Anaphylaxis

Symptoms of Anaphylaxis

There are many signs to help parents and children recognize anaphylaxis.

• Breathing difficulty: Includes wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain, tightness, nasal congestion, fever-like syndrome, and trouble swallowing.
  
  
• Circulation problems: Includes pale/blue color, poor pulse, passing out, dizzy, lightheaded, low blood pressure, shock.
  
  
• Stomach factors: Includes nausea, pain/cramps, vomiting, diarrhea, and itchy mouth/throat.
  
  
• Other symptoms: Includes anxiety, feeling of "impending doom," itchy/watery eyes, red eyes, headache, and cramping of the uterus.

Reactions usually begin within minutes of exposure, however with some people the reactions can be delayed for hours. The most dangerous symptoms are low blood pressure, breathing difficulties, shock and loss of consciousness—all which can be fatal.

Allergic Triggers

An anaphylactic reaction is usually triggered by an exposure to an allergic trigger. These can occur by injection, swallowing, inhalation, or skin contact. Even though anaphylaxis is rare, and most people with allergies will never have such a reaction, it is wise to be an informed parent and know the facts.

The following substances may trigger a reaction:

Foods: Any food can indeed cause an allergic reaction, however some of the most common foods that cause severe anaphylaxis are peanuts, nuts from trees (walnut, cashew, Brazil nut), shellfish, fish, milk, and eggs. Additionally, food additives such as sulfites can sometimes trigger reactions in sensitive people.

Stinging Insects: The venom of stinging insects, such as yellow jackets, honeybees, paper wasps, hornets, and fire ants, cause discomfort for most people who are stung, but may be deadly for those with allergies to these venoms.

Medications: Any medication can cause an allergic reaction, however, the most common categories that cause anaphylaxis are antibiotics and anti-seizure drugs. Other medical therapies such as post-surgery fluids, vaccines, blood and blood products, radio contrast dyes, pain medications, and other drugs may also cause anaphylaxis.

Latex: Products made from natural latex (from the rubber tree) contain allergens that may cause a reaction in sensitive individuals. The greatest danger is when the latex comes in contact with moist areas of the body or internal surfaces during surgery.

Exercise: Exercise can trigger anaphylaxis, although this is very rare. Oddly, it does not occur after every exercise session. And it can sometimes occur after eating certain foods before exercise. Although any food could cause a reaction, the ones that have been reported to cause reactions when coupled with exercise include wheat, shellfish, fruit, milk, celery, and fish.

Idiopathic: When no cause is found, and the reaction is definitely an anaphylactic reaction, it is termed idiopathic anaphylaxis.

Treatment and Prevention

If you, or anyone with you, show severe allergy symptoms, you should call immediately for help. "Anaphylaxis is a medical emergency," states Dr. Hernandez-Trujillo. "The emergency medical system should be activated. Epinephrine is usually administered immediately, as the first line of therapy, and the child should go to the emergency room for monitoring and further treatment. An antihistamine should not be the first or only treatment used. Antihistamines do not prevent progression of the reaction. Steroids are often needed to decrease or stop progression of the reaction. Medications, such as steroids, may be necessary if the child has difficulty breathing."

"After an anaphylactic episode occurs, close follow-up by the child's pediatrician is essential. Often, an allergy specialist can work with the child's pediatrician to perform an allergy evaluation to attempt to determine the cause of the reaction. The evaluation consists of laboratory tests, including skin-prick tests or blood tests to detect the levels of the antibody (IgE) produced when allergies to specific allergens, such as foods, are present. A prescription for an epinephrine auto-injector to be used in case of emergency, along with proper education, should be given to patients with a history of food or insect anaphylaxis. In conclusion, Dr. Hernandez-Trujillo adds, "Avoidance is the most essential component in the prevention of anaphylaxis."

Purchasing and wearing a special bracelet or necklace may be the best investment you can make. It identifies that you have a severe allergy and supplies important information to medical personnel in the event you cannot speak. "Joelle, now 16, wears a medic alert bracelet," says Vogel. Her physicians suggested it. Also her medical records don stickers with big red letters,"NO SULFA: NO CECLOR."

Planning Ahead

According to the AAAAI, people with allergies can work with an allergist/immunologist to create a goal plan in the prevention of anaphylaxis. Consider the following points when creating your own emergency plans:

• Determine if you have had, or are at risk for anaphylaxis.
  
• Determine what trigger(s) may cause your reaction.
  
• Learn how to avoid the allergen(s).
  
• Provide education about recognizing symptoms of an allergic reaction.
  
• Create an emergency treatment plan for use by you and others.
  
• Offer the most up-to-date therapies to treat and/or prevent reactions.

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