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What is Anaphylaxis? The nitty-gritty

Posted on by Kate Young

What is it?

Anaphylaxis (also known as ‘anaphylactic shock’ or ‘anaphylaxia’) is a severe allergic reaction that affects the patient’s airways, heart, circulation, gut, and skin. The reaction usually occurs within minutes of exposure to the triggering allergen but can begin up to 2 or even 3 hours after initial contact. This reaction is potentially life-threatening and should be treated immediately by a medical professional.

Signs and Symptoms of Anaphylaxis

As anaphylaxis affects various systems within the body, there are many signs and symptoms of the reaction.

  • Trouble swallowing
  • Wheezing and a tight test
  • Nausea, abdominal pain, and vomiting
  • Diarrhoea
  • Feeling weak and floppy
  • Swelling of the lips, throat or anywhere on the body
  • Collapsing and/or passing out         
  • Flushed skin (this may be widespread)
  • Sudden drop in blood pressure
  • Itchy rash (or hives)

Causes of Anaphylaxis

Anaphylaxis is almost exclusively caused by an allergy, with the vast majority of cases being triggered by one of the 14 major allergens;

  • celery
  • cereals containing gluten – including wheat, rye, barley and oats
  • crustaceans – such as prawns, crabs and lobsters
  • eggs
  • fish
  • lupin
  • milk
  • molluscs – such as mussels and oysters
  • mustard
  • tree nuts – including almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts
  • peanuts
  • sesame seeds
  • soybeans
  • sulphur dioxide and sulphites (if they are at a concentration of more than ten parts per million)

Having an allergy to any of these major allergens increases the risk of anaphylaxis. The incidence of anaphylaxis appears to be increasing in the UK. Between 1992 and 2012, the number of yearly hospital admissions tracked by the NHS increased by over 600%, from approximately 1,150 admissions to over 8,200 [1]. The trend seems to be continuing, with admission for under 18’s Between 2014 and 2019 has risen by a staggering 70% [2].

Treatment and Outlook

If you are experiencing a bout of anaphylaxis, it is important to act fast. The first course of action is to administer adrenaline. Pre-loaded auto-injectors containing adrenaline are prescribed to individuals at high risk of anaphylaxis. These auto-injectors should be available at all times – no exceptions.

Adrenaline is crucial in these first few minutes as it acts to rapidly open up the patient’s airways, get their blood pressure back up and stop any swelling. If you suspect that you’re experiencing anaphylaxis but aren’t certain, it is recommended that adrenaline is administered anyway – as it’s better to be safe than sorry.

Following administering adrenaline, an ambulance should be called immediately, even if the person’s condition improves upon injecting adrenaline. If their condition gets worse after making that initial 999 call, call them again to ensure an ambulance is dispatched, as you will be put on a higher priority. 5-10 minutes after the first adrenaline injection, a second shot should be administered if the symptoms of anaphylaxis remain. 

Remember, anaphylaxis always requires an immediate emergency response. In the US, an estimated in the US, an estimated, 1% of hospitalisations due to anaphylaxis have a fatal outcome [3], so medical attention is vital.

Risk Factors

There are several risk factors associated with anaphylaxis that can be partly controlled or seen as times, to take extra precautionary measures. These include;

  • Poorly controlled asthma
  • Current or recent infection
  • Exercise prior to or shortly after contact with the allergen
  • Suffering from hay fever or other aeroallergen symptoms
  • Emotional stress
  • Drinking alcohol

Research has also highlighted a few other risk factors to be aware of. For example, this study found that as a patient’s age increases, their risk of developing severe cardiovascular symptoms increases substantially [4].  

Suffering from a pre-existing respiratory illness can also be a factor, as studies have shown that poor management of allergic bronchial asthma drastically increases the risk of severe anaphylaxis [5]. 

Lastly, it appears that male patients are more likely to develop anaphylaxis from insect venom compared to females [6]. This has been observed in both male adults and children.

Prevention

The best way to prevent anaphylaxis is to be aware of your allergies and be mindful to avoid them wherever possible. Many people are unaware of any allergies they may have, and most health professionals don’t carry out routine testing without prior evidence of an existing allergy or a family history.

Some people may feel that this is something they want to take into their own hands and opt for allergy testing to ensure they don’t remain ignorant of any potential allergies they may have.  

Final Thoughts

While the number of yearly deaths from anaphylaxis is relatively small, it still concerns us to know we may be at risk of anaphylaxis. And it’s far from an enjoyable experience either way. This life-threatening condition can be avoided with diligence and the knowledge of what your body may react adversely to.

Research

[1] Turner, P.J., Gowland, M.H., Sharma, V., Ierodiakonou, D., Harper, N., Garcez, T., Pumphrey, R. and Boyle, R.J. (2015). Increase in anaphylaxis-related hospitalizations but no increase in fatalities: An analysis of United Kingdom national anaphylaxis data, 1992-2012. Journal of Allergy and Clinical Immunology, 135(4), pp.956-963.e1. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382330/ [Accessed 2 Mar. 2020].

[2] NHS Digital. (2018). Hospital admissions for allergies and anaphylactic shock – NHS Digital. [online] Available at: https://digital.nhs.uk/data-and-information/find-data-and-publications/supplementary-information/2018-supplementary-information-files/hospital-admissions-for-allergies-and-anaphylactic-shock [Accessed 2 Mar. 2020].

[3] Ma, L., Danoff, T.M. and Borish, L. (2014). Case fatality and population mortality associated with anaphylaxis in the United States. Journal of Allergy and Clinical Immunology, [online] 133(4), pp.1075–1083. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0091674913016424 [Accessed 2 Mar. 2020].

