Anaphylaxis is one of the most serious allergic reactions that the body can have. Triggered by exposure to allergens via skin contact, ingestion, or injection, it develops rapidly and can be severe if left untreated, causing approximately 400-800 deaths each year in the U.S. It’s estimated that up to 15% of the American population is at risk of contracting anaphylaxis due to a variety of allergens.

Anaphylaxis mechanisms

When initially exposed to the allergen, the body of an anaphylaxis sufferer immediately begins producing antibodies to fend off the intruder. The antibodies that are produced are known as lgE antibodies. They bind to the surface of mast cells located in the connective tissues, and they also latch onto the white blood cells known as basophils.

Although the reaction may initially be fended off, anaphylaxis sets in when the allergen reenters the body and immediately begins fighting back against the antibodies. Within moments, this can trigger the release of histamines and other chemicals, resulting in a narrowing of the esophagus, muscle spasms, and even circulatory collapse.

The most common allergens that can trigger anaphylaxis are:

• Medications, such as antibiotics, vaccines, hormones, anti-inflammatory drugs, aspirin, and allopurinol.
• Foods such as nuts, fish shellfish, soy, milk, wheat, and eggs.
• Latex, such as the kind used in medical contexts.
• Biological agents such as tetanus antitoxin, antigens, and snake venom antitoxin.
• Insect stings, especially form bees and wasps.

The speed with which the reaction sets in is generally a good indication of how severe it is. Mild reactions can take up to two hours to develop, while more severe interactions can happen immediately and progress rapidly from minor swelling to life-threatening throat constriction. The worst cases can result in cardiac arrest and coma.

How your doctor can help

Because severe anaphylaxis can set in almost instantly and progress rapidly, it’s essential to seek medical care as soon as possible. The symptoms will be evaluated by the physician, who will then decide the best course of treatment. In any case, the sooner the reaction is identified, the better the prognosis will be.

For non-life-threatening but severe reactions, epinephrine may be administered through the subcutaneous tissue in the upper thigh. Meanwhile, corticosteroids and antihistamines may be given to relieve inflammation and other symptoms. Bronchodilators may be used to fight restriction of air passages. In cases such as these, the patient may be monitored in-hospital for 12 hours.

In severe cases in which anaphylaxis leads to cardiac arrests, emergency room personnel will begin cardiopulmonary resuscitation and administer oxygen to prevent brain damage.

How to prevent anaphylaxis

If you know that you’re allergic to something, avoid that allergen at all costs. If there is even a small chance that you will be exposed in the future, keep an emergency kit containing everything you need to fight the reaction until you can receive medical treatment.

If you’ve had an allergic reaction that you suspect may have been a mild case of anaphylaxis, talk to a doctor about how to handle these situations in the future and whether there is anything you can do to minimize your reactions.