Anaphylaxis

Many people experience annoying allergy symptoms—a rash, sniffles, or even mild stomach upset. However, a small number of highly allergic children and adults are susceptible to a life-threatening allergic reaction called anaphylaxis, also known as anaphylactic shock. It's a situation, although rare, when a body suddenly, severely, and systemically overreacts to a foreign substance.

"Anaphylaxis is a severe reaction that can occur after an exposure to a food, medication, or insect bite. The reaction can consist of generalized skin hives, vomiting, difficulty breathing, loss of consciousness, or other symptoms. If severe and left untreated, the child can die," explains Vivian Hernandez-Trujillo M.D., attending physician in the division of Allergy/Immunology at Miami Children's Hospital in South Florida.

Leslie Vogel of South Florida learned first-hand of the dangers of anaphylaxis when her then four-year-old daughter Joelle was treated with an antibiotic and wound up in the hospital—twice. Joelle, who had a history of ear infections and a known reaction to Sulfa drugs, was treated for an infection just days before a family vacation.

"The doctor decided upon Ceclor, an antibiotic that had previously worked two other times with no adverse side effects," says Vogel. "On day seven of our trip and her course of medication, I noticed a rash behind Joelle's ears. It seemed to get worse as the day wore on. We took her to a local emergency room and the doctor confirmed that Joelle was having an allergic reaction, [stopped] the Ceclor, and prescribed Prednisone—a potent anti-inflammatory drug."

Two days after their trip to the ER, the rash was back. "I knew something was not right. I felt [Joelle's] head and she was burning up with fever, welts and rash covered her body, and she was shaking violently," remembers Vogel. "On the way to the hospital, Joelle became more lethargic and was not responding properly. The hospital staff explained that she needed a shot of epinephrine immediately or her body would start shutting down…. Miraculously, as the epinephrine took effect, I saw the color back to my daughter's cheeks and her eyelids open [and] no longer swollen. This was such a frightening moment in my life."

Unfortunately, anaphylaxis is not only a problem kids just outgrow. "Five years ago, I had an anaphylactic reaction in my adult life and it was one of the scariest things that I've ever experienced," recalls Steffany Lockhart of San Jose, California. "To this day I don't know what I reacted to, although my doctors suspect it was some kind of sulphite wash used to prepare the potato or salad I had at dinner, which apparently some restaurants use even though they are not supposed to. My reaction was fairly typical; I started to feel short of breath and noticed that my face was literally beet red. I rushed to the emergency room and even in those few minutes, my throat started to constrict and I began to hyperventilate."

Shortly after Lockhart arrived at the hospital her symptoms began to subside. While she didn't need epinephrine, they monitored her for about an hour. "Thankfully I have only had this one episode, but I do carry an Epi-Pen just in case," she says.

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), "When allergens first enter the body of a person predisposed to allergies, the immune system produces the allergen-specific IgE antibodies. The IgE antibodies attach themselves to the surface of cells called mast cells. The next time that allergic individuals comes into contact with the allergen, the IgE identifies it and quickly initiates the release of chemicals—such as histamine, from the mast cells. These potent chemicals cause the symptoms seen in allergic reactions and anaphylaxis."