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showAnaphylaxis is an acute hypersensitive, rapidly evolving and life-threatening allergic reaction. Individuals may develop its symptoms after exposure to certain triggers like a specific food, medicine, pollen, rubber, the sting of an insect, etc.
The worldwide incidence of anaphylaxis is 50 to 112 cases per every 1,00,000 person [1]. The symptoms of this allergic reaction, such as low blood pressure, rashes, difficulty in breathing, etc. appear within a few seconds or minutes of their contact with the trigger. It is necessary that they get the necessary medical intervention immediately to restrict the complications from being life-threatening.
Here’s a quick glimpse of the causes, symptoms, diagnosis and treatment of anaphylaxis:
Symptoms | Swollen throat and affected body part, wheezing, tightness in the chest, hoarse voice, vomit, diarrhoea, stomach cramping, collapsing. |
Complications | Cardiac arrest, blocked airway, respiratory arrest |
Causes | Exposure to triggers like a certain food, medicine, sting of insects, chemicals, rubber, red meats etc. |
Onset | After a few seconds to a few minutes of exposure to a trigger |
Diagnosis | Skin-prick test, intradermal skin test, allergy patch test, blood tests, food challenge test |
Prevention | Staying away from the allergic trigger |
Medication | Adrenaline injection, antihistamines, steroids, etc. |
To understand this acute allergic reaction better, check out the details below:
You can get anaphylaxis symptoms within 5-30 minutes of coming in contact with the allergen. These can appear suddenly but progress very rapidly. In very little time, the situation can worsen [2].
Following are the warning symptoms of anaphylaxis [2]:
Anaphylaxis results from your immune system’s erroneous reaction to certain triggers. In simpler words, it happens when your body’s immunity system overreacts to a certain trigger. This is why you should ideally know which allergen makes your immunity system vulnerable.
Following are some major triggers that can lead to the development of anaphylaxis [3]:
By knowing your trigger for anaphylaxis, you can prevent its complications.
Here are the different anaphylaxis categorised according to the types of allergen [4]:
If you are diagnosed with anaphylaxis, you need to take the necessary advice from a certified doctor immediately. They will guide you about the medicines you need to keep at home or with you during your travel or commute.
Besides medications, doctors will give you the required knowledge about how you should act after encountering the symptoms of anaphylaxis so that the complications do not proceed further and situations come under your control quickly. By acting according to their advice during those emergency hours, you can avoid severe allergic shock, which can otherwise be life-threatening.
Anaphylaxis is generally a severe allergic reaction which can even lead to morbidity [7]. To diagnose the trigger of anaphylaxis, you will have to contact an allergist or immunologist. You need to inform them about past instances of your allergic reaction. An allergist performs a thorough examination of all the potential triggers that may cause your allergic reactions.
Following are some anaphylaxis diagnosis processes to detect the allergic trigger of an individual [2]:
Skin-prick is the least expensive test that can give you an accurate result within just 15-20 minutes. The method of this diagnosis is also simple and safe. In this diagnostic process, doctors first put drops of different potential allergens on a patient’s skin. After this, they prick the area through the allergen using a lancet. They conduct the process with all the potential allergens until they find a specific trigger for the individual.
If the skin is allergic to a particular substance, it swells and becomes red and itchy. A larger area of that wheal suggests that your sensitivity to that particular substance is intense.
Sometimes, the skin-prick test may not distinguish the right trigger. Then, doctors perform an intradermal skin test to determine whether an allergen can be your trigger. In this diagnosis process, they insert a minuscule amount of suspected allergen into your skin through a needle or a syringe. Following this, they will assess you after 10-15 minutes. If you are allergic to that particular substance, the skin will develop symptoms like a small bump, red patches and itchy feelings.
In an allergy patch test, the allergist will attach a patch to your back. These patches contain different substances, which can be your potential triggers. These include probable allergens like cosmetic ingredients, medicaments, rubber chemicals, metals, foods, etc. The allergist will detach the patch after around 48 hours and examine the reaction on your skin after around 72 to 96 hours.
You will get a local rash on your skin if you are allergic to a certain substance included in the patch. Further, if there are more than one local rash, your allergen will infer that you may be allergic to more than one substance. Following this, they will proceed to perform another test to confirm the triggers.
