Substances that cause anaphylaxis are often called allergens or triggers. Common triggers include:
- Medications (eg, antibiotics, seizure medications, muscle relaxants)
- Insect stings or bites
- Foods and food additives, especially eggs, peanuts, seafood, cow's milk, soy, and tree nuts
- Blood products
- Latex products (eg, gloves, medical tubing, condoms)
Allergic Reaction to Medication (Hives)
Some triggers, like dyes used in x-ray procedures, can cause a reaction similar to anaphylaxis.
These factors increase your chance of developing anaphylaxis. Tell your doctor if you have any of these risk factors:
The symptoms of anaphylaxis usually occur within minutes after exposure to an allergen, but can occur hours later. Symptoms may be mild or very severe, including death. They include:
- Hives]]> and itching
- Swelling, redness, stinging or burning, especially on the face, mouth, eyes, or hands
- Lightheadedness, caused by a drop in blood pressure
- Obstruction of the nose, mouth, and throat
- Severe respiratory distress
- Chest tightness, shortness of breath, wheezing
- Nausea, vomiting, cramping, ]]>diarrhea]]>
- Heart ]]>arrhythmias]]>
- Low blood pressure, ]]>shock]]> ( occurs in 30% of cases)
Diagnosis is based on the symptoms. The doctor will suspect anaphylaxis if you have symptoms and have been exposed to a likely allergen.
Anaphylaxis is a medical emergency that requires immediate medical treatment, including:
- Epinephrine (adrenaline) injection—makes blood vessels constrict, relaxes the airway, stops itching and hives, and relieves gastrointestinal cramping
- Other medications—corticosteroids and/or antihistamines may be given after the epinephrine to decrease inflammation and improve breathing.
- Bronchodilators—to improve breathing
- Intravenous fluids
- Cardiopulmonary resuscitation]]> (CPR)—may be necessary in severe cases when anaphylaxis leads to cardiovascular collapse. Severe anaphylaxis may require ]]>mechanical ventilation]]> until swelling is brought under control.
If you are diagnosed with anaphylaxis, follow your doctor's instructions .
Avoiding substances that trigger anaphylaxis is the best prevention. In addition:
- Allergy shots can decrease the risk of anaphylaxis and reduce the severity of the reactions to certain triggers.
- Wear a medical alert jewelry that lists your allergies.
- Tell your doctor or dentist about your allergies before taking any medication. When possible, ask that medications be taken as a pill. Allergic reactions can be more severe with injected medications.
- Keep self-injectable epinephrine (eg, Epi-Pen, Twin-ject) with you at home, work, in the car, and when you travel. Be sure family and friends know how to use the kit too.
- Make sure the school nurse knows about any allergies your child has.
- If allergic to insect stings, wear protective clothing when outside.
- Always remain in the doctor's or dentist's office 30 minutes after receiving an injection. Report any symptoms right away.
American Academy of Allergy, Asthma, and Immunology
The Food Allergy and Anaphylaxis Network
Allergy Asthma Information Association
Calgary Allergy Network
Anaphylaxis. Emedicine . May 2001 .
Kay AB. Allergy and allergic diseases–second of two parts. N Engl J Med . 2001;344:109-113.
National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/ . Accessed March 25, 2007.
Pumphrey, R. Anaphylaxis: can we tell who is at risk of a fatal reaction?. Curr Opin Allergy Clin Immunol 2004; 4:285.
Sampson, HA, Munoz-Furlong, A, Campbell, RL, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006;117:391.
Winbery SL, Lieberman PL. Anaphylaxis. Immunol Allergy Clin North Am 1995;15:447.
Last reviewed February 2009 by ]]>Julie D.K. McNairn, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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