Summary about Disease
Anaphylaxis is a severe, potentially life-threatening allergic reaction that is rapid in onset and affects multiple organ systems. It can cause a range of symptoms, including hives, swelling, breathing difficulties, and a sudden drop in blood pressure, potentially leading to shock. Prompt recognition and treatment are crucial.
Symptoms
Symptoms can vary in severity and can include:
Hives (urticaria)
Angioedema (swelling, usually of the lips, tongue, throat, face, or eyelids)
Difficulty breathing (wheezing, shortness of breath)
Hoarseness or throat tightness
Nausea, vomiting, or diarrhea
Dizziness or fainting
Rapid or weak pulse
Feeling of impending doom
Loss of consciousness
Causes
Anaphylaxis is typically triggered by an allergen, which is a substance that the body's immune system mistakenly identifies as harmful. Common causes include:
Foods: Peanuts, tree nuts, milk, eggs, shellfish, fish, soy, wheat
Insect stings: Bees, wasps, hornets, yellow jackets
Medications: Penicillin and other antibiotics, aspirin, NSAIDs
Latex: Found in gloves, balloons, and other medical and dental supplies
Exercise: Rarely, exercise can trigger anaphylaxis, sometimes in conjunction with certain foods.
Medicine Used
Epinephrine (EpiPen, Auvi-Q, others): This is the primary treatment for anaphylaxis. It reverses many of the symptoms by constricting blood vessels, relaxing airway muscles, and reducing swelling.
Antihistamines (Diphenhydramine, Cetirizine): Can help relieve hives and itching, but they are not a primary treatment for anaphylaxis and should be used in conjunction with epinephrine.
Corticosteroids (Prednisone, Methylprednisolone): These can help reduce inflammation and prevent a delayed reaction, but they are not a primary treatment for the immediate symptoms of anaphylaxis.
Oxygen: If breathing is difficult, supplemental oxygen may be needed.
Beta-agonists (Albuterol): If bronchospasm is present, beta-agonists can help open the airways.
Is Communicable
Anaphylaxis is not communicable. It is an allergic reaction to a specific substance and cannot be spread from person to person.
Precautions
Identify and avoid allergens: The most important precaution is to identify the specific allergens that trigger a reaction and strictly avoid them.
Carry epinephrine auto-injector: Individuals at risk of anaphylaxis should carry an epinephrine auto-injector at all times and know how to use it.
Wear medical identification: A medical alert bracelet or necklace can inform others of allergies in case of an emergency.
Educate others: Inform family, friends, and coworkers about allergies and how to recognize and treat anaphylaxis.
Read food labels carefully: Always check ingredient lists on food products.
Inform healthcare providers: Tell doctors and dentists about allergies before any procedures or medications are administered.
Have an emergency plan: Develop a plan of action in case of anaphylaxis, including who to call and where to go.
How long does an outbreak last?
Anaphylaxis is not an outbreak. It is a single, acute reaction that occurs when exposed to an allergen. Symptoms can develop within minutes to hours of exposure. Without treatment, the reaction can be fatal. With prompt treatment, the reaction can be controlled, but symptoms may persist for several hours. A biphasic reaction (a recurrence of symptoms after the initial reaction has subsided) can occur, sometimes hours later.
How is it diagnosed?
Clinical history: A detailed history of the events leading up to the reaction, including potential allergens, is crucial.
Physical examination: Assessment of symptoms, such as hives, swelling, and breathing difficulties.
Allergy testing: After the acute episode has resolved, allergy testing (skin prick tests or blood tests) can help identify the specific allergens that triggered the reaction.
Serum tryptase: A blood test to measure tryptase levels, which can be elevated during anaphylaxis.
Timeline of Symptoms
The timeline of symptoms can vary but typically follows this pattern:
Minutes: Initial symptoms such as itching, hives, flushing, or angioedema may appear.
Minutes to Hours: More severe symptoms such as difficulty breathing, wheezing, vomiting, diarrhea, dizziness, and loss of consciousness can develop.
After Treatment: With prompt epinephrine administration, symptoms can improve within minutes, but close monitoring is still necessary. Biphasic reactions can occur hours later.
Important Considerations
Epinephrine is the first-line treatment: Do not hesitate to administer epinephrine if anaphylaxis is suspected.
Call emergency services: After administering epinephrine, call emergency services (911 in the US) immediately.
Lie flat: If possible, lie the person flat with legs elevated to help maintain blood pressure.
Monitor closely: Even after epinephrine is administered, continue to monitor the person closely for any recurrence of symptoms.
Seek medical attention: Everyone who has anaphylaxis needs to be evaluated in an emergency room or urgent care facility.
Follow up with an allergist: After an anaphylactic event, it's important to follow up with an allergist for allergy testing and management.