What is Anaphylaxis?

Anaphylaxis is a severe, body-wide reaction that is considered a true medical emergency.  These reactions can occur very quickly and without warning.  Without immediate treatment, anaphylaxis can be fatal.  

Symptoms of Anaphylaxis: can occur alone or in  combination

  • Breathing: wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain/tightness, trouble swallowing, itchy mouth/throat, stuffy nose/congestion
  • Circulation: pale/blue color, low pulse, dizziness, lightheadedness/passing out, low blood pressure, shock, loss of consciousness
  •  Skin: hives, swelling, itching, warmth, redness, rash
  • Stomach: nausea, pain/cramps, vomiting, diarrhea
  • Other: anxiety, feeling of impending doom, itchy/red/watery eyes, headache, cramping of the uterus

**The most dangerous and potentially fatal symptoms are low blood pressure, breathing difficulty and loss of consciousness. 

The most common causes of anaphylaxis include:

  • Foods: such as peanuts, tree nuts, shellfish, milk and dairy products, and eggs. 
  • Medications: penicillin, aspirin/NSAIDs, and allergy injections
  • Insect Stings: bees, wasps, and hornets
  • Radiocontrast media: contrary to popular belief, these reactions are not related to iodine “allergy” or allergy to shellfish.

Other causes of anaphylaxis include:

  • Exercise: sometimes in combination with certain foods
  • Latex: exposure can be through the skin, the mucus membranes, by inhalation, or by blood.  
  • Idiopathic: cause is unsure

Anaphylaxis can be worse if:

  • There is a delay in treatment
  • The exposure is by blood rather than by mouth
  • If the onset of the reaction is rapid
  • If the patient has asthma or heart problems

Any patient who has experienced anaphylaxis should be thoroughly evaluated by an allergist to determine the cause of the reaction.   

  • This is accomplished through obtaining a comprehensive medical history including a detailed account of the event(s).  
  • Testing may be warranted depending on the suspected cause.  
  • Also during this visit, the patient will need to be educated about risk factors regarding the specific cause of anaphylaxis, how to recognize a severe reaction, and how and when to use their epinephrine, as well as other treatment options, if available.

 When patients have life-threatening reactions, they must receive in injection of epinephrine to avoid going into shock.  For patients who have a history of severe reactions, carrying an auto-injector kit, such as an Epi-Pen, is common.  However, even for patients who carry their own epinephrine, medical care should be sought as soon as possible.  Very often, patients will need more medications, and possibly IV fluids and oxygen.  It is also important that even after a reaction resolves, the patient is closely monitored in case symptoms return after several hours. 

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