Anaphylaxis is a life-threatening condition, representing a severe allergic reaction that requires immediate and proper treatment. It can be difficult to distinguish from other illnesses due to its wide range of symptoms. Anaphylaxis is a serious allergic response with sudden onset and multiple symptoms, which can be fatal, as tragically occurred with a 28-year-old pregnant woman in Arta, leaving many questions unanswered.
For diagnosis, one of the following three criteria must be met:
1. Acute onset of illness (within minutes or hours) involving skin or mucosal tissue (e.g., generalized hives, itching, swelling of lips or tongue) AND at least one of the following:
– Respiratory symptoms (e.g., shortness of breath, wheezing, bronchospasm)
– Drop in blood pressure
Skin symptoms appear in approximately 90% of anaphylactic reactions.
2. At least two of the following occurring within minutes to hours after exposure to a likely allergen:
– Skin or mucosal symptoms
– Respiratory symptoms
– Drop in blood pressure
– Persistent gastrointestinal symptoms (e.g., abdominal pain, vomiting)
3. A drop in blood pressure after exposure to a known allergen:
– In adults: systolic BP <90 mmHg or >30% decrease from baseline
– In children: systolic BP below age-appropriate norms
Common symptoms include:
– Skin involvement (~90% of cases)
– Respiratory issues (~70%)
– Gastrointestinal symptoms (~40%)
– Cardiovascular symptoms (35%)
Anaphylaxis can manifest through various combinations of nearly 40 possible symptoms. When low blood pressure is present, it’s referred to as anaphylactic or allergic shock.
Reactions are typically most severe within two hours of allergen exposure. About 20% of patients experience a recurrence of symptoms within 8 hours (biphasic anaphylaxis), necessitating close monitoring.
Common triggers include:
– Foods: nuts, shellfish, eggs, milk
– Insect stings
– Latex
– Medications: penicillin and other beta-lactam antibiotics
– Biological agents: vaccines, hormones
– Food additives: dyes, preservatives
– Physical factors: exercise, cold, sunlight
– Alcohol
Treatment:
The primary treatment for anaphylaxis is epinephrine (adrenaline). Timely administration is critical—studies show the average time from symptom onset to cardiac arrest in fatal cases is less than 30 minutes. Patients with a history of anaphylaxis should carry an auto-injector and be trained to use it promptly during an episode.
Source: iatropedia