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Anaphylaxis

Anaphylaxis is a severe and rapid systemic allergic reaction to a trigger substance, called an allergen. Minute amounts of trigger substances may cause a life-threatening anaphylactic reaction. Anaphylaxis may occur after ingestion, inhalation, skin contact or injection of a trigger substance. The most severe type of anaphylaxis - anaphylactic shock - will usually result in death in mere minutes if untreated. more...

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The word is from New Latin (derived from Greek ἀνα-/ana, meaning "up, again, back, against") + φύλαξις/phylaxis, meaning "guarding, protection"—cf. prophylaxis.)

Immediate action

Anaphylactic shock is a life-threatening medical emergency because of rapid constriction of the airway, often within minutes of onset. Calling for help immediately is important, as brain damage occurs rapidly without oxygen. Anaphylactic shock requires advanced medical care immediately; but other first aid measures include rescue breathing (part of CPR) and administration of epinephrine. Rescue breathing may be hindered by the constricted airways but can help if the victim stops breathing on their own. If the patient has previously been diagnosed with anaphylaxis, they may be carrying an EpiPen (or similar device) for immediate administration of epinephrine (adrenaline) by a layperson to help keep open the airway. Repetitive administration can cause tachycardia (rapid heartbeat) and occasionally ventricular tachycardia with heart rates up to 240 beats per minute, but is only dangerous when done in rapid succession. Nevertheless, if epinephrine prevents worsening of the airway constriction, it may still be life-saving.

Symptoms

Symptoms of anaphylaxis are related to the action of immunoglobulin E (IgE) and other anaphylatoxins, which act to release histamine and other mediator substances from mast cells (degranulation). In addition to other effects, histamine induces vasodilation and bronchospasm (constriction of the airways).

Symptoms can include the following:

  • respiratory distress,
  • hypotension (low blood pressure),
  • fainting,
  • unconsciousness,
  • urticaria (hives),
  • flushed appearance,
  • angioedema (swelling of the face, neck and throat),
  • tears (due to angioedema and stress),
  • vomiting,
  • itching, and
  • anxiety, including a sense of impending doom


The time between ingestion of the allergen and anaphylaxis symptoms can vary for some patients depending on the amount of allergen ingested and sensitivity. Symptoms can appear immediately, or can be delayed by half an hour to several hours after ingestion. However, symptoms of anaphylaxis usually appear very quickly once they do begin.

Causes

Common causative agents in humans include:

  • foods (e.g. milk, cheese, nuts, peanuts, soybeans and other legumes, fish and shellfish, wheat and eggs);
  • drugs (e.g. penicillin and other cephalosporins, contrast media, ASA and other NSAIDs such as ibuprofen and diclofenac);
  • latex;
  • Hymenoptera stings from insects such as bees, wasps, yellow jackets, hornets, and some stinging ants; and
  • exercise (see exercise-induced anaphylaxis).

Transfusion of incompatible blood products may lead to extremely similar symptoms, albeit for substantially different biochemical reasons.

Read more at Wikipedia.org


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Anaphylaxis - Information: from your family doctor
From American Family Physician, 10/1/03

What is anaphylaxis?

Anaphylaxis (say "anna-full-ax-iss") is a life-threatening allergic reaction. It starts soon after you are exposed to something to which you are allergic. You may have swelling, itching, or a rash. Some people have trouble breathing, a tight feeling in their chest, dizziness, and they feel anxious. Other people have stomach cramps, nausea, or diarrhea. Some people lose consciousness ("pass out").

What causes anaphylaxis?

Many things can cause anaphylaxis. The cause is different for each person and can be hard to find. Some common causes include the following:

* Foods, such as shellfish, nuts, peanuts, eggs, and fruits

* Medicines, such as antibiotics, aspirin, over-the-counter pain relievers, allergy shots, and contrast dye for radiologic procedures

* Latex, or rubber, which is found in surgical gloves, medical supplies, and many products in your home

* Insect stings, especially from bees, wasps, hornets, yellow jackets, sawflies, and fire ants

How do I prevent a reaction?

You can do many things to help prevent a reaction.

* If you have had anaphylaxis, make sure your doctor and dentist know and that it is recorded on your medical chart. Tell them what you are allergic to if you know.

* Keep an emergency anaphylaxis kit with you at all times. Make sure the people around you, such as your family and friends, know how to use it.

* If you are allergic to insect stings, wear protective clothing and insect repellent when outside.

* Avoid handling or eating foods to which you are allergic. Even tiny amounts mixed by accident into your food can cause a reaction. Read the ingredient list on packaged foods you are going to eat.

* Wear or carry a medical alert bracelet, necklace, or keychain that warns emergency medical technicians (EMTs) and doctors that you are at risk for anaphylaxis.

* Ask your doctor if you need desensitization shots.

* Ask your doctor if there are other things to which you also might be allergic.

What is in an emergency anaphylaxis kit?

An emergency anaphylaxis kit is what you or people around you can use if you have a severe allergic reaction. You might need medical help right away. The kit contains the epinephrine medicine that you inject into your arm or leg (or have a friend inject). Your doctor will prescribe a kit with the right dose of medicine and teach you how to use it. Make sure your family, friends, and others also know how to use the kit. Sometimes your doctor will tell you to keep an antihistamine, such as diphenhydramine (one brand name: Benadryl), in the kit.

How do I treat future anaphylaxis reactions?

Call 911 to get emergency medical help, even if you do not feel very sick. Get your anaphylaxis kit. Inject yourself with epinephrine or have someone help. Take an antihistamine if your doctor recommends it. If you stop breathing, you may need CPR (cardiopulmonary resuscitation) until help arrives.

What can I expect after an allergic reaction?

You should recover completely with treatment. Most people live a normal, full life. You can get back to your normal activities once you are feeling better. However, you should have someone stay with you for 24 hours after an attack to make sure another attack does not happen.

Where can I get more information?

Your doctor.

American Academy of Allergy, Asthma, and Immunology

Telephone: 1-800-822-2762

Web address: www.aaaai.org

Food Allergy and Anaphylaxis Network

Telephone: 1-800-929-4040

Web address: www.foodallergy.org/index.html

Medic-Alert Bracelet (medical identification)

Telephone: 1-800-432-5378

Web address: www.medicalert.org

COPYRIGHT 2003 American Academy of Family Physicians
COPYRIGHT 2003 Gale Group

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