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Anaphylaxis

Anaphylaxis is a dramatic and wide­spread acute atopic reaction marked by the sudden onset of rapidly progressive urticaria and respiratory distress. A severe anaphylactic reaction may precipitate vascular collapse, leading to systemic shock and, sometimes, death.

Causes

Many things can cause anaphylaxis. 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, 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

Signs and symptoms

An anaphylactic reaction produces sudden physical distress within seconds or minutes after exposure to an allergen. They may include the following:

• Difficulty breathing
• Wheezing
• Nasal congestion
• Cough
• Confusion
• Nausea, vomiting
• Diarrhea
• Abdominal pain or cramping
• Slurred speech
• Rapid or weak pulse
• sweating
• shortness of breath

Diagnosis

Anaphylaxis can be diagnosed by the rapid onset of severe respiratory or cardiovascular symptoms after ingestion or injection of a drug, vaccine, diagnostic agent, food, or food additive or after an insect sting. If these symptoms occur without a known allergic stimulus, rule out other possible causes of shock (such as acute myocardial infarction, status asthmaticus, and heart failure).

Treatment

Acute anaphylaxis must be treated as a medical emergency with stabilisation of airway, breathing and circulation. Intramuscular adrenaline must be given immediately to patients with signs of shock, airway swelling, or definite difficulty in breathing. This is followed by treatment with an antihistamine, corticosteroid and perhaps other drugs.

Adrenaline may not be necessary for skin manifestations of anaphylaxis. Treatment with antihistamines may be all that is required.

Prevention

Prevention is the best medicine for anaphylaxis . Follow these steps to help ensure your well-being:-

• Wear a medical alert necklace or bracelet to indicate if you have an allergy to specific drugs or other substances.
• A person with a known history of allergies should receive a drug with a high anaphylactic potential only after cautious pretesting for sensitivity. Closely monitor the patient during testing, and make sure you have resuscitative equipment and epinephrine ready
• Avoid wearing sandals or walking barefoot in the grass if you're allergic to insect stings.
• People who have a history of allergy to insect bites/stings should be instructed to carry (and use) an emergency kit consisting of injectable epinephrine and chewable antihistamine. They should also wear a Medic-Alert or similar bracelet/necklace stating their allergy.