Anaphylaxis Allergic Shock - Managing Your Allergies: Allergies

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Anaphylaxis (allergic shock)

Anaphylaxis, sometimes called allergic shock, is a reaction affecting the entire body. It ranges from relatively mild to life-threatening. In the United States, anaphylaxis is responsible for somewhere between 500 and 1,000 deaths each year. Peanuts and tree nuts (such as walnuts) appear to be the prime culprits and account for most of the deaths attributable to anaphylactic shock in children. The onset of symptoms includes feeling flushed, sneezing, itchiness, hives, nasal congestion, and watery red eyes, progressing to difficulty breathing and swelling of the throat and tongue, which is sometimes associated with nausea, vomiting, and diarrhea. Involvement of the cardiovascular system can cause a precipitous drop in blood pressure, followed by fainting or loss of consciousness, shock, and — without swift action — death.

Anaphylaxis is a serious, bodywide response. Immediate action is essential. Those at risk should carry epinephrine (adrenaline) with them at all times. Epinephrine is available by prescription in an autoinjector device under the brand name EpiPen, and a pediatric prescription (EpiPen Jr.) is available for children. An EpiPen injects an intramuscular dose of epinephrine into the thigh. EpiPen carriers should become very familiar with how to work the device and should show others in their circle — family members and work colleagues — how to use it in case of an emergency. Teachers of school-age children should also be alerted, because up to 20% of children at risk may have their first anaphylactic reaction when they are in school.

One misconception is that anaphylaxis follows very quickly upon exposure to the triggering allergen. Although anaphylaxis commonly begins 5–60 minutes after exposure, this is not the whole picture. Anaphylaxis can happen hours after the event, and it can happen more than once. If you know you are at risk for anaphylaxis and begin to experience the symptoms described, use your EpiPen swiftly and call 911.

Don’t rely on an antihistamine to treat anaphylaxis. On its own, it’s not up to the job. And don’t wait to treat your symptoms. In a study of deaths in children from anaphylaxis, death was associated with late administration of epinephrine and coexisting asthma. Act soon!

Another misconception is that once you use your EpiPen, you’ve been treated and the problem is over. An EpiPen is only a stopgap measure. You need to go immediately to the emergency room. A systemic (bodywide) reaction may repeat several times.

Theoretically, anaphylaxis could be brought on by any allergen, but in actuality some substances are more likely than others to trigger anaphylaxis.

Anaphylaxis triggers Foods (peanuts, tree nuts, shellfish, milk, soy, eggs, wheat) Venom of stinging insects (bees, wasps) Drugs (e.g., antibiotics, NSAIDs) Radiographic contrast media Latex Blood products Anesthetic agents Exercise (a rare cause of anaphylaxis, usually associated with food allergies; neither one alone produces symptoms, but the combination is dangerous) Unknown causes

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Last updated:	August 21, 2006
Reviewed By:	Faculty of Harvard Medical School

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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