[4] Worm, M., Babina, M. and Hompes, S. (2013). Causes and risk factors for anaphylaxis. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, [online] 11(1), pp.44–50. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23181736 [Accessed 2 Mar. 2020].

[5] Iribarren, C., Tolstykh, I.V., Miller, M.K. and Eisner, M.D. (2010). Asthma and the prospective risk of anaphylactic shock and other allergy diagnoses in a large integrated health care delivery system. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, [online] 104(5), pp.371–7. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20486326?dopt=Abstract [Accessed 2 Mar. 2020].

[6] Ruëff, F., et al. (2009). Predictors of severe systemic anaphylactic reactions in patients with Hymenoptera venom allergy: importance of baseline serum tryptase-a study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity. The Journal of allergy and clinical immunology, [online] 124(5), pp.1047–54. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19895993?dopt=Abstract [Accessed 2 Mar. 2020].

What causes an allergic reaction?

Posted on by Kate Young

There are many questions which come about due to people suffering from an allergic reaction. But do you know all about the symptoms of an allergy? Do you know how to diagnose an allergy? Do you know about the treatment and management of an allergy? If you want to know the answers to any of these questions, read on below…

Allergies are a chronic condition

Allergies themselves are one of the most common chronic conditions around the world. Varied from an intolerance due to their life-long nature, allergies can be life-threatening. However, not all are that serious, but they all have an impact on someone’s livelihood.

The symptoms of an allergic reaction range drastically, from leaving someone a bit down in the dumps, to being at risk of a life-threatening reaction.

Where does an allergic reaction begin?

Unlike an intolerance, an allergic reaction begins in the immune system. This is important to note as the terms allergy and intolerance are often used interchangeably, but they are completely different. Leading scientists and experts believe that an allergic reaction starts with the immune system. Well, our immune system to protect us from invading organisms which often cause illnesses. BUT, if you have an allergy, your immune system thinks that a harmless substance actually has the potential to harm you. This item that is harmful is known as an allergen.

IgE antibodies

Lifelab Testing is able to help you get closer to knowing if you as an individual are suffering from an allergy or an intolerance. An allergic reaction is when the immune system produces Immunoglobulin E (aka IgE antibodies) antibodies because it thinks it is protecting the body. As stated by the American Academy of Allergy Asthma and Immunology, the antibodies will travel to cells which are releasing histamines and other chemicals, leading to an allergic reaction.

Symptoms of an allergic reaction

An allergic reaction itself typically triggers symptoms in the body, but not necessarily the immune system. Swelling of the tongue, throat and constant headaches, as well as itchy skin, is usually a sign of a food allergy or a non-food allergy.

What are the most common allergens?

Harmful foods and non-foods which most people report an allergy to include pollen (hay fever), dust (from not cleaning the skirting boards), insect stings (wasps and bees), and also latex (washing up gloves etc). If you suspect that you have an allergy to any of these items, then an allergy test would be able to help you gain an idea of what you may have an allergy to.

Are you wanting to find out what is causing your allergic reaction?

If you are wanting to know which foods are potentially causing your issues, then a food allergy test would be ideal for you. Allergic reactions come about from anything, but you do need to know which items are more likely to cause issues. Lifelab Testing offers a range of allergy and intolerance tests, priced competitively.

Am I Having an Allergic Reaction that needs Emergency Treatment?

Posted on by Kate Young

The subject of allergy testing is a very pertinent one at this moment in time, as a number of high-profile deaths have been caused by incorrect allergy labelling at one of the UK’s largest sandwich shop chains. What these tragedies serve to highlight is that allergic reactions are a very real threat to health and to life itself. The most worrying thing is that without allergy testing, none of us really know if we’re at risk and if we can’t trust food manufacturers’ own labels about what their food contains, there’s a question that needs to be asked: If I’m having one, am I having an allergic reaction that needs emergency treatment?

The fact is that an allergic reaction to any given food type can develop at any point in our lives, which means that recognising the signs of a reaction is a good thing to know. Allergy testing, which can be used to effectively determine foods that your body has a problem dealing with, is something that we’ll elaborate on, but right now, we’ll look at the telltale signs that you’re having a reaction.

Signs of an Allergic Reaction

Without wishing to overplay the facts, being able to spot the symptoms associated with anaphylactic shock – the most severe type of reaction – and administer an EpiPen or other relevant medication, can in all truth, save yours or someone else’s life. In this situation, every moment counts.

Symptoms can vary a lot from one person to the next and each separate reaction can even manifest differently in the same person. However, all of the most common types to look out for, tend to fall within the following group:

● Itchiness in the mouth or throat.

● Any type of difficulty in breathing, such as wheezing or coughing.

● Difficulty swallowing.

● Nausea, vomiting, diarrhoea or stomach pain.

● An itchy redness to the skin, including raised red bumps, hives or welts.

● Mental confusion.

● Tightness or discomfort in the chest.

● Lightheadedness or dizziness.

● Low blood pressure, rapid pulse or heart palpitations.

● Fainting or loss of consciousness.

Important note: If you encounter any of the symptoms from the above list, it should be considered as an emergency and treated as anaphylaxis. This would usually involve the use of an EpiPen and calling an ambulance via 999, even if the symptoms pass. 

Biphasic anaphylaxis is something that can come back even stronger after a few hours and getting medical attention is highly recommended. Don’t assume that everything’s ok, consult a medical professional as soon as possible.

Take Control

In order to manage food allergies properly, you need to know exactly what your body is allergic to. That’s where allergy testing comes in and at Lifelab Testing, we provide laboratory blood screening services from as little as £74.99. You’ll be tested against 25 key food and drink allergies, which will give you all you need to know about what foods to avoid and enable you to create strategies for coping with an attack.

Find out more about allergy testing and the wide range of services we provide on our website or give us a call now on 01332 32 18 92.

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