What is anaphylaxis? Symptoms, Diagnosis & Treatment

Some people with severe allergic conditions may develop anaphylaxis, a life-threatening event following exposure to these potent allergens. Anaphylaxis is a severe allergic reaction that occurs after the use of various poisons, nutrients, or drugs. In most of these cases, food allergies such as bee stings or peanuts are detected.

After the development of anaphylaxis, people may experience skin rash, low heart rate, and shock. Care should be taken as this can be fatal if not intervened early.

With epinephrine injections, the anaphylactic reaction can be controlled before it becomes fatal. If you have experienced and been diagnosed with an anaphylactic reaction before, physicians are usually advised to carry epinephrine injections with them.

What is anaphylaxis?

Anaphylaxis is a common medical emergency that occurs after a hypersensitivity reaction. The resulting reaction tends to progress rapidly and can affect all body systems in a short time. If appropriate treatment is not given, anaphylactic reaction triggers respiratory problems and can be fatal.

With the development of anaphylaxis, a number of 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 heartbeat, skin rashes, 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, a predisposition to allergic reactions may occur against various substances. Care should be taken, as the anaphylactic reaction may develop in cases of latex hypersensitivity that is increasing gradually. Despite all these factors, the cause of anaphylaxis may not be clarified in some cases and this situation is called idiopathic anaphylaxis.

The biological cause of anaphylaxis is the overreaction of the immune system after contact with an allergen to the body. The anaphylactic reaction may progress over time and result in the development of allergic shock. There are many allergens that can trigger this condition:

  • Certain medications, such as penicillin
  • insect bites
  • Various nuts
  • shellfish
  • milk and eggs
  • Latex

In rare cases, in addition to these factors, excessive aerobic activation resulting from exercises such as running may also trigger an anaphylactic reaction.

Effective risk factors for susceptibility to anaphylactic reaction have not been fully defined. However, in some cases, it is recommended to be careful because there may be a predisposition to anaphylaxis. Having a previous history of anaphylaxis carries an increased risk that the person may experience the 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 that may be at increased risk of anaphylaxis. Apart from these situations, there may be an increased risk for anaphylaxis in conditions where certain white blood cell types are excessively increased, such as mastocytosis, or in certain heart conditions.

How does an anaphylactic reaction develop, its symptoms appear?

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 more quickly than this and similar types of allergies, can progress to life-threatening dimensions in a short time if not properly intervened.

The allergens that can trigger this reaction can come into contact with the body through inhalation (during breathing), through the digestive system by swallowing, on the skin by touch, or directly through injections. After contact, the body begins to respond within seconds or minutes at the latest. In moderate allergies, no obvious symptoms may occur for several hours.

The anaphylactic response usually tends to begin shortly after exposure. During this period, the body begins to fight against this substance, which it responds to, by releasing many chemicals into the bloodstream. Circulating chemicals trigger a series of chain reactions, and thus the symptoms of anaphylaxis begin to appear. Many symptoms are among the early symptoms of anaphylaxis:

  • Feeling of tightness or discomfort in the chest area
  • Shortness of breath
  • Cough
  • Nausea and vomiting
  • Diarrhea
  • Stomach ache
  • Difficulty swallowing
  • Itching
  • Tongue twitching while speaking
  • Dizziness

These initial symptoms may worsen with the progression of anaphylaxis. Serious symptoms, especially in people for whom appropriate treatment has not been initiated, can be summarized as follows:

  • Low blood pressure
  • Weakness
  • Loss of consciousness
  • Irregular heart rhythm
  • Acceleration in heart rate
  • Wheezing during breathing
  • Obstruction in the airways
  • Itchy lesions on the skin
  • Intense edema formation that can manifest itself in any part of the body, especially the face and eye area
  • Shock
  • Cardiac arrest
  • Respiratory arrest (loss of function of the respiratory system)

Early recognition of anaphylaxis and appropriate intervention are very important issues so that patients do not experience these frightening symptoms.

What is anaphylaxis? Symptoms, Diagnosis & Treatment

How is anaphylaxis diagnosed?

The diagnosis of anaphylaxis is made on the basis of clinical signs, therefore no laboratory studies or other examinations are required. In cases of anaphylactic shock, deaths usually occur within the first hour of exposure to the allergen, so early recognition and action are vital.

During the evaluation of people who come to the emergency services with the suspicion of anaphylaxis, physicians can investigate the presence of any wheezing sound due to fluid collection 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 had any previous allergic reaction to allergens that may trigger the symptoms.

After the appropriate diagnosis and intervention, the diagnosis can be confirmed by means of various examinations. The blood level of the enzyme tryptase rises 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 period, examining which allergens patients are sensitive to by means of various skin and blood tests also contributes to supporting the diagnosis of anaphylaxis.

How is anaphylaxis treated?

Allergic reactions are considered a medical emergency as they can quickly develop into a state of anaphylaxis or anaphylactic shock. In these cases, at the first stage of treatment planning, the patient’s airway is secured and fluid support can be given. After the completion of this stage, the factors that may 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 for the treatment of anaphylaxis is between 0.3-0.5 ml. In cases of young age, the appropriate dose is calculated according to the child’s weight. Intramuscular administration of epinephrine is a preferred method as it gives faster results than intravenous or subcutaneous injections. Patients usually show improvement after a single injection, but in some patients, it may be necessary for physicians to repeat epinephrine injections at 5-10 minute intervals.

Because of its life-threatening symptoms, anaphylaxis should be recognized at an early stage and appropriately intervened. When you think you are experiencing an allergic reaction or that someone else may be experiencing it, it is important to stay calm and focus on what can be done. It is recommended that you apply to a health institution as soon as possible and get help from experts about the allergen and symptoms you suspect.

In addition to severe reactions such as anaphylaxis, if you feel symptoms that may cause you to suspect allergic conditions, it is recommended that you seek support from allergy and immunology specialists in order to reveal and control this situation.

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