There are two types of blood tests that the health care expert may conduct to diagnose the causes of your allergy:
Generally, the IgE count increases during the allergic reaction. So, doctors examine the IgE count within the serum to check whether an individual is allergic to a substance.
Nevertheless, it may not be an accurate diagnosis process because the increase in IgE may result from the invasion of pathogens like bacteria, viruses, fungi, etc.
Doctors may also perform the IgE test against specific allergens like house mites, pollen, peanuts, other foods etc. In this process, the doctor will collect your blood sample and add potential allergens to it separately. Then they will examine the antibodies produced in your blood against allergens. This helps them determine which allergen may be your trigger for anaphylaxis.
Specific IgE test is a useful diagnosis process if your doctor cannot conduct other tests due to your skin condition or other reasons. This is because they will not have to bring you directly in exposure to the trigger.
You can understand whether a particular food or medicine is your allergic trigger. In the oral food challenge test, your doctor will suggest that you intake a measured amount of probable allergic foods. Following this, they will take you under observation for a certain period. If there is no observable allergic reaction against a small amount of food, the doctor will increase the amount of the consumable item. They will stop repeating this process as soon as your skin develops symptoms.
The treatment cannot relieve individuals from their triggers entirely. If they come in direct exposure or contact with their triggers, the onset of anaphylaxis symptoms may be inevitable.
In case one develops anaphylaxis, they need to take adrenaline injections immediately to subdue their symptoms. They should also take proper care from a hospital until they recover from their complications and get control over them. Even after the treatment, one may experience biphasic anaphylaxis in which the symptoms come back again after a few hours, even without any exposure to triggers [8].
In fact, after medical treatment, one may encounter challenges like renal infections, a decrease in the count of blood cells and electrodes, cardiovascular complications, etc. This is why it is imperative that they visit their hospitals for follow-up care as the doctor advises during their release. In follow-up care, doctors may perform several tests like chest radiograph, electrocardiograph, or diagnosis of histamine and mast cell tryptase count, as necessary.
Anaphylaxis can even be fatal if individuals fail to get the necessary medical treatment on time.
There are various medications and treatments available for anaphylaxis:
One of the primary and most effective anaphylaxis medications is adrenaline or epinephrine dosage. It enhances the circulation of blood, thereby helping a patient breathe comfortably and reducing swelling developed on the skin. Another major reason why it is imperative to take adrenaline dosage is that it works very quickly, within a span of a few minutes [9].
Doctors generally recommend anaphylaxis patients carry adrenaline auto-injectors. By taking the dosages, they can instantly reduce anaphylaxis complications and manage their health emergencies.
Nevertheless, you should know how to use those injectors properly. If you are vulnerable to anaphylaxis, you should ideally carry two auto-injectors with you wherever you go. In case the complication does not wane after taking one injection, you can take another after 5-10 minutes [9].
If you develop the symptoms of anaphylaxis, you should adopt the right posture and position, as mentioned below:
Furthermore, if your breathing stops due to severe complications of anaphylaxis, you will need cardiopulmonary resuscitation or CPR immediately.
Generally, the effects of anaphylaxis are reduced after getting doses of adrenaline. However, they may also reoccur after 6-12 hours. To avoid such a situation, you need to get admission to a specialised hospital for the required care.
The anaphylaxis treatments that you can get from a hospital are as follows:
You should be discharged from the hospital only after ensuring that your complications are under control and they will not return. Furthermore, the physician may also prescribe you steroid and antihistamine tablets after releasing you from the hospital. You may have to take them for a few days as per your physician’s suggestions.
To prevent the anaphylaxis symptoms, you need to first identify your allergic trigger. You should consciously make an effort to eliminate your exposure to those triggers [10]. Furthermore, the prevention of anaphylaxis depends on the type of condition you experience, as mentioned below [11]:
You should always stay aware of the foods you take. While purchasing processed food or other edible items, you need to read the label to ensure that it does not contain the trigger of your anaphylaxis. Furthermore, your family members, friends and other near ones also should know about it so that they do not end up giving you that particular food item. Besides, if you eat outside, for example, in a hotel, you ideally should sensitise the concerned person about the food you are allergic to.
If you know the medications that cause anaphylaxis reactions, you need to convey that to your doctor every time you visit them. This will help them suggest alternative medicines. The physician will also be able to recommend alternative treatment methods if necessary so that you do not need to take those allergy-triggering medicines.
