Anaphylaxis – causes, symptoms & therapy

Anaphylaxis is a serious and potentially life-threatening allergic reaction. The reaction can occur within seconds when an allergic person is exposed to the allergen; e.g. a nut or the venom of a bee.

The torrent of endogenous chemicals released by the immune system during anaphylaxis can produce shock. Blood pressure falls, airways narrow; Dizziness, rash and vomiting are common direct symptoms. Anaphylaxis requires immediate medical attention and an epinephrine shot. If left untreated, the shock can lead to death.

causes

The human immune system produces antibodies that defend the body against foreign substances. This makes sense if the attacking foreign body is actually harmful, such as certain bacteria or viruses .But the immune system of many people reacts to substances that are not harmful. When this happens, a chain reaction begins that leads to allergy symptoms. Usually these symptoms are not life-threatening, but some people have an allergic reaction that is severe enough to lead to anaphylaxis.

A variety of allergens can trigger anaphylaxis. This depends on what the affected person is allergic to. Common causes are certain medications, most notably penicillin. Food such as nuts, grains, fish, milk, eggs. Or insect bites from bees, hornets or ants. The reaction to the allergens can vary greatly from person to person.

When to the doctor?

Since anaphylaxis or anaphylactic shock is life-threatening, the person affected should see a doctor or call an ambulance immediately at the first sign. If he is already in shock, witnesses must contact an ambulance and provide first aid until he arrives. Anaphylaxis is a sudden breakdown of the immune system. Therefore, a quick and good reaction is essential for survival. Multiple organ failure is possible, so that the affected person often collapses physically.

A doctor must be consulted as soon as the first breathing problems or interruptions occur. The mucous membranes in the mouth and throat reduce the usual air supply, resulting in shortness of breath . A doctor must be called in the event of disturbances in consciousness, tachycardia or spasms throughout the body. Problems with speaking, seeing or hearing indicate an acute reaction of the body that requires immediate action.

If high blood pressure sets in, swelling of the skin or itching occurs, a doctor must be consulted. Reddening of the skin, eyes or sudden runny nose must be examined and clarified by a doctor. If symptoms such as nausea, vomiting or dizziness occur, a doctor should be consulted immediately.

symptoms and course

Typical symptoms of anaphylaxis:

• skin rash

• swelling

• itching

• difficulty breathing

• shortness of breath

• dizziness

• Vomit

• nausea

Anaphylaxis usually occurs seconds after exposure to the allergen. In some cases, however, half an hour can pass between contact and reaction. Symptoms of anaphylaxis include skin reactions, including itchy rashes, and almost always pale complexion. Those affected become hot and feel a lump in their throat. As the throat, airways, and tongue swell, it can become difficult to breathe. The pulse quickens and flattens out. Dizziness, vomiting, diarrhea and fainting can also set in. Those present should act quickly if these symptoms occur and call an ambulance. Many people with severe allergies also carry an epinephrine injection on their body.

Diagnose

To make a diagnosis, the doctor will ask specific questions about past allergic reactions. Which foods or medicines could be suspected, for example, are there reactions to contact with latex or insect bites. A skin or blood test can also be used to make a more accurate diagnosis . Another variation is the exact listing of all foods that are eaten during the day, or the omission of certain foods for a defined period of time. In addition, if there is suspicion, an attempt is made to rule out other disorders that could be responsible for the reactions. Heart problems or psychological disorders can also cause the listed symptoms.

complications

The most severe consequence of an allergic reaction is anaphylaxis, which is associated with far-reaching and sometimes even life-threatening complications. If the sufferer has an allergy to a certain substance, they must constantly avoid that substance in order to prevent an allergic reaction. This severely limits the quality of life, since the person concerned must always be careful. A reaction can begin harmlessly at first, with the skin turning red and also starting to itch. Small blisters, the wheals , often begin to form, which also increases the itching. In addition, the reaction can spread and go to the airways, which can swell and lead to severe shortness of breath in the patient, the affected person threatens to suffocate.

Due to the anatomical proximity of the airways to the esophagus, there are also difficulties in swallowing. A form of allergic reaction that is more difficult to treat is Quincke’s edema , in which the deeper layers of the skin also swell. Anaphylaxis can cause the blood vessels in the body to open wide, resulting in a sharp drop in blood pressure, resulting in anaphylactic shock. As a result, important organs are no longer supplied with blood properly and can die as a result. The most common of these is kidney or lung failure. Not infrequently (in 1 percent of cases), anaphylaxis leads to the death of the patient.

treatment and therapy

An emergency physician will perform cardiopulmonary resuscitation (CPR) for anaphylaxis if breathing stops or the heart stops beating. The administration of medication is also common. These include: epinephrine (adrenaline, which slows down the body’s response to the allergen), oxygen to stabilize breathing, intravenous antihistamines , and cortisone to reduce airway inflammation.

People with anaphylaxis need help fast. If the symptoms are listed, bystanders should call the emergency services as soon as possible and bring the person concerned into a comfortable position with their legs raised. Breathing and pulse should ideally be tested by the first aider and resuscitation carried out if necessary.In addition, the affected person should be searched for possible medication or an EpiPen. The EpiPen is injected into the thigh. In some cases there is the possibility of reducing a severe allergy with immunotherapy. In most cases, however, the allergy and thus the cause of the anaphylaxis cannot be cured.

The only option for those affected is to avoid future allergic reactions by consciously dealing with their allergy. This primarily means bypassing and avoiding contact with known allergens. If necessary, an EpiPen should be carried, as well as antihistamines and prednisone.

prevention

The best way to prevent anaphylaxis is to avoid the allergen. This applies to both food (read the ingredients) and insects. Special collars or wrist bands can be worn by people with severe allergies to provide the right information in an emergency. Likewise, people in the risk group should always have a complete set of necessary medication to hand in case of an emergency.