Anaphylaxis

Anaphylaxis is a chronic condition; it is an allergic reaction that may be life-threatening and sometimes takes place rapidly upon contact with allergens. Common causes include insect stings, latex, medications, and some foods. This allergic response causes the immune system to release a flood of chemicals, resulting in symptoms that can disrupt several body functions. These symptoms may include difficulty breathing, rapid heartbeat, swelling, and a drop in blood pressure.

If not treated immediately, it may lead to many complications. It can be treated with epinephrine injections. People with known allergies need to carry an epinephrine auto-injector and should seek emergency care if they observe anaphylaxis symptoms. Awareness and early intervention can save lives, making guidance and management of anaphylaxis important.

Symptoms Of Anaphylaxis

Anaphylaxis can be manifested by various symptoms, which may appear within minutes after exposure to an allergen. Some of the symptoms are given below:

• Skin reactions (hives, itching, flushed or pale skin): Skin reaction is the earliest symptom of anaphylaxis, including raised, red welts and hives on the skin. The skin may become pale or flushed, and itching may be severe.
• Swelling of the face, lips, throat, or tongue: Angioedema (swelling) is a dangerous and common symptom. It can impact the lips, tongue, throat, and face, causing difficulty swallowing and breathing. This swelling may grow faster and need immediate treatment.
• Difficulty breathing or wheezing: Airways may become constricted due to anaphylaxis, causing shortness of breath, difficulty breathing, and wheezing. This respiratory disorder is a critical sign that requires urgent medical attention.
• Rapid or weak pulse: Heart rate may be disrupted due to anaphylaxis, causing a weak or rapid pulse rate. This symptom may occur with a sudden drop in blood pressure, leading to fainting or dizziness.
• Dizziness or fainting: When low blood pressure and a rapid pulse occur together, it can cause symptoms such as dizziness, lightheadedness, or loss of consciousness. These symptoms occur when the body suffers from a deficiency of oxygen and needs urgent medical intervention.
• Nausea, vomiting, or diarrhea: Gastrointestinal symptoms, including diarrhea, vomiting, or nausea, may occur during anaphylaxis. These conditions occur due to severe reactions of the body to the allergen and may contribute to overall weakness.

When to See a Doctor

Anaphylaxis is a severe allergic reaction that needs immediate medical attention. If you or someone around you notices symptoms of anaphylaxis, use an epinephrine auto-injector, if available, and seek immediate medical care. Delays in treatment can cause reactions to be long-lasting, resulting in severe complications or even death.

FitwellHub provides comprehensive support in managing allergies and preventing anaphylaxis. Our panel of specialist and expert doctors gives you guidance on handling allergic reactions.

Causes

Various causes of anaphylaxis are discussed below:

1. Certain foods: The most common reason is the use of certain foods, particularly eggs, milk, shellfish, tree nuts, and peanuts. Even a small quantity of these allergens may lead to severe allergic reactions in susceptible people.
2. Insect stings: Another common cause of anaphylaxis is insect stings. The venom from stings by wasps, hornets, or bees may lead to a life-threatening reaction in an individual allergic to it.
3. Medications: Some medicines, like Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), aspirin, and antibiotics (penicillin), can cause anaphylaxis in more susceptible individuals. It is essential to tell your doctor about any known medicine allergies.
4. Latex: A material known as latex is usually used in balloons, medical devices, and gloves. Its exposure can trigger in individuals with latex allergies. Individuals and healthcare workers with continuous exposure to latex are at higher risk.
5. Exercise-induced anaphylaxis: Rarely, physical exercise may cause anaphylaxis, particularly when combined with medication and certain foods. This kind can occur in otherwise healthy individuals.
6. Idiopathic anaphylaxis: It occurs when the cause is unknown is called idiopathic anaphylaxis. This condition is difficult to handle, as its causes are unknown.

Risk Factors

Various risk factors may increase the chances of anaphylaxis occurrence. Understanding these risk factors can assist in taking preventive measures. Some of the preventive measures are given below:

Risk Factor	Description
Previous Anaphylactic Reaction	People with a history of anaphylaxis are at greater risk of future allergic reactions, with intensity potentially increasing with each subsequent exposure.
Allergies or Asthma	Individuals with asthma or allergies are more prone to anaphylaxis, especially if their condition is poorly managed.
Family History of Anaphylaxis	A family history of severe allergies or anaphylaxis increases the likelihood of experiencing a similar reaction.
Certain Medical Conditions	Chronic conditions such as mastocytosis, which leads to abnormal buildup of mast cells, may predispose individuals to anaphylaxis.
Age and Sex	Anaphylaxis can occur at any age, but causes vary: drug-induced anaphylaxis is more common in adults, while food-induced anaphylaxis is more common in children.

