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Block 1.2, KFU, Al-Ahsaa, Saudi Arabia

Case 8.2

Published in: Health & Medicine
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  1. 1. Anaphylaxis Abdullatiff Sami Al-Rashed Group No.: 3
  2. 2. Objectives  Allergic reactions ( hypersensitivity ).  Anaphylaxis.
  3. 3. Allergic Reactions  Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastrointestinal tract. They can be breathed into the lungs, swallowed, or injected.  In an allergic reaction, the immune system starts fighting substances that are usually harmless as though these substances were trying to attack the body.  Many allergic reactions are mild, while others can be severe and life-threatening and the manifestation that happen according to the severity of the reaction.  An allergic reaction is more serious when severe allergic reaction (anaphylaxis) occurs
  4. 4. Types of hypersensitivity ( Allergic Reaction ) Type I: Immediate Hypersensitivity Type II: Cytotoxic Hypersensitivity Type III: Immune Complex Hypersensitivity Type IV: Delayed Hypersensitivity
  5. 5. Type I IgE Mediated Classic Allergy Type II IgG/IgM Mediated rbc lysis Type III IgG Mediated Immune complex Disease Type IV T cell Delayed Type Hypersensitivity Gel and Coombs classification of hypersensitivities.
  6. 6. Anaphylaxis  Anaphylaxis is a sudden, severe allergic reaction that can be life-threatening. It is a medical emergency case.  It can occur within seconds or minutes of exposure to something someone is allergic to  Anaphylaxis is under hypersensitivity type 1 Anaphylaxis baby
  7. 7. Etiology  Our immune system produces antibodies that defend against foreign substances.  This is good when a foreign substance is harmful (such as certain bacteria or viruses).  But some people's immune systems overreact to substances that shouldn't cause an allergic reaction.  When this occurs, the immune system sets off a chemical chain reaction, leading to allergy symptoms.  Normally, allergy symptoms are not life-threatening.  But some people have a severe allergic reaction that can lead to anaphylaxis.
  8. 8. Etiology  Anaphylaxis can occur in response to almost any foreign substance h.  The most common causes of anaphylactic shock are: 1. Certain medications, especially penicillin 2. Foods, such as peanuts, tree nuts (walnuts, pecans), fish, shellfish, milk and eggs 3. Insect stings from bees, yellow jackets, wasps, hornets and fire ants  Less common causes of anaphylaxis include: 1. Exercise, often after eating certain foods.  Anaphylaxis usually happens within minutes of exposure and almost always within two hours
  9. 9. Pathophysiology  Anaphylaxis is a severe allergic reaction of rapid onset affecting many body systems.  It is due to the release of inflammatory mediators and cytokines from mast cells and basophils, typically due to an immunologic reaction but sometimes non- immunologic mechanism.
  10. 10. Cont..  D-Vfmbt4s
  11. 11. Risk factors  There aren't many known risk factors for anaphylaxis, but some things that may increase your risk include: 1. A personal history of anaphylaxis: If you've experienced anaphylaxis once, your risk of having this serious reaction is increased. Future reactions may be more severe than the first reaction. 2. Allergies or asthma: People who have either condition are at increased risk of having anaphylaxis. 3. A family history: If you have family members who have experienced exercised-induced anaphylaxis, your risk of developing this type of anaphylaxis is higher than it is for someone without a family history.
  12. 12. Sign & Symptoms  Anaphylaxis symptoms include: 1. Skin reactions, including hives along with itching, flushed or pale skin (almost always present with anaphylaxis) 2. A feeling of warmth 3. The sensation of a lump in your throat 4. Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing 5. A feeling of impending doom 6. A weak and rapid pulse 7. Nausea, vomiting or diarrhea 8. Dizziness or fainting
  13. 13. Cont..  Heart and circulation: Dizziness, weakness, fainting, rapid, slow, or irregular heart rate, or hypotension.  Digestive system: Nausea, vomiting, abdominal cramps, or diarrhea  Nervous system: Anxiety, confusion, or a sense of impending doom
  14. 14. hives Swelling of conjunctiva
  15. 15. Investigation  Allergy testing is ordered to help in determining the trigger.  Skin allergy testing (such as patch testing) is available for certain foods and venoms. Blood testing for specific IgE can be useful to confirm milk, egg, peanut, tree nut and fish allergies.
  16. 16. Diagnosis  Anaphylaxis is diagnosed based on clinical criteria.  When any one of the following three occurs within minutes/hours of exposure to an allergen there is a high likelihood of anaphylaxis: 1. Involvement of the skin or mucosal tissue plus either respiratory difficulty or hypotension. 2. Two or more of the following symptoms: a. Involvement of the skin or mucosa
 b. Respiratory difficulties
 c. Low blood pressure
 d. Gastrointestinal symptom 3. Low blood pressure after exposure to a known allerge.
  17. 17. Cont..  During an attack, blood tests for tryptase or histamine (released from mast cells) might be useful in diagnosing anaphylaxis due to insect stings or medications. However these tests are of limited utility if the cause is food or and they are not specific for the diagnosis.
  18. 18. Treatment  During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if the patient stops breathing or his heart stops beating. He/she may be given medications including: 1. Epinephrine (adrenaline) to reduce the body's allergic response. 2. Oxygen, to help compensate for restricted breathing. 3. Intravenous (IV) antihistamines and cortisone to reduce inflammation of air passages and improve breathing. 4. A beta agonist (such as albuterol) to relieve breathing symptoms.
  19. 19. Complication of Anaphylaxis  Airway blockage  Cardiac arrest (no effective heartbeat)  Respiratory arrest (no breathing)  Shock
  20. 20. Prevention  The best way to prevent anaphylaxis is to avoid substances that cause this severe reaction.
  21. 21. First Aid  If you're with someone having an allergic reaction with signs of anaphylaxis: 1. Immediately call your local medical emergency number. 2. Ask the person if he or she is carrying an epinephrine autoinjector to treat an allergic attack (for example, EpiPen, Twinject). 3. If the person says he or she needs to use an autoinjector, ask whether you should help inject the medication. This is usually done by pressing the autoinjector against the person's thigh. 4. Have the person lie still on his or her back.
  22. 22. Cont.. 5. Loosen tight clothing and cover the person with a blanket. Don't give the person anything to drink. 6. If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking. 7. If there are no signs of breathing, coughing or movement, begin CPR. Do uninterrupted chest presses — about 100 every minute — until paramedