ANAPHYLAXIS

Prof. Rusudan Karseladze

 Anaphylaxis
Ana (without), phylaxis (protection).

Anaphylaxis is a severe, potentially life-threatening allergic

reaction. It can occur within seconds or minutes of exposure to
something allergic , such as peanuts or bee stings.

Anaphylaxis causes immune system to release a flood of

chemicals that can cause shock for patient — blood pressure
drops suddenly , airways narrow and blocking breathing. 

Hypersencitivity reaction (type 1).

Etiology
Causes of anaphylaxis in a study of 266 patients (Data
from Kemp et al)
2% Food
7%
Idiopathic

20% 34% Drugs

Exercise
37%
Latex, hormons, ins
ect bites
Etiology
Pharmacologic agents
• Antibiotics (penicillin)
• Nonsteroidal anti-inflammatory drugs (Asprin)
• intravenous (IV) contrast agents

Stinging insects
• Ants, bees, hornets, wasps, and yellow
jackets.

Food
• Peanuts, seafood, and
wheat

Latex
• Rare
• No latex-associated
deaths
Pathophysiology
 First exposure
 Activation of TH2 cell → Stimulate IgE
switiching

Allergen

B Cell
TH2 Cell
Pathophysiology
 First exposure
 IgE production

IgE secreting B cell

IgE
Pathophysiology
 First exposure
 IgE bind to mast
cell

Mast cell
FcɛRI
IgE
Pathophysiology
 Second exposure
Allergen
 Recognition

Mast cell
FcɛRI
IgE
Pathophysiology
 Second exposure
 Activation of mast cell to release
histamine
and other mediators Allergen

Mast cell
Mediators FcɛRI
IgE
Pathophysiology

Mediators

Vascoactive aminase &

Cytokines
lipid

Immediate
Late phase reaction (6-
hypersensitivity reaction
(minutes) 24 hours)
 Signs & Symptoms

Skin

Itching flushing

hives (urticaria) swelling

 Signs & Symptoms

Eyes

Itching tearing

swelling around the

redness
eyes
 Signs & Symptoms
Nose &
mouth
Sneezing
runny nose nasal congestion

swelling of the
metallic taste
tongue
 Signs & Symptoms

Lungs and thraot

wheezing or other
Difficulty breathing coughing chest tightness
sounds

increased mucus throat swelling or or a sensation of

change in voice
production itching choking
 Signs & Symptoms

Heart and circulation

Dizziness weakness fainting

rapid, slow, or
low blood pressure
irregular heart rate
 Signs & Symptoms

Digestive system

Nausea vomiting

cramps diarrhea
 Signs & symptoms

Nervous system

Anxiety confusion

sense of impending
doom
 Diagnosis
 The diagnosis of anaphylaxis is based upon symptoms
that occur suddenly after being exposed to a potential
trigger.
 Differential diagnosis
 severe asthma attack
 heart attack
 panic attack
 food poisoning
 An increased amount of tryptase protein can be
measured in a blood sample collected during the first
three hours after anaphylaxis symptoms have
begun.
 tryptase levels are seldom elevated in food-induced
First Aid

Place patient in
Establish and
Trendelenburg
maintain airway.
position.

Give oxygen via Place a tourniquet

nasal cannula as above the
needed. reaction site.

Epinephrine at the
site of antigen Start IV to rise BP.
injection.
 Treatment
Epinephrine (adrenaline) to reduce body allergic
response.

Oxygen, to help breathe.

Intravenous (IV) antihistamines and cortisone to reduce

inflammation of air passages and improve breathing.

A beta-agonist (such as albuterol) to relieve breathing

symptoms.
Prevention

Avoid the responsible allergen (e.g.

food, drug, latex, etc.).

Keep an adrenaline kit (e.g. Epipen) and

Benadryl on hand at all times.

Wear medic Alert

bracelets .

Venom immunotherapy is highly effective in

protecting insect-allergic individuals.