What is Anaphylaxis? Symptoms, Causes, and Treatment

Anaphylaxis

Anaphylaxis is an emergency condition that often starts mildly but can turn into a serious clinical picture within minutes due to an overreaction of the immune system. Although generally defined in society as a severe allergic reaction, anaphylaxis is a critical condition with distinct medical characteristics that should not be confused with an ordinary allergy. The degrees of anaphylaxis can vary from mild skin findings to life-threatening multi-organ involvement. Sometimes a bite of peanut butter, sometimes a bee sting, or even a single dose of medication can trigger this process. Especially in individuals who have experienced similar reactions before, the risk of recurrence is high, making it vital to recognize this condition and take necessary precautions.

What is Anaphylaxis?

Anaphylaxis is a serious, potentially life-threatening allergic reaction that occurs as a result of the immune system's excessive and sudden response to a specific substance. Everyone's immune system has its own sensitivities. While some people sneeze at pollen, others react intensely to a bee sting. However, the situation is a bit more complex in anaphylaxis. The body wages war against a substance it perceives as a threat. This reaction usually develops within seconds or minutes. Symptoms appear rapidly and, if left untreated, can result in respiratory arrest, loss of consciousness, and even death. Therefore, anaphylaxis is not just an allergic reaction. In anaphylaxis, adrenaline must be administered intramuscularly as soon as possible, and the patient must be kept under observation.

What Are the Symptoms of Anaphylaxis?

Anaphylaxis is a serious condition in which the body's response to an allergen occurs very rapidly and strongly. Therefore, symptoms can affect more than one system simultaneously and usually become noticeable within a few minutes. Symptoms generally follow a course that starts on the skin but rapidly spreads to the respiratory and circulatory systems. Sometimes the first symptom may only be a tingling sensation in the mouth, while at other times the person may panic upon realizing they cannot breathe. What is unique to anaphylaxis is that these symptoms escalate in a very short time, posing a life-threatening risk. Therefore, even a seemingly mild symptom must be taken seriously and should not be ignored, especially in individuals who have previously experienced allergic reactions. When the body perceives a foreign substance as a threat, it activates the immune system. However, in anaphylaxis, this response turns into an uncontrolled state. Although skin redness, itching, and hives are common, these symptoms may not always be present. Narrowing of the airways, a sensation of swelling in the throat, difficulty breathing, hoarseness, or wheezing are some of the most frightening signs. Circulatory system effects such as increased heart rate, low blood pressure, dizziness, and fainting can also be added to the clinical picture. Digestive system complaints such as nausea, vomiting, abdominal pain, and diarrhea occasionally accompany the condition. In some patients, symptoms develop so rapidly that loss of consciousness can occur within minutes.

What Causes Anaphylaxis?

Anaphylaxis is an allergy-based immune system response and generally develops against substances to which sensitization has previously occurred. Anaphylaxis occurs when the immune system overreacts by perceiving a substance that should be harmless as a threat. This exaggerated defense mechanism causes the release of powerful chemicals such as histamine in the body. These substances lead to the widening of blood vessels, a drop in blood pressure, and the narrowing of the airways. As a result, the emerging clinical picture ceases to be just an allergic response and becomes a systemic crisis affecting the entire body. Among the most common triggers of anaphylaxis are certain foods, medications, and insect stings. While anaphylaxis due to foods such as peanuts, tree nuts, milk, eggs, and seafood is particularly common in children, antibiotics, painkillers, and muscle relaxants stand out in adults. Stings from insects such as bees and wasps can also cause rapidly onset anaphylactic reactions. At the same time, certain substances like latex or, rarely, reactions developing in the body after exercise can trigger this condition. Sometimes, anaphylaxis can also occur against a substance to which the person has never reacted before. This makes diagnosis even more difficult.

How is Anaphylaxis Diagnosed?

The diagnosis of anaphylaxis must be made rapidly based on clinical symptoms, and intervention must be carried out without wasting time. Anaphylaxis diagnostic criteria are usually established based on the symptoms experienced by the patient and the pattern of onset, meaning clinical observation. Because this condition progresses so rapidly, there may not be time to wait for laboratory tests. For example, if a person has difficulty breathing a few minutes after coming into contact with a known allergen, develops widespread redness on their body, and experiences a drop in blood pressure, this clinical picture must be evaluated as anaphylaxis. One of the most important elements in diagnosis is the simultaneous involvement of different organ systems. Systems such as the skin, respiratory, circulatory, or digestive systems can be affected at the same time. After emergency intervention is performed, certain tests may be applied to better understand the cause of the event. One of these is the serum tryptase test. This test measures the level of chemicals released in the body during anaphylaxis and is usually performed within a few hours after the event. At the same time, allergy skin tests or blood tests examining IgE antibody levels can be conducted to understand which substance the person is sensitive to. These tests are generally planned by allergy specialists after the patient is stabilized.

How is Anaphylaxis Treated?

Anaphylaxis treatment is a serious emergency approach that requires swift action. When this reaction begins, it is a race against time. The anaphylaxis treatment protocol includes adrenaline, antihistamines, fluid support, and corticosteroids if necessary. Every minute, and even every second, matters. Therefore, the first and most critical step of treatment is the injection of adrenaline (epinephrine). Adrenaline quickly suppresses the body's excessive responses, opens the airways, helps stabilize blood pressure, and maintains blood flow to vital organs. Administration is usually done intramuscularly into the outer part of the thigh and, if possible, without delay. Adrenaline is the only medication that can bring anaphylaxis under control. Therefore, it is of vital importance that it be administered without wasting time. After adrenaline is administered, the patient must definitely not be left alone, and emergency medical teams must be notified immediately. If symptoms persist despite adrenaline, a second dose of anaphylaxis adrenaline may be administered. Emergency medical teams arriving at the scene provide oxygen support, open a vascular access to start fluid therapy, and administer supportive medications such as antihistamines or corticosteroids if deemed necessary. However, these never replace adrenaline and are only complementary in nature. Once the patient's condition is stabilized, they may need to be kept under observation in the hospital for a few hours or, in some cases, up to 24 hours. This is because a second anaphylaxis attack called a biphasic reaction may occur in some patients after the initial symptoms improve. This observation process is quite important in terms of taking precautions against potential recurrences. Anaphylaxis treatment is not limited to controlling the immediate situation. Following the event, the patient must also be educated and referred to an allergy specialist. The identity of the allergen must be determined, the patient must learn how to protect themselves from this substance, and carrying an adrenaline auto-injector should become a habit. Because anaphylaxis can recur, the person must learn to live with this condition. The best treatment is the prevention of the next attack.

When any symptoms suggesting suspected anaphylaxis are observed, emergency medical assistance must be sought without hesitation. Such complaints, especially occurring immediately after a known contact with an allergen, can be brought under control with fast and correct intervention.

Frequently Asked Questions

Anaphylaxis usually develops within the first few minutes after contact with the allergen. The rapidity of this process indicates that treatment must be initiated without delay. In the vast majority of cases, symptoms appear within 5 to 30 minutes. In rare cases, anaphylactic symptoms may develop after 1 to 2 hours. This delayed-onset form is particularly seen in reactions developing due to certain foods or medications. At the same time, it is possible for symptoms that once resolved to start again hours later. This is called biphasic anaphylaxis. Therefore, even if symptoms subside, the person should be kept under medical observation for a while. The allergens most frequently causing anaphylaxis can vary depending on age and lifestyle. Among children, causes of anaphylaxis generally prominent are foods such as milk, eggs, peanuts, and other tree nuts. In adults, medications such as seafood, antibiotics (especially penicillin), painkillers, and muscle relaxants are more frequent triggers. Insect stings can also be a serious cause of anaphylaxis, especially for individuals spending time outdoors. Apart from these, products containing latex (natural rubber) or rarely specific types of allergies emerging after exercise can also initiate the clinical picture. Every anaphylaxis is an allergic reaction, but not every allergic reaction is anaphylaxis. Allergic reactions are usually limited to mild symptoms. They can manifest with conditions such as mild skin redness, runny nose, and itching. Anaphylaxis, on the other hand, is much more severe and affects multiple systems (respiratory, circulatory, skin, digestive) simultaneously. Since anaphylaxis can lead to life-threatening consequences such as respiratory failure, low blood pressure, and loss of consciousness, it should not be confused with ordinary allergic symptoms. A person who has experienced anaphylaxis may experience it again if exposed to the same or a similar allergen. Moreover, the second reaction can sometimes be milder or follow a more severe course. Therefore, it is very important for individuals who have experienced anaphylaxis once to organize their lifestyles accordingly. Avoiding contact with the allergen, being under regular doctor follow-up, carrying an adrenaline auto-injector, and informing those around them play a critical role in preventing recurrence. If there is a suspicion of anaphylaxis, first aid should be applied without wasting time. If the person has difficulty breathing, they should be allowed to remain in a sitting position. If the person has an adrenaline auto-injector, it should be administered as soon as possible. Then, 112 emergency health services must be called and the situation clearly explained. The person must definitely not be left alone, and their consciousness and breathing must be monitored. The adrenaline dose (auto-injector) in anaphylaxis is generally administered intramuscularly into the outer part of the thigh. It can be applied through clothing because the device is suitable for this structure. After the injection is made, the needle should be held in place for a few seconds, and then the device should be safely removed. After the injection, it can be understood whether the application was done correctly by checking whether there is a color indicator change on the needleless end of the device. These devices, which are easy to use, are of vital importance especially for individuals in the risk group. If left untreated, anaphylaxis can be fatal. Anaphylaxis can lead to respiratory arrest, circulatory failure, and loss of consciousness within minutes. However, this condition can be completely controlled when managed correctly. The fatality of anaphylaxis stems from late recognition or delayed treatment. Therefore, every individual, especially those with a history of allergies, must learn to recognize symptoms and know the first response steps. In emergencies, diagnosis is mainly made through the patient's complaints and physical examination. However, after the event, certain tests may be performed to determine the cause and prevent recurrence. Additionally, allergy skin tests (prick test) and blood tests examining specific IgE levels can be conducted to determine which allergen sensitivity exists. These tests are generally planned with the accompaniment of an allergy specialist. The most effective precaution is to stay completely away from the allergen causing anaphylaxis. Therefore, the first step is to clearly determine what the responsible substance is. Food labels must be read carefully, and allergy history must certainly be conveyed to the doctor before medication use. Furthermore, individuals in the risk group must always carry an adrenaline auto-injector with them. Since the adrenaline dose for anaphylaxis can vary in children, it must be kept under control by their parents. If necessary, people in environments such as schools and workplaces should be informed about this condition, and basic first aid knowledge should even be shared. Personalized allergy bracelets and emergency cards are also among extremely useful precautions. Individuals carrying the risk of anaphylaxis must definitely have an adrenaline auto-injector with them. Besides this, a bracelet or emergency card clearly bearing an allergic individual warning facilitates rapid intervention by medical personnel. In addition, a list of allergenic substances, contact information of people to be called in an emergency, and a doctor's report if any should also be carried. Such preparations save time for both the patient and those around them in the event of a potential attack.

Anaphylaxis is a life-threatening emergency, and intervention performed at the right time saves lives.

If you have a history of allergies, have previously experienced a severe allergic reaction, or if your child is in the risk group, you can consult our specialist physicians for early diagnosis and a protection plan.

You can get in touch to make an appointment and obtain detailed information.