definition
Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you're allergic to, such as a peanut or the venom from a bee sting.
The flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. Signs and symptoms of anaphylaxis include a rapid, weak pulse, a skin rash, and nausea and vomiting. Common triggers of anaphylaxis include certain foods, some medications, insect venom and latex.
Anaphylaxis requires an immediate trip to the emergency department and an injection of epinephrine. If anaphylaxis isn't treated right away, it can lead to unconsciousness or even death.
symptoms
Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include:
Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis)
A feeling of warmth
The sensation of a lump in your throat
Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
A weak and rapid pulse
Nausea, vomiting or diarrhea
Dizziness or fainting
causes
Your immune system produces antibodies that defend against foreign substances. This is good when a foreign substance is harmful (such as certain bacteria or viruses). But some people's immune systems overreact to substances that shouldn't cause an allergic reaction. When this occurs, the immune system sets off a chemical chain reaction, leading to allergy symptoms. Normally, allergy symptoms aren't life-threatening. But some people have a severe allergic reaction that can lead to anaphylaxis. Even if you or your child has had only a mild anaphylactic reaction in the past, there's still a risk of more severe anaphylaxis.
A number of allergens can trigger anaphylaxis, depending on what you're allergic to.
Common anaphylaxis triggers include:
Certain medications, especially penicillin
Foods, such as peanuts, tree nuts (walnuts, pecans, almonds, cashews), wheat (in children), fish, shellfish, milk and eggs
Insect stings from bees, yellow jackets, wasps, hornets and fire ants
Less common causes of anaphylaxis include:
Latex
Medications used in anesthesia
Exercise
Anaphylaxis symptoms are sometimes caused by aspirin and other drugs — such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Midol Extended Relief) — and the intravenous (IV) contrast used in some X-ray imaging tests. Although similar to allergy-induced anaphylaxis, this type of reaction isn't triggered by allergy antibodies.
Anaphylaxis triggered by exercise is not common and varies from person to person. In some people, aerobic activity, such as jogging, triggers anaphylaxis. In others, less intense physical activity, such as walking, can trigger a reaction. Eating certain foods before exercise or exercising when the weather is hot, cold or humid also has been linked to anaphylaxis in some people. Talk with your doctor about any precautions you should take when exercising.
If you don't know what triggers your allergy attack, your doctor may do tests to try to identify the offending allergen. In some cases, the cause of anaphylaxis is never identified. This is known as idiopathic anaphylaxis.
risk factors
there aren't many known risk factors for anaphylaxis, but some things that may increase your risk include:
A personal history of anaphylaxis. If you've experienced anaphylaxis once, your risk of having this serious reaction increases. Future reactions may be more severe than the first reaction.
Allergies or asthma. People who have either condition are at increased risk of having anaphylaxis.
A family history. If you have family members who've experienced exercise-induced anaphylaxis, your risk of developing this type of anaphylaxis is higher than it is for someone without a family history.
complications
An anaphylactic reaction can be life-threatening when a severe attack occurs; it can stop breathing or stop your heartbeat. In this case, you'll need cardiopulmonary resuscitation (CPR) and other emergency treatment right away.
treatment
During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medications including:
Epinephrine (adrenaline) to reduce your body's allergic response
Oxygen, to help compensate for restricted breathing
Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
A beta-agonist (such as albuterol) to relieve breathing symptoms
Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include:
Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis)
A feeling of warmth
The sensation of a lump in your throat
Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
A weak and rapid pulse
Nausea, vomiting or diarrhea
Dizziness or fainting
causes
Your immune system produces antibodies that defend against foreign substances. This is good when a foreign substance is harmful (such as certain bacteria or viruses). But some people's immune systems overreact to substances that shouldn't cause an allergic reaction. When this occurs, the immune system sets off a chemical chain reaction, leading to allergy symptoms. Normally, allergy symptoms aren't life-threatening. But some people have a severe allergic reaction that can lead to anaphylaxis. Even if you or your child has had only a mild anaphylactic reaction in the past, there's still a risk of more severe anaphylaxis.
A number of allergens can trigger anaphylaxis, depending on what you're allergic to.
Common anaphylaxis triggers include:
Certain medications, especially penicillin
Foods, such as peanuts, tree nuts (walnuts, pecans, almonds, cashews), wheat (in children), fish, shellfish, milk and eggs
Insect stings from bees, yellow jackets, wasps, hornets and fire ants
Less common causes of anaphylaxis include:
Latex
Medications used in anesthesia
Exercise
Anaphylaxis symptoms are sometimes caused by aspirin and other drugs — such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Midol Extended Relief) — and the intravenous (IV) contrast used in some X-ray imaging tests. Although similar to allergy-induced anaphylaxis, this type of reaction isn't triggered by allergy antibodies.
Anaphylaxis triggered by exercise is not common and varies from person to person. In some people, aerobic activity, such as jogging, triggers anaphylaxis. In others, less intense physical activity, such as walking, can trigger a reaction. Eating certain foods before exercise or exercising when the weather is hot, cold or humid also has been linked to anaphylaxis in some people. Talk with your doctor about any precautions you should take when exercising.