Complications

Anaphylaxis can result in serious complications if left untreated. These complications may be life-threatening and need sudden medical attention. Some of the complications are given here:

• Respiratory failure
• Cardiovascular collapse
• Brain damage
• Death

Severe constriction of the airways and swelling can cause respiratory failure in which the lungs fail to supply enough oxygen to the body. This is a chronic condition that needs immediate medical intervention. It may lead to a drop in blood pressure eventually, causing cardiovascular collapse and shock. This condition is life-threatening and may result in organ failure if left untreated. Long-term deprivation of oxygen may result in brain damage. 

Without immediate treatment, anaphylaxis can result in death within minutes. The rapid progression of symptoms underscores the importance of quick action in response. It may cause sudden death within minutes if not treated immediately. The rapid progression of symptoms emphasizes the importance of immediate action in response to anaphylaxis.

Prevention

Preventing anaphylaxis involves avoiding known allergens and being prepared to manage symptoms if they occur. These preventive measures can reduce the risk of anaphylaxis and improve safety for those at risk. Preventing anaphylaxis includes:

• Avoid allergens: Avoiding known allergens is the most effective way to prevent anaphylaxis. This can be done by reading the food labels, asking about food ingredients at restaurants, and informing doctors about drug allergies.
• Carry epinephrine: People with known allergies should carry an epinephrine auto-injector. They and their family members and caregivers should know how to use it.
• Wear an alert bracelet: Individuals at higher risk should wear a medical alert bracelet, as the first responder can get crucial information in an emergency case. It should show the allergies of the individual and the requirement for epinephrine.
• Create an action plan: For effective treatment, make a personalized anaphylaxis action approach with the doctor. This approach should recognize symptoms, involve steps to avoid causes, and manage emergency treatment.

FitwellHub provides a Healthy Elite Lifestyle Program that involves guidance for preventing and managing anaphylaxis. To learn more about this program and other services, visit the FitwellHub Help page.

Diagnosis

Diagnosing anaphylaxis depends on the symptom recognition and the history of allergic reactions. Diagnosis includes a combination of diagnostic tests and clinical assessment.

Tests 

1- Skin prick test

A skin prick test is used to detect specific allergies by injecting tiny amounts of allergens into the skin. This test assists in determining the allergies that could trigger in an individual.

2- Blood tests

Blood tests help to analyze the specific IgE antibody levels of several allergens. Increased levels may indicate increased chances.

3- Tryptase levels

Mast cells release tryptase (an enzyme) during an allergic reaction, and its increased levels may indicate recent anaphylaxis.

4- Allergy testing

Comprehensive allergy testing includes blood tests for specific IgE antibodies or skin tests and may detect potential allergens that can cause anaphylaxis. 

5- Medical history review

Evaluation of the medical history of patients, such as previous allergic reactions and causes, is important for diagnosing and planning effective treatment.

FitwellHub offers advanced diagnostic services to assist in identifying allergens and managing them. To learn more or to schedule a test, visit the FitwellHub Lab page.

Treatment

Early epinephrine management and supportive care are highly effective in the treatment of anaphylaxis. Some of the treatment approaches are given below:

Epinephrine

Epinephrine is used as the basic treatment of anaphylaxis, which is given by auto-injector. It relieves the symptoms of anaphylaxis such as relaxing airway muscles, reducing swelling, and constricting blood vessels.

Oxygen therapy

In case of serious respiratory issues, supplemental oxygen can be given in case of serious respiratory issues, and make sure the presence of sufficient oxygen levels in the blood.

Intravenous fluids

Intravenous fluid management is used to regulate blood circulation and maintain blood pressure in severe cases of hypertension or shock.

Anaphylaxis In Pakistan

Anaphylaxis is a significant health concern in Pakistan, with a study at Aga Khan University Hospital in Karachi identifying 129 cases over 24 years. The most common triggers were drugs (60.5%), food (16.3%), and intravenous contrast (10.9%). Despite its severity, only 22.5% of cases received epinephrine initially, and 3.1% of patients died from the condition.

Medications

Several medications may be used along with epinephrine to alleviate symptoms and support quick recovery.

1- Antihistamines

Loratadine or diphenhydramine can assist in reducing hives, itching, and some other allergic reactions. However, they should be used as supplementary treatment and cannot be taken as an epinephrine substitute.

2- Corticosteroids

Hydrocortisone or prednisone can be suggested to decrease swelling and avoid the recurrence of symptoms in most severe cases. These medicines are frequently used with epinephrine.

3- Bronchodilators

Albuterol can relieve bronchospasm and enhance breathing when the airways are constricted. This medication is useful, especially for people with respiratory or asthma symptoms.

FitwellHub provides multiple medications to manage the anaphylaxis treatment, such as epinephrine auto-injectors or other supportive medicines. To learn more, visit the FitwellHub Pharmacy.

Frequently Asked Questions (FAQ’s)