Anaphylaxis is the most serious form of allergic reaction, sometimes leading to death. Awareness of possible severe reactions, and what to do if they occur, is critical for allergy sufferers. Specialists in the Baptist Health medical network can assist you in managing your allergies.

What Is Anaphylaxis?

Anaphylaxis is a severe and potentially fatal allergic reaction. It is similar to other, milder reactions in that it results from the hypersensitivity of the immune system to “foreign” or “invading” substances, introduced from outside. The allergen’s presence sets off an immune response in the body, causing it to attack a substance that in most people would be harmless or even beneficial (e.g., certain medicines or food). 

Where anaphylaxis differs from most allergic reactions is in the scope of the response. Instead of affecting a localized area, say, the upper respiratory system, an anaphylactic response affects multiple organ systems throughout the body. The extent of the response increases its severity, often leading to a state of shock. Anaphylaxis should be treated as a medical emergency. 

How Do I Know If I’m Having an Anaphylactic Reaction?

Anaphylaxis is marked by multiple major symptoms. These usually appear quickly, within 30 minutes of contact with the allergen:

• Swollen throat, lips, or tongue
• Impaired breathing
• Skin rashes or hives
• Rapid pulse
• Dizziness, lightheadedness, or fainting
• Change of color in the face or body (turning pale or red)
• Gastrointestinal pain
• Vomiting or diarrhea
• Uterine cramps

Anaphylaxis also has a psychological aspect, with many sufferers reporting a sense of imminent doom.

To complicate matters further, anaphylactic episodes sometimes come in pairs. About 20 percent of those who experience a first episode will undergo a second one within 12 hours. 

What Causes Anaphylaxis?

Anaphylaxis can potentially occur with exposure to any allergen but some substances are more likely to trigger an extreme reaction than others. The most prominent of these are:

• Food items, including peanuts and other nuts, seafood including shellfish, and milk and dairy products. Children are especially susceptible to food allergies.
• Some drugs and medications, including antibiotics such as penicillin, aspirin, NSAIDs like ibuprofen, and some intravenous (IV) agents. These are more common in adults.
• Insect stings, including bees, wasps, hornets, yellow jackets, and ants.
• Latex items, such as gloves, mattresses, swim caps, and other domestic objects.
• Behaviors can play a role in anaphylactic onset. Intense physical activity, including aerobic exercise, has occasionally been linked to extreme allergic reactions. This is particularly true of outdoor activities in hot, cold, or humid weather. 

Researchers believe that there are several other factors that may increase the possibility of anaphylaxis. These include:

• A personal medical history of allergies or asthma
• A previous episode of anaphylaxis
• The presence of heart disease or mastocytosis (unusually large accumulations of white blood cells in the skin, bone marrow, or internal organs such as the liver, intestines, and spleen)

Anaphylaxis Diagnosis

After providing immediate care for anaphylaxis, your provider will perform a proper evaluation. He or she may take the following steps to diagnose your case:

• Conduct a physical examination
• Document your symptoms and family medical history
• Administer a radioallergosorbent, or RAST, test to identify your allergen or allergens
• Conduct a skin-prick test
• Administer an IgE antibody test

The skin-prick test involves injecting tiny amounts of potential irritants under your skin, to look for evidence of an allergic response (e.g., swelling, itching, or redness). The IgE antibody test indicates past contact with an allergen.

If your physician examines you shortly after a severe allergic episode, he or she may administer a test that measures the amount of tryptase in your bloodstream. Elevated levels of tryptase, an enzyme, would confirm anaphylaxis and may provide a clue as to the allergen that triggered it. 

Anaphylaxis Treatment

Anaphylaxis is a life-threatening condition and requires immediate treatment. If you or someone you are with shows symptoms of anaphylactic shock:

• Call 911 for emergency medical assistance
• Administer epinephrine, if available
• Position the body horizontally, face up, elevating the legs
• Utilize CPR and other first-aid measures

Once the allergy sufferer has been transported to a medical facility, he or she will receive:

• A first or second dose of epinephrine, to curtail the allergic response
• Oxygen, to assist with breathing
• Intravenous medications to restore breathing function and reduce lung inflammation
• Albuterol or another beta-agonist to suppress breathing complications

The medical team will make every effort to identify the allergen that triggered the attack. Avoiding this irritant is critical to avoiding future anaphylactic episodes. In some cases, such as insect bites, allergy shots (immunotherapy) can limit the chances of a reoccurrence. Carrying an epinephrine auto-injector at all times is highly recommended.