What is anaphylaxis?
In some people with severe allergic conditions, anaphylaxis, a life-threatening event, may occur after exposure to these potent allergens. Anaphylaxis is a severe allergic reaction picture that occurs after the use of various poisons, nutrients, or drugs. Food allergies such as bee stings or peanuts are detected in most of these cases.
After the development of anaphylaxis, skin rash, low pulse, and shock may occur in people. If it is not intervened early, care should be taken as this situation can be fatal.
Thanks to epinephrine injections, an anaphylactic reaction can be controlled before it becomes fatal. If you have had an anaphylactic reaction before and have been diagnosed, it is usually recommended by physicians to carry epinephrine injections with them.
What is anaphylaxis?
Anaphylaxis is a common medical emergency that occurs after a hypersensitivity reaction. The reaction that occurs tends to progress rapidly and can affect all body systems in a short time. Without proper treatment, anaphylactic reaction triggers respiratory problems and can be fatal.
With the development of anaphylaxis, several chemicals are secreted by the immune system, and depending on these substances, the person may progress to a state of shock. In the case of shock, a sudden drop in blood pressure occurs and the person’s breathing becomes difficult with the narrowing of the airways. These symptoms may also be accompanied by symptoms such as an accelerated but weakened heart rate, skin rash, nausea, and vomiting.
What are the causes of anaphylaxis?
Insect bites, certain medications, or food products are common causes of anaphylaxis. After immunotherapy injections are used for various reasons, susceptibility to allergic reactions against various substances may occur. Caution should be exercised, as the anaphylactic reaction may also develop in cases of latex hypersensitivity that gradually increases. Despite all these factors, the cause of anaphylaxis may not be elucidated in some cases, and this condition is called idiopathic anaphylaxis.
The biological cause of anaphylaxis is the overreaction of the immune system after contact with an allergenic substance. An anaphylactic reaction may progress over time, resulting in allergic shock. Many allergens can trigger this condition:
- Some medications, such as penicillin
- Insect bites
- Various nuts
- Milk and eggs
In rare cases, in addition to these factors, excessive aerobic activation resulting from exercise such as running may also trigger an anaphylactic reaction.
The effective risk factors for susceptibility to anaphylactic reaction have not been fully defined. However, caution is recommended as there may be a predisposition to anaphylaxis in some cases. Having a previous history of anaphylaxis has an increased risk of experiencing this condition again for the rest of their life. Future reactions in these people may be more severe than the first attack. People with allergies or asthma are another group where the risk of anaphylaxis may be increased. Apart from these conditions, there may be an increased risk of anaphylaxis in situations where some white blood cell types such as mastocytosis or some heart diseases are excessively increased.
How does an anaphylactic reaction develop, what are the symptoms?
Allergic reactions occur due to the body’s response to a substance. For example, spring allergies are triggered by vegetative factors such as pollen or grass that occur during seasonal transitions. Anaphylaxis, which occurs within minutes faster than these and similar types of allergies, can progress to life-threatening dimensions in a short time if appropriate intervention is not done.
With the allergens that can trigger this reaction, the body can come into contact with inhalation (during breathing), from the digestive system by swallowing, through the skin by touch, or directly through injections. After contact, the body begins to respond within seconds or minutes at the latest. In mild allergies, no obvious symptoms may occur for a few hours.
The anaphylactic response usually tends to start shortly after contact. During this time, the body releases a large number of chemicals into the bloodstream and engages in a fight against this substance to which it responds. The circulating chemicals trigger a series of chain reactions, so the symptoms of anaphylaxis begin to occur. Many symptoms are among the early symptoms of anaphylaxis:
- A feeling of tightness or discomfort in the chest area
- Shortness of breath
- Nausea and vomiting
- Abdominal pain
- Difficulty swallowing
- Language entanglement while speaking
These initial symptoms may worsen with the progression of anaphylaxis. Serious symptoms that occur especially in people who do not receive appropriate treatment can be summarized as follows:
- Low blood pressure
- Loss of consciousness
- Irregular heart rhythm
- Acceleration in heart rate
- Wheezing during breathing
- Obstruction in the airways
- Itchy lesions on the skin
- Intense edema can manifest itself in any part of the body, especially in the face and eye area.
- Cardiac arrest (heart arrest)
- Respiratory arrest (loss of function of the respiratory system)
Early recognition of anaphylaxis and appropriate intervention are very important issues for patients not to experience these frightening symptoms.
How is the diagnosis of anaphylaxis?
The diagnosis of anaphylaxis is based on clinical symptoms, so there is no need for any laboratory studies or other tests. In cases of anaphylactic shock, deaths usually occur within the first hour of exposure to the allergen, so early recognition of cases and action is vital.
During the evaluation of people who come to emergency services with suspicion of anaphylaxis, physicians can examine the presence of any wheezing sound that occurs due to fluid accumulation by listening to the lungs of the patients with physical examination methods. At the same time, the medical history of the person is evaluated and it is questioned whether the patient has experienced any allergic reaction to allergens that may trigger the symptoms.
After the appropriate diagnosis and intervention, the diagnosis can be confirmed by various examinations. The blood level of the tryptase enzyme increases within approximately 3 hours after anaphylaxis. Therefore, biochemical examination of this enzyme level may be useful in confirming the diagnosis of anaphylaxis. In the next process, examining which allergens the patients are sensitive to using various skin and blood tests also contributes to the diagnosis of anaphylaxis.
What is the treatment for anaphylaxis?
Allergic reactions are considered a medical emergency as they can quickly develop into anaphylaxis or anaphylactic shock. In these cases, the safety of the patient’s airway is ensured and fluid support can be given at the first stage of treatment planning. After the completion of this phase, the factors that can initiate this condition of the patient are quickly evaluated and it is ensured that the exposure does not continue.
The main treatment for anaphylaxis is epinephrine injection. The intramuscular (intramuscular) application dose of epinephrine with a concentration of 1 in 1000 is between 0.3-0.5 ml for the treatment of anaphylaxis. In younger cases, the appropriate dose is calculated according to the child’s weight. Intramuscular administration of epinephrine is a preferred method because it gives faster results than intravenous or subcutaneous injections. Patients usually improve after a single injection, but in some patients, it may be necessary for physicians to repeat epinephrine injection at 5-10 minute intervals.
Because of its life-threatening symptoms, anaphylaxis should be recognized early and treated appropriately. It is important to stay calm and focus on what can be done when you think you are experiencing an allergic reaction or someone else may be experiencing it. It is recommended that you apply to a health institution as soon as possible and get help from experts about the allergens and symptoms your suspicion originates from.
In addition to severe reactions such as anaphylaxis, if you feel symptoms that may cause you to suspect allergic conditions, it is recommended to get support from allergy and immunology specialists to reveal and control this situation.
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