If you don't know what triggers your allergy attack, your doctor may do tests to try to identify the offending allergen. In some cases, the cause of anaphylaxis is never identified. This is known as idiopathic anaphylaxis.
risk factors
there aren't many known risk factors for anaphylaxis, but some things that may increase your risk include:
A personal history of anaphylaxis. If you've experienced anaphylaxis once, your risk of having this serious reaction increases. Future reactions may be more severe than the first reaction.
Allergies or asthma. People who have either condition are at increased risk of having anaphylaxis.
A family history. If you have family members who've experienced exercise-induced anaphylaxis, your risk of developing this type of anaphylaxis is higher than it is for someone without a family history.
complications
An anaphylactic reaction can be life-threatening when a severe attack occurs; it can stop breathing or stop your heartbeat. In this case, you'll need cardiopulmonary resuscitation (CPR) and other emergency treatment right away.
treatment
During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medications including:
Epinephrine (adrenaline) to reduce your body's allergic response
Oxygen, to help compensate for restricted breathing
Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
A beta-agonist (such as albuterol) to relieve breathing symptoms
tests and diagnosis
Your doctor will ask you questions about your allergies or any previous allergic reactions you've had. This evaluation will include questions about:
Whether any particular foods seem to cause a reaction
Any medications you take, and if certain medications seem linked to your symptoms
Whether you've had allergy symptoms when your skin has been exposed to latex
Whether stings from any particular type of insect seem to cause your symptoms
To help confirm the diagnosis:
You may be tested for allergies with skin tests or blood tests
You may also be asked to keep a detailed list of what you eat or to stop eating certain foods for a time
Your doctor will want to rule out other conditions as a possible cause of your symptoms, including:
Seizure disorders
A condition other than allergies that causes flushing or other skin symptoms
Mastocytosis, an immune system disorder
Psychological issues, such as panic attacks
Heart or lung problems
Your doctor will ask you questions about your allergies or any previous allergic reactions you've had. This evaluation will include questions about:
Whether any particular foods seem to cause a reaction
Any medications you take, and if certain medications seem linked to your symptoms
Whether you've had allergy symptoms when your skin has been exposed to latex
Whether stings from any particular type of insect seem to cause your symptoms
To help confirm the diagnosis:
You may be tested for allergies with skin tests or blood tests
You may also be asked to keep a detailed list of what you eat or to stop eating certain foods for a time
Your doctor will want to rule out other conditions as a possible cause of your symptoms, including:
Seizure disorders
A condition other than allergies that causes flushing or other skin symptoms
Mastocytosis, an immune system disorder
Psychological issues, such as panic attacks
Heart or lung problems
preventiom
The best way to prevent anaphylaxis is to avoid substances that you know cause this severe reaction. Follow these steps:
Wear a medical alert necklace or bracelet to indicate if you have an allergy to specific drugs or other substances.
Alert your doctor to your drug allergies before having any medical treatment. If you receive allergy shots, always wait at least 30 minutes before leaving the clinic so that you can receive immediate treatment if you have a severe reaction after the allergy shot.
Keep a properly stocked emergency kit with prescribed medications available at all times. Your doctor can advise you on the appropriate contents. This may include an epinephrine autoinjector. Make sure your autoinjector has not expired; these medications generally last 18 months.
If you're allergic to stinging insects, exercise caution when they're nearby. Wear long-sleeved shirts and pants and don't wear sandals or walk barefoot in the grass. Avoid bright colors and don't wear perfumes or colognes. Stay calm if you are near a stinging insect. Move away slowly and avoid slapping at the insect.
If you have specific food allergies, carefully read the labels of all the foods you buy and eat. Manufacturing processes can change, so it's important to periodically recheck the labels of foods you commonly eat. When eating out, ask about ingredients in the food, and ask about food preparation because even small amounts of the food that you're allergic to can cause a serious reaction.
The best way to prevent anaphylaxis is to avoid substances that you know cause this severe reaction. Follow these steps:
Wear a medical alert necklace or bracelet to indicate if you have an allergy to specific drugs or other substances.
Alert your doctor to your drug allergies before having any medical treatment. If you receive allergy shots, always wait at least 30 minutes before leaving the clinic so that you can receive immediate treatment if you have a severe reaction after the allergy shot.
Keep a properly stocked emergency kit with prescribed medications available at all times. Your doctor can advise you on the appropriate contents. This may include an epinephrine autoinjector. Make sure your autoinjector has not expired; these medications generally last 18 months.
If you're allergic to stinging insects, exercise caution when they're nearby. Wear long-sleeved shirts and pants and don't wear sandals or walk barefoot in the grass. Avoid bright colors and don't wear perfumes or colognes. Stay calm if you are near a stinging insect. Move away slowly and avoid slapping at the insect.
If you have specific food allergies, carefully read the labels of all the foods you buy and eat. Manufacturing processes can change, so it's important to periodically recheck the labels of foods you commonly eat. When eating out, ask about ingredients in the food, and ask about food preparation because even small amounts of the food that you're allergic to can cause a serious reaction.
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