Anaphylaxis
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Anaphylaxis refers to a severe allergic reaction in which prominent dermal and systemic signs and symptoms manifest. The full-blown syndrome includes urticaria (hives) and/or angioedema with hypotension and bronchospasm. The classic form, described in 1902, involves prior sensitization to an allergen with later re-exposure, producing symptoms via an immunologic mechanism. An anaphylactoid reaction produces a very similar clinical syndrome but is not immune-mediated. Treatment for both conditions is similar, and this article uses the term anaphylaxis to refer to both conditions unless otherwise specified. 2
Anaphylaxis is a severe allergic reaction that may involve the entire body. It can result in trouble breathing, loss of consciousness and even death. Anaphylaxis is a medical emergency that requires immediate medical treatment and follow-up care by an allergist/immunologist. 4
Anaphylaxis is a systemic, immediate hypersensitivity reaction caused by immunoglobulin (Ig) E-dependent activation of effector cells of the immune system, predominantly mast cells and basophils. Mediators elaborated by these effector cells are responsible for the symptoms of anaphylaxis, which may involve the cutaneous, respiratory, gastrointestinal, or cardiovascular systems. Anaphylactoid reactions are clinically similar to anaphylactic reactions but are not mediated by IgE-dependent activation. Thus, regardless of triggering cause, anaphylactic or anaphylactoid reactions occur as a consequence of inappropriate and overwhelming mast cell or basophil activation and will be discussed as a single clinical entity in this chapter. 38
Exercise-induced anaphylaxis (EIA) is a severe allergic reaction caused by exercise, and may be related to eating certain foods before exercising. Learn how EIA is different from physical urticarias, such as cholinergic urticaria, how the diagnosis is made, and how it’s treated. 6
Anaphylaxis is the most severe form of allergic reaction. It is a rapid, immune-mediated, systemic reaction to allergens that a person has been previously exposed to. The reaction occurs rapidly and often dramatically, and is usually unanticipated. Signs and symptoms arise systemically and may include faintness, severe difficulty breathing and throat closing. 13
Anaphylaxis is a �systemic reaction,� which means that various parts of the body are affected that are a distance from the allergen’s initial entry site (e.g., a sting site for insects or the stomach for foods). Symptoms of anaphylaxis can vary from mild to severe and are potentially deadly. 3
This is an emergency situation in which a severe allergic reaction has occurred. The whole body is affected, usually within minutes of exposure and symptoms can vary in severity including the following:- The most common cause of anaphylaxis in the UK is the peanut. Some people react badly to tree nuts (such as almonds, walnuts, hazelnuts, brazils) some react to peanuts and tree nuts. 13
Common substances that trigger anaphylaxis are foods, insect stings, and medications. It has been estimated that up to 15% of the population is at risk for anaphylaxis, and each year, about 40 people die after an anaphylactic reaction to insect stings, and about 100 people die from reactions to food. Below are tips to help avoid these triggers this summer. 4
Anaphylaxis is the systemic manifestation of allergy – when an allergic reaction affects the body as a whole and not just locally. In other words, some patients have hives just in the area of contact with the food allergen, such as the lips and mouth, while other patients have hives over their entire body, regardless of the route of exposure. It is this latter systemic total body reaction that is termed anaphylaxis. The severity of anaphylaxis can be graded mild, moderate, or severe. 13
This report emphasizes the potential severity of food reactions and the importance of prompt administration of epinephrine. The authors suggested that: ” Factors believed to have contributed to the fatal outcome included the patients’ denial of symptoms, reliance on antihistamines alone for treatment, and failure to administer epinephrine (adrenalin) immediately.” All the children in the study had asthma as part of their allergic pattern. Typical symptoms of a a major reaction were itching and swelling sensation of the lips, mouth and tongue, followed by nausea, stomach cramping, vomiting, hives and difficulty breathing. 21
Medications: Virtually any medication can trigger an allergic reaction. Common categories of drugs that cause anaphylaxis are antibiotics and anti-seizure medicines. Medical therapies such as certain post-surgery fluids, vaccines, blood and blood products, radiocontrast dyes, pain medications and other drugs may cause anaphylaxis or anaphylactoid reactions. 3
Less commonly, a person may have biphasic or protracted anaphylaxis. A patient with biphasic anaphylaxis has a reaction that resolves but recurs one to eight hours later; second reactions have occurred as much as 72 hours later. A patient with protracted anaphylaxis has signs and symptoms that persist for up to 48 hours despite treatment. 15
Virtually any medication can trigger an allergic reaction. Common categories of drugs that cause anaphylaxis are antibiotics and anti-seizure medicines. Medical therapies such as certain post-surgery fluids, vaccines, blood and blood products, radiocontrast dyes, pain medications and other drugs may cause anaphylactic reactions. 4
Minor anaphylactic reactions resolve spontaneously and are common. Since serious reactions are impossible to predict a good protective policy has to balance caution against unreasonable fears. If an allergic person knowingly risks eating reactive foods, some protection might be available with a dose of antihistamine taken before the meal. Antihistamines are more effective as preventive medication than as treatment medications once the allergic reaction is underway. 21
This is a serious allergic reaction to a food protein, stinging insect or medication. Such a reaction has many symptoms (from the “symptoms of food allergy” list above) and engages one or more of the body’s systems: the gastrointestinal tract, the respiratory tract, the skin and the cardiovascular system. Anaphylaxis usually involves difficulty breathing and can lead to a loss of consciousness or even death. Such a severe reaction must always be treated as a medical emergency. 13
References
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