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Anaphylaxis And Allergies
Anaphylaxis (or "anaphylactic shock") is a severe allergic reaction that needs to be treated right away. If you have an anaphylactic reaction, you need a shot of epinephrine (adrenaline) as soon as possible, and someone should call 911 for emergency medical help. Left untreated, it can be deadly.
Epinephrine can reverse the symptoms within minutes. If this doesn't happen, you may need a second shot within half an hour. These shots, which you need a prescription to get, come pre-filled in ready-to-use pens.
You should not take an antihistamine for an anaphylactic reaction.
Anaphylaxis is rare, but some people are more likely to have it than others. Most people recover from it. But it's important to tell your doctor about any drug or latex allergies you have before any kind of medical treatment, including dental care. It's also a good idea to wear a medical alert bracelet or pendant or carry a card with information about your allergy.
If you've had an anaphylactic reaction before, you have a higher risk of having another one. You also have a higher risk if you have a family history of anaphylaxis or have asthma.
Anaphylaxis and its symptoms usually happen in stages. But it can worsen fast. Your symptoms are likely mild at first and will get worse over time. By recognizing a reaction early, you can get help before your symptoms are more severe or even life-threatening. These stages include:
The first signs of an anaphylactic reaction may look like typical allergy symptoms: a runny nose or a skin rash. But within about 30 minutes, more serious signs appear.
You'll usually have more than one of these signs:
Some people also remember feeling a "sense of doom" right before the attack. Symptoms can move to shock and loss of consciousness.
As many as 1 out of every 5 people may have a second anaphylactic reaction within 12 hours of the first. This is called a biphasic anaphylaxis.
Anaphylaxis happens when you have an antibody, something that usually fights infection, that reacts too much to something that should be harmless like food. It might not happen the first time you come in contact with the trigger, but it can get worse over time.
In children, the most common cause of anaphylaxis is food. For adults, medications more often cause it.
Common food triggers for children are:
Common food triggers for adults are:
It's rare, but some people are so sensitive that even the smell of the food can trigger a reaction. Some are also allergic to certain preservatives in food.
Common medication triggers are:
Anaphylaxis also can be triggered by a few other things. But these aren't as common:
Some people can have an anaphylactic reaction if they breathe in latex.
Some can have a reaction to a combination of things:
In rare cases, it can be triggered by 2 to 4 hours of exercise after eating certain foods or by exercise on its own.
Anaphylactic reactions usually start within minutes of contact with the trigger, but they can also happen an hour or more later.
Some people never figure out what caused their reactions. That's known as idiopathic anaphylaxis. If you don't know your triggers, you can't avoid them. So it's especially important to carry epinephrine injectors, make sure you and people close to you know how to use them, and wear medical alert jewelry.
You're at more risk for anaphylaxis if you've had it before. Your reactions may get worse every time you have them.
Other things that can increase your risk include:
If you think you have serious allergies or are at risk for anaphylaxis, see a doctor. Your doctor will ask you about any signs of allergic reactions you've had. They'll ask if you've seen signs of a reaction from:
To find out if you have an allergy that could cause anaphylaxis or may have had an anaphylactic reaction, you may need more tests. These may include:
Since other conditions can look like anaphylaxis, your doctor may run other tests to make sure your symptoms aren't a sign of some other health problem.
Epinephrine is the most effective anaphylaxis medication, and the shot should be given right away (usually in the thigh). If you've had an anaphylactic reaction before, you should carry at least two doses of epinephrine with you at all times.
Epinephrine expires after about a year, so make sure your prescription is up to date. If you have an anaphylactic reaction and the pen has expired, take the shot anyway.
When medical personnel arrive, they may give you more epinephrine. If you're not able to breathe, they may put a tube down your mouth or up your nose to help. If this doesn't work, they might do a kind of surgery called a tracheostomy that puts the tube directly into your windpipe.
Either in the ambulance or at the hospital, you may need fluids and medications to help you breathe. If the symptoms don't go away, doctors may also give you antihistamines and steroids. Other treatments you may need include:
You probably will need to stay in the emergency room for several hours to make sure you don't have a second reaction.
After the initial emergency is over, see an allergy specialist, especially if you don't know what caused the reaction. An allergy specialist may also give you a series of allergy shots to help your body get used to the trigger and make anaphylaxis less likely to happen again.
