start out slow with a runny nose, rash, or itching but can rapidly progress to life threatening symptoms such as trouble breathing or drop in blood pressure.  Even if a person’s initial reactions are mild, if they have a true allergy to that substance, then they can potentially have a life-threatening reaction in the future. Symptoms can involve a variety of body systems and can include:

  • Trouble
    Breathing

  • Hives /
    Swelling

  • Throat
    Tightness

  • Hoarse
    Voice

  • Nausea

  • Vomiting

  • Abdominal
    Pain

  • Diarrhea

  • Dizziness

  • Fainting

  • Low Blood
    Pressure

  • Rapid Heartbeat

  • Feeling of Doom

  • Cardiac
    Arrest

Triggers of Anaphylaxis

When a person becomes allergic to a substance he or she develops IgE which is an allergic type of antibody to that substance.  Then when they are exposed to that substance again, the IgE becomes active leading to the release of histamine and other chemicals that lead to the symptoms of anaphylaxis.  It is important to know your triggers for anaphylaxis so you can avoid them. Common triggers of anaphylaxis include:

Foods

Any food can cause anaphylaxis but the most common foods are peanuts, tree nuts, fish, shellfish, eggs, and milk.  A delayed onset of anaphylaxis can occur with a specific type of allergy to mammalian meats. Learn more about food allergy here.

Medications

Almost any medication could potentially lead to anaphylaxis but more common medications are antibiotics such as penicillin.

Stinging Insects

Stings from venomous insects such as fire ants, bees, wasps, hornets, and yellow jackets can lead to anaphylaxis.  Immunotherapy, also known as allergy shots, can be a lifesaving treatment for  those allergic to stinging insects.  Although biting insects, such as mosquitos, can lead to bothersome localized reactions, it is rare for them to cause anaphylaxis.

Latex

Natural latex comes from the sap of a rubber tree and is commonly found in balloons, rubber gloves, and medical equipment.  Latex allergy is more common in healthcare workers, people with spina bifida, or those with a history of multiple surgeries.

Exercise

In some people, strenuous exercise can lead to anaphylaxis.  It has also been found that the cause of anaphylaxis may be due to specific foods being eaten around the time of exercise.

Other

Other causes of anaphylaxis can include water, cold temperature, hormones, sunlight, and food additives.  When the cause of anaphylaxis is not found it is called idiopathic anaphylaxis.

Diagnosis

People who think they may have had an episode of anaphylaxis should see a board-certified allergist to make sure they receive an accurate diagnosis.  It is important to correctly identify a person’s allergic triggers while also not unnecessarily avoiding substances which a person is not allergic to.  Board-certified allergists have the training and expertise to review your history of allergic reactions, conduct diagnostic tests to determine your triggers, review treatment options, and teach avoidance techniques.  Allergists may use tests such as skin tests, specific IgE blood tests, and/or oral challenge tests to help accurately diagnose allergies.

Avoidance

Once a person’s triggers for anaphylaxis have been confirmed with allergy testing, patients need to practice avoidance measures to prevent future episodes of anaphylaxis.  Patients with food allergies need to learn to read food packaging labels, inform restaurant staff about their allergy, and make sure schools and daycares are aware of their food allergy.  Patients with medication allergies should make sure all their medical providers and pharmacies are aware of their specific medication allergies. Patients with insect sting allergies should avoid walking barefoot in grass, drinking from open soft drink cans, wearing bright colored clothing with flowery patterns, sweet smelling perfumes, hairsprays and lotion during active insect season in late summer and early fall.

Treatment

When a person recognizes that they are having anaphylaxis, they should use their prescribed epinephrine auto-injector as soon as possible.  Epinephrine is the best treatment of anaphylaxis and it can stop the progression of the reaction. If you are unsure if you are having anaphylaxis then it is still better to use epinephrine right away than to wait too long.  If the reaction is scaring you then it is probably a good idea to use epinephrine. The person should also seek medical help as soon as possible by calling 911 or going to the nearest emergency room. Anaphylaxis sometimes requires treatment with multiple doses of epinephrine and sometimes the symptoms will go away only to return a few hours later.  For these reasons, it is recommended that people who are at risk for anaphylaxis should always carry and have two doses of epinephrine auto-injectors readily available.

If you think you might have experienced anaphylaxis and would like to have your allergies evaluated, please contact us today.