Anaphylaxis

Anaphylaxis is a severe, sometimes life-threatening, allergic reaction. It affects multiple organs, including the heart and lungs.

It is important to seek medical care right away if there are symptoms of anaphylaxis.

Substances that cause anaphylaxis are often called allergens or triggers. Common triggers include:

• Blood transfusion
• Foods and food additives, especially eggs, peanuts, seafood, cow's milk, soy, fish, shellfish, seeds, and tree nuts
• Insect stings or bites from bees, wasps, hornets, yellow jackets, and fire ants
• Latex products (eg, gloves, medical tubing, condoms)
• Medicines (eg, antibiotics, seizure medications, muscle relaxants)
• Some pain medicines, especially narcotics
• Vaccines

Some triggers, like dyes used in x-ray procedures, can cause a reaction similar to anaphylaxis.

These factors increase your chance of developing anaphylaxis. Anyone can have anaphylaxis. Tell your doctor if you have any of these risk factors:

• Children who have certain conditions, such as spina bifida and urogenital defects may be at increased risk for latex allergy (because of heavy exposure to latex they have during multiple surgeries)
• History of eczema , hay fever , or asthma
• Previous allergic reaction to the substances listed above, even if it is a mild reaction

The symptoms of anaphylaxis usually occur within minutes after exposure to an allergen, but can occur hours later. Symptoms may be mild or very severe, including death. They include:

• Heart arrhythmias
• Low blood pressure, shock
• Nausea, vomiting, cramping, diarrhea , or abdominal pain
• Convulsions
• Feelings of anxiety
• Hives and itching
• Lightheadedness, pale/blue skin color, low pulse, dizziness
• Obstruction of the nose, mouth, and throat
• Severe respiratory distress (eg, chest tightness, shortness of breath, wheezing)
• Swelling, redness, stinging or burning, especially on the face, mouth, eyes, or hands
• Warmth or redness of skin

The doctor will suspect anaphylaxis if you have symptoms and have been exposed to a likely allergen. It is also important to follow up with a doctor who specializes in allergies (allergist/immunologist). The diagnosis of allergy with a risk of anaphylactic reactions is made based on the patient’s history. It is confirmed with skin tests and sometimes blood tests done by allergy specialists.

Anaphylaxis is a medical emergency that requires immediate medical treatment, including:

• Bronchodilators—to improve breathing
• Cardiopulmonary resuscitation (CPR)—may be necessary in severe cases when anaphylaxis leads to cardiovascular collapse. Severe anaphylaxis may require mechanical ventilation until swelling is brought under control.
• Epinephrine (adrenaline) injection—makes blood vessels constrict, relaxes the airway, stops itching and hives, and relieves gastrointestinal cramping
• Intravenous fluids—to maintain blood pressure
• Other medicines—corticosteroids and/or antihistamines may be given after the epinephrine to decrease inflammation and improve breathing.
• Oxygen

NOTE : If you receive emergency epinephrine, you should go to the emergency room right away, even if your symptoms have gone away.

If you are diagnosed with anaphylaxis, follow your doctor's instructions .

Avoiding substances that trigger anaphylaxis is the best prevention. In addition:

• Your doctor may give you self-injectable epinephrine to keep with you at home, work, in the car, and when you travel. Be sure family and friends know how to use the kit too. Get training from your doctor and practice using it in the doctor's office.
• Allergy shots can decrease the risk of anaphylaxis and reduce the severity of the reactions to certain triggers.
• Always remain in the doctor's or dentist's office 30 minutes after receiving an injection. Report any symptoms right away.
• If allergic to insect stings, wear protective clothing when outside.
• Make sure the school nurse and teachers know about any allergies your child has. If your child has self-injectable epinephrine, make sure school staff knows how to use it and understands when it is needed.
• Make sure your epinephrine kit is not expired.
• Tell your doctor or dentist about your allergies before taking any medicine. When possible, ask that medicines be taken as a pill. Allergic reactions can be more severe with injected medicines.
• Wear a medical alert jewelry that lists your allergies.