Severe Allergic Reaction (Anaphylaxis)
Introduction
Severe allergic reactions, also called anaphylaxis, affect people of all ages. Common triggers include foods, insect stings, and medications. Less common triggers include immersion in cold water and exercise. There are other medical conditions that may mimic anaphylaxis. In some cases, despite an extensive medical work-up, the cause cannot be found. This type of severe allergic reaction is called idiopathic anaphylaxis. It represents a true disease entity with recurrent episodes of severe allergic reactions probably from a yet to be discovered auto-immune process.
Severe Allergic Reaction
Diagnosis
In order to diagnose a severe allergic reaction, your allergist will take an extensive history, examine you, and, in many cases, perform skin testing and blood allergy tests. Occasionally, other tests such as a chest x-ray, lung function tests, more blood tests, and skin tests to fresh foods may be needed. Unfortunately, a cause cannot always be found and the diagnosis of a severe allergic reaction without a cause (idiopathic anaphylaxis) is given. Severe allergic reactions without a cause (Idiopathic anaphylaxis) has been extensively studied by physician-scientists and is probably caused by an unknown process within the body, as opposed to an outside trigger that is being missed.
Individualized
Treatment Plan
Your BVAAC board-certified allergist will formulate an individualized treatment plan. This plan will include extensive education on allergen avoidance, instruction in the use of epinephrine in conjunction with an anaphylaxis action plan, and avoidance of medications which might intensify the allergic reaction (e.g. beta-blockers, ACE-inhibitors). Your allergist will also give you preventative medications if indicated, and optimize the management of your asthma, if present.
Epinephrine is the optimal treatment for anaphylaxis. It is commonly available in the form of an auto-injector called an Epi-Pen which can be injected through clothing into the muscle of the front of the thigh in the event of a severe allergic reaction. A newer form of epinephrine, called neffy, which is administered via nasal spray, is also now available. Your allergist will instruct you on whether you should immediately call 911 if epinephrine is administered.
