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.
The symptoms of severe allergic reactions (anaphylaxis) include hives/itching, swelling, wheezing, throat constriction, vomiting, and dizziness. These symptoms can come on quickly and may potentially be life-threatening. Risk factors for a more severe allergic reaction having asthma, the current use of a medication called a beta-blocker, and, in some cases, the use of a medication called an angiotensin-converting enzyme inhibitor (ACE-inhibitor) ( if swelling is one of the symptoms).
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 anapylaxis) 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.
Your BVAAC board-certified allergist will then formulate an individualized treatment plan. This plan will include extensive education on allergen avoidance, instruction in the use of epinephrine in an auto-injector (such as an Epi-pen) 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 willalso give you preventative medications if indicated, and opimize the management of your asthma, if present.
Epinephrine is the optimal treatment for a severe allergic reaction (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. Auto-injectable epinephrine wears off relatively quickly, so it is important to call 911 or go to an emergency room if epinephrine has been used.