Thursday, August 16, 2018

Anaphylaxis - Fatal Allergy

Dr Abe V Rotor
avrotor.blogspot.com

What I am going to relate is a true story about anaphylaxis. It happened to my youngest son, Leo Carlo when he was in the elementary during a family vacation in our ancestral home in San Vicente, Ilocos Sur.

Our dish for dinner was a fine, big talakitok, broiled on charcoal. I noticed that Carlo particularly liked the egg mass. By the way this prized fish was freshly caught in the estuary of San Sebastian river. It was a family feast. And we were all very happy to settle for the night.

By midnight Carlo crept to wake me up. His face was swollen, his eyes nearly shut. His skin was red, and his voice was a whisper. "I can't breath, Papa." His heart was racing, and his whole body seemed to be shaking.

I assured my family not to panic as I prepared the car to take Carlo to a hospital to Vigan, three km away. Luckily I had Antihistamine tablet in my pocket, and I gave it to him immediately as a palliative measure. At the hospital he was given an injection that brought him relief, then he fell asleep. 


Our vacation was cut short. That same evening we drove back to Manila where Carlo was further diagnosed and treated. It took him a week to fully recover and return to school.

Anaphylaxis can strike within seconds or minutes of exposure to an allergen. Or it may sneak up slowly, with symptoms delayed up to 2 hours from the time of exposure, Initial symptoms may even disappear, then return full-force within 4 to 12 hours.

••It’s a terrifying feeling, you may become flushed, and your skin may become quite itchy and red. The frightening thing is, you begin to feel you’re having difficulty taking a full breathe, that you are suffocating. As your blood pressure drops, you feel dizzy and sweaty and become pale. You body is not kidding. Anaphylaxis can kill by suffocation.


Anaphylaxis – systemic reaction, during which exposure to an allergen triggers an allergic response throughout the body rather than just near the site.


1. It doesn’t take much to trigger this body-wide allergic response – a single peanut or tiny paper wasp can set off the reaction.


2. During an anaphylactic attack, a rush of chemicals – histamines, leukotrienes, and prostaglandins – is released in an attempt by the body to defend itself. These chemicals are produced by basophiles found in the blood, mast cells found throughout the body, including eyes, noise skin and gastrointestinal tract.


3. Anaphylaxis may affect many organs, such as the throat, lungs, blood vessels, and intestines. Histamine and other chemicals released by the body may produce widespread itching, welts, and hives on your skin.


4. Cause blood vessels to become leaky, resulting in a drop in blood pressure, swelling of the skin, and fluid in your lungs.


5. Bring circulation of your blood and oxygen to a near-standstill as your blood pressure drops.


6. Make it difficult or impossible to breathe as your tongue and throat swell up and your lungs go into asthmatic spasms.


7. Trigger nausea, vomiting, and diarrhea as your gastrointestinal system goes haywire.


Anaphylaxis is an allergic reaction that can trigger reactions all over your body, affecting the various systems in the body


1. Cardiovascular: Light-headedness, feeling faint, loss of consciousness (syncope), heart palpitations.


2. Upper respiratory : nasal congestion, sneezing, difficulty swallowing


3. Lower airway obstruction: coughing, wheezing

4. Skin: welts or hives, swelling of the skin (particularly on face and around lips and tongue), flushing


5. Gastrointestinal: bloating, nausea, vomiting, diarrhea, cramps
6. Elsewhere: metallic taste in the mouth, cramping of the uterus during pregnancy, sudden need to urinate.

Facts about Anaphylaxis

90% of adults didn’t even tell their doctors about their anaphylaxis reactions.
  • Chances are: If you are have had anaphylaxis in the past, the odds are you will have it again. (from 380 anaphylaxis patients)
  • 25% had just 1 episode
  • 18% had 2 episodes
  • 57 % had 3 or more
  • Keep a diary of your allergens and avoid them. Weed out your refrigerator, cupboard, drawers. Allergens may appear in an unsuspecting product.
Causes of Anaphylaxis
  • Food – peanut, shellfish, crustaceans,
  • Insects – fire ant, honeybee, bugs Drugs – more than ½ million serious allergic reaction occur in hospitals (Penicillin)
  • Latex – condoms, balloons, gloves
  • Exercise – eating 3-4 hrs before exercising increases risk
  • Narcotics
  • Aspirin
  • Blood transfusions
  • Food additives
References
Dr R Ansorge R and Dr E Metcalf et al
Hampton JK (1991) The Biology of Human Aging, Wm C Brown Publishers 343 pp
Jacobson E (1964) You Must Relax, McGraw-Hill 270 pp
Rotor AB (1983) The Men Who Play God: A Collection of Short Stories Ateneo de Manila University Press 147 pp
Rotor A V (2007) Living With Nature in Our Times, UST Publishing House 318 pp.

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