The only way to prevent the onset of anaphylaxis symptoms is to avoid circumstances that can get you stung by insects. First of all, you need to know the insect whose sting may lead you to develop anaphylaxis. Following this, you should know where they reside or where their natural habitats could be. You will have to avoid those places to reduce your confrontation with those insects. For example, if you are allergic to the stings of wasps, avoid bushes and forests that are likely to have a wasp nest.
As stated earlier, you will develop the symptoms of this anaphylaxis after intense exercises and coming in direct contact with co-triggers. In absence of the co-trigger, your body may not develop anaphylaxis. This is why you must first identify the co-trigger through allergy diagnosis processes and avoid that before and after your exercise.
If you are allergic to galactose-alpha-1,3-galactose or oligosaccharide epitope, the only way to prevent the onset of anaphylaxis is to avoid foods that contain them. Since these are mostly available in mammalian meats, you should not eat them. You also need to sensitise your close ones about your severe allergic reaction to red meats.
If you have idiopathic anaphylaxis, you need to stay in touch with a physician. They can suggest you medicines like an anti-IgE antibody, omalizumab, antihistamines, etc., according to your symptoms.
Whatsoever, you should carry adrenaline auto-injectors with you when you go outside. With the timely intervention of this injection, you can avoid the progression of anaphylaxis complications.
Following are some of the complications that patients of anaphylaxis may encounter if they fail to get prompt care [11]:
The average cost of anaphylaxis treatment is around Rs.1,000. You need to pay for purchasing necessary medicines like epinephrine auto-injector and antihistamine or steroid drugs. Nevertheless, the entire cost of treating anaphylaxis may vary from one person to another.
The overall cost also mostly depends on the severity of complications and the treatment they have to undergo. The charges of certified doctors in clinics or hospitals also influence the overall expenditure on medical treatment.
Anaphylaxis is a severe allergic reaction that can be potentially fatal. The person showing an allergic reaction must receive immediate medical care. As an anaphylaxis patient, you also need to keep an adrenaline auto-injector ready. By injecting adrenaline on time, you will be able to reduce complications of anaphylaxis significantly. Nevertheless, you need to visit hospitals or a certified doctor to get the necessary medical interventions and guidance once you experience the symptoms.
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ABCDE approach is the initial medical care tailored for individuals who develop the symptoms of anaphylaxis. In this approach, each letter starting from A to E stresses the importance of the following factors: A: Airway B: Breathing C: Circulation D: Disability E: Epinephrine
You need to keep the epinephrine or adrenaline within the plastic cover it comes with. You need to ensure that the drug is closed tightly and is far away from the reach of children. You have to keep it at room temperature, not in the refrigerator or your car so that it does not get excessively cold or hot. If you drop the auto-injector by mistake, you should check it properly and ensure there is no leakage or damage.
You may develop the below-mentioned side effects after injecting epinephrine: Red patch on the location of injection Nausea Sweating Breathing difficulty Vomiting Pounding heartbeat Dizziness Nervousness Headache Anxiety or restlessness Weakness Pale skin If you notice these side effects, you need to inform your doctor about the same to get the required follow-up care.
Yes, there are some disorders that you may confuse with anaphylaxis. Some of these are syncope (fainting), acute angioedema, acute generalised urticaria, acute asthma exacerbations and panic attacks.
There are three major types of adrenaline auto-injection that you can use. They are: EpiPen Emerade Jext Note that you should follow the instruction of a certified doctor while purchasing and using any type of adrenaline auto-injectors.
https://www.sciencedirect.com/science/article/pii/S1939455120303756
https://www.aaaai.org/conditions-treatments/allergies/anaphylaxis
https://www.nhs.uk/conditions/anaphylaxis/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754021/
https://www.frontiersin.org/articles/10.3389/fimmu.2019.00673/full
https://link.springer.com/article/10.1007/s40521-015-0055-z
https://gaapp.org/what-types-of-tests-do-doctors-use-to-diagnose-allergies/
https://acaai.org/allergies/symptoms/anaphylaxis/
https://sci-hub.se/10.2217/fmeb2013.13.49
https://pubmed.ncbi.nlm.nih.gov/24811018/
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/anaphylaxis
https://www.nhs.uk/conditions/anaphylaxis/treatment/
https://www.ncbi.nlm.nih.gov/books/NBK464181/
https://www.nhs.uk/conditions/anaphylaxis/prevention/
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