Anaphylaxis has been characterized as a serious allergic reaction that is rapid in onset and may cause death. The reaction can range from mild to severe. It could be a bee sting, as in your friend's case, or a food substance that triggers this reaction.
The body's immune system occasionally identifies a substance -- for example, insect venom -- as a foreign invader, almost like bacteria, and sends antibodies to attack the offending substance. This action results in a release of chemicals within the body that can cause an allergic reaction, such as hives.
However, sometimes an individual develops a sensitivity to the allergen and, when exposed to it, the immune system has an over-the-top response. The chemicals are released in a flood, the blood pressure may drop and the bronchial tubes narrow, causing difficulty breathing or even unconsciousness and death. An anaphylactic response can occur within seconds or minutes of exposure to the allergen.
Why some people have this reaction is still a matter of debate and research. Infrequently the condition appears to be inherited or genetic, but for the majority of cases, we don't have an answer.
We do know that certain factors such as eczema and childhood asthma appear to put people at higher risk for an anaphylactic reaction. But often it's completely unpredictable.
People who've had a mild reaction to a food substance or insect sting should be wary. A mild reaction in the first episode, for example a couple of hives, could be associated with a severe or life-threatening reaction the next time.
You also should be aware that the symptoms may recur soon after treatment. Typically, such symptoms (a biphasic reaction) would return within eight hours of treatment, but in rare instances, they may recur 24 hours or even a day or two later.
Prevention is key. Avoid exposure to known allergens. People who are at risk should carry a syringe of adrenaline (epinephrine). These auto-injectors (EpiPen, Twinject) can be self-administered or used by a loved one on your behalf in the event of an anaphylactic reaction. Some research on desensitization to allergens is under way, but so far desensitization has not been entirely successful.
A S.A.F.E. campaign was developed by experts to promote steps you should take when confronted with such a situation:
Seek support -- If you've had an anaphylactic reaction, educate those around you as to its signs and symptoms and when and how to use medication such as the auto-injector. It also means that during an event, contact 911 early. Even after using an auto-injector, you still need to go to an emergency department to be evaluated for care, as the effects of the epinephrine are only temporary.
Assess for allergen -- Right after the event is probably the time when you and your family are best able to remember what you were exposed to. Most of the time it is obvious, for example, an insect sting or a food source such as seafood, a peanut or tree nut, such as a walnut or pecan.
Follow-up -- Anyone who has experienced a systemic allergic reaction should seek timely follow-up care with a primary care physician and referral to an allergist for further treatment and testing.
Epinephrine -- This is really the cornerstone of treatment for severe reactions with hypotension (low blood pressure) or difficulty breathing. The epinephrine should be given right away at home, in the field or in the emergency room. Those who have had an anaphylactic episode should carry an auto-injector of epinephrine.
Some kinds of food reactions are not dangerous, for example mild scratching in the roof of the mouth or a mildly upset stomach. On the other hand, we prefer to err on the side of caution. People who have experienced an allergic reaction to a food substance or an insect sting should talk to their primary care provider about whether they should carry epinephrine.
Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
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