To protect yourself against anaphylaxis, the best way is to find out what caused your reaction and stay away from it. Some other steps to protect yourself include:
Even if you do everything possible, you could still come in contact with one of your triggers. If this happens, make sure you and your loved ones and friends know what to do. If you have a plan in place, you can see the signs and symptoms and get help before it gets worse.
When your anaphylaxis is severe, it can be fatal. It can stop you from breathing. You may not have a heartbeat anymore. Your risk for the most serious complications are even greater if you have other health conditions, such as heart disease, asthma, or other lung diseases. If you are at risk for anaphylaxis, make sure you know the signs and what to do if it happens. By taking steps to avoid your triggers and knowing what to do in the event it happens, you can prevent the worst from happening.
The Most Common Triggers
So for life threatening anaphylaxis, probably the top three triggers are food allergies, insect stings, and medications.And it depends, like, a drug reaction, and it primarily depends on the age group. Like, with younger ones it's more likely to be food allergies, and in older patients it's probably more likely to be a drug allergy or insect allergy. But those are the biggest triggers around.
There are some uncommon ones that you can have. Latex allergy. Some people even have anaphylaxis to red meat, secondary to a tick bite.
Again, these are somewhat more uncommon or off the beaten track. And some people even have an idiopathic anaphylaxis, where they have anaphylaxis, and we don't know the specific trigger.
Some people have exercise induced anaphylaxis, where they're totally fine, and only when they exercise do they have signs and symptoms of the anaphylaxis. So anaphylaxis can be a broad range of triggers.
If you have an anaphylaxary reaction you should see an allergist, so they could do some testing or better history, just to figure out what might have caused that.
There's testing to look for different foods, for insects, as well, a lot of times, in the history. It'll help you to decide what the trigger was.
And then there's a good percentage of patients that go to the ER, have an anaphylatic reaction, and a specific trigger is not found. That's actually not uncommon.","publisher":"WebMD Video"} ]]>
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THOMAS CHACKO
So for life threatening anaphylaxis, probably the top three triggers are food allergies, insect stings, and medications.And it depends, like, a drug reaction, and it primarily depends on the age group. Like, with younger ones it's more likely to be food allergies, and in older patients it's probably more likely to be a drug allergy or insect allergy. But those are the biggest triggers around.
There are some uncommon ones that you can have. Latex allergy. Some people even have anaphylaxis to red meat, secondary to a tick bite.
Again, these are somewhat more uncommon or off the beaten track. And some people even have an idiopathic anaphylaxis, where they have anaphylaxis, and we don't know the specific trigger.
Some people have exercise induced anaphylaxis, where they're totally fine, and only when they exercise do they have signs and symptoms of the anaphylaxis. So anaphylaxis can be a broad range of triggers.
If you have an anaphylaxary reaction you should see an allergist, so they could do some testing or better history, just to figure out what might have caused that.
There's testing to look for different foods, for insects, as well, a lot of times, in the history. It'll help you to decide what the trigger was.
And then there's a good percentage of patients that go to the ER, have an anaphylatic reaction, and a specific trigger is not found. That's actually not uncommon.
Allergies To Dental Materials
Suspected allergies in dentistry should be confirmed by an allergy test conducted by a dermatologist or allergist, due to the potential for a life threatening allergic reaction or the development of a long-term occupational disability. When an allergy test to a certain dental material is found to be positive, the dental team should take appropriate precautions to eliminate the use of the offending allergen by using alternative materials, for example, latex-free gloves or nickel-free alloys.
Research demonstrates that there are numerous potential allergens in everyday dental practice. However, currently there is not enough evidence to indicate that use of popular dental materials should be discontinued. Nevertheless, the dental team should remain vigilant and acutely aware of the potential of the many available dental materials and products to cause allergic hypersensitivity within the mild to severe range, both intra-orally and at unrelated parts of the body. Materials that warrant particular awareness include latex, nickel, methacrylate, eugenol and polyether impression materials.
References available from the author on wiltshir@cc.Umanitoba.Ca.
Box 1: Test yourself1. What proportion of orthodontic patients with pierced ears is allergic to nickel?
A. 60% B. 20% C. 30%
2. When did latex allergy become more common?
A. 21st century B. 1980s C. 1940s
3. A Type IV reaction is:
A. Delayed B. Immediate C. Fatal
ANSWERS: 1C, 2B, 3A.
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