Anaphylaxis: Causes, Symptoms, Diagnosis and Treatment

Anaphylaxis

Today we are going to discuss one of the most common life-threatening conditions that is anaphylaxis. Synonyms for anaphylaxis are anaphylactic shock, anaphylactic reaction or severe allergic reaction. Anaphylaxis is a systemic allergic reaction. Anaphylactic shock is mainly caused by allergens which may lead to the release of some chemicals from mast cells, these chemicals are mainly histamines and other vasoactive mediators.

Anaphylaxis causes

As we have discussed earlier anaphylaxis is one type of systemic allergic reaction. This kind of allergic reaction is mainly caused due to some allergens such as foods, drugs, chemicals, insect bites, etc.

The causes of anaphylaxis or anaphylactic shock:

Food

  • Milk
  • Eggs
  • Fish
  • Peanuts
  • Soya beans

Drugs 

  • NSAID’s (Nonsteroidal anti-inflammatory drugs)
  • Aspirin
  • Radio contrast media used during various investigations such as MRI, CT scan, fluoroscopy etc.
  • Penicillin

Chemicals

  • Anesthetic agents I.V. suxamethonium, propofol, etc.

Insect bites

  • Venom from bees, wasp, etc.

Latex 

Patients with latex allergy may show the anaphylactic reaction on contact with them.

Idiopathic

Risk Factors for Anaphylaxis

It is proven that patients with some pre-existing medical conditions are more prone to anaphylaxis or anaphylactic shock. E.g. asthma. If asthmatic patients are well controlled than its fine but if a patient is not well-controlled chances are more for having anaphylaxis or anaphylactic shock.

Signs and Symptoms of Anaphylaxis

  • Urticaria
  • Hypotension
  • You may notice itching in palms and soles of feet and even in your genitals
  • Laryngeal obstruction (tridor)
  • Wheezing
  • Bronchoconstriction
  • Loss of consciousness
  • Angioedema of lips and mucous membranes
  • Flushing and sweating

Anaphylaxis diagnosis

What Investigations do you need to carry out for Anaphylactic Reaction?

The important investigation to be done is of serum mast cell tryptase concentration. This test helps in confirmation of anaphylactic reaction. Special investigations for IgE are done to rule out the allergic reaction.

Anaphylaxis treatment

Anaphylaxis is an acute medical emergency. The patients that have resolved after the attack need to go for the specialist assessment about the reaction. The patient should be educated about the allergen they are affected to or any reaction and specific treatment measures such as immunotherapy is conducted. In case if the trigger factor or the allergen cannot be identified then it can prove as a risk to the patient further also. The patients should be given self- injectable adrenaline for further risk prevention and their family members should be explained about its uses and side effects.

Further here we have mentioned about the indications and risk and use of self-injectable adrenaline.

First, let us tell you about emergency protocols just in case when you see or come across any such reaction what at the time steps you should do?

Emergency Management of Anaphylactic Shock or Anaphylaxis

  • If suppose the reaction is caused by an allergen like bee sting than at first remove the allergen as soon as possible.
  • Maintain clear airway to the patient.
  • Administer Intramuscular adrenaline promptly. The dose will be 0.3-1.0ml 1:1000 solution (adults) as it acts within very few minutes. If you find no response then give again after 10-15 minutes.
  • Antihistaminic drugs can be helpful e.g. Chlorpheniramine 10mg i.m. or slow i.v. they slow down the effects of mast cell activation.
  • Administer corticosteroids e.g. hydrocortisone 200mg I.V. it helps rebound the symptoms in affected patients.
  • And the supportive treatment would be to give fluids and oxygen and decrease bronchoconstriction by beta 2 agonists.

When to use Self-Injectable Adrenaline?

Self-injectable adrenaline can be used in a case where venom or foods are the allergens to Anaphylaxis. It can also be used when a person is more prone to get exposed to allergens that can lead to the anaphylactic reaction. Some anaphylaxis case where the cause is unknown.

When not to use Self-Injectable Adrenaline?

Self-injectable adrenaline must not use where a patient is having systemic diseases or conditions like Heart diseases, hypertension, etc. If the patient is having tricyclic antidepressant or oxidase inhibitors or cocaine. In such cases, self-injectable adrenaline is contraindicated.

How can the Doctor educate Patients’ family members regarding Self-Injectable Adrenaline?

The doctor will teach patient’s family regarding self-injectable adrenaline such as What is this self-injectable adrenaline? How does this device work? How to use this device? The doctor will suggest a patient and his/her family carry the device all the times.

Conclusion

Anaphylaxis though being an acute condition you need to take due care about the allergen you get affected with. This reaction requires self-care and self-awareness.