Anaphylaxis

About Anaphylaxis

Anaphylaxis is a severe, potentially life threatening allergic reaction that occurs rapidly, usually within minutes to hours of exposure to an allergen. It affects multiple organ systems and can lead to respiratory compromise and cardiovascular collapse. Common triggers include foods peanuts, tree nuts, shellfish, milk, eggs, medications penicillin and other antibiotics, NSAIDs, chemotherapy, insect stings bees, wasps, hornets, fire ants, latex, and exercise sometimes food dependent. Symptoms develop rapidly and may include skin flushing, hives urticaria, itching, swelling of lips, tongue, throat angioedema, difficulty breathing, wheezing, stridor, abdominal cramps, vomiting, diarrhea, dizziness, low blood pressure, rapid heart rate, confusion, and loss of consciousness. A drop in blood pressure and airway obstruction are the primary causes of death. Diagnosis is clinical, supported by elevated serum tryptase within 2 hours of the reaction. Anaphylaxis is a medical emergency; use an adrenaline auto injector if available and call your local emergency number. The person should lie down and not stand or walk, even if they feel better; legs can be raised, and if breathing is hard they can sit up slowly. If there is no improvement after 5 minutes, use a second auto injector. Intramuscular adrenaline epinephrine, usually injected into the outer thigh, is the first line treatment, and further doses may be given by emergency staff. Adjunctive hospital treatments include antihistamines diphenhydramine, corticosteroids methylprednisolone, H2 blockers famotidine, bronchodilators albuterol, IV fluids, and oxygen. People are usually observed in hospital for several hours afterwards because symptoms can recur biphasic reaction. People who have had anaphylaxis are commonly prescribed adrenaline auto injectors such as EpiPen or Auvi Q and referred to an allergy specialist for trigger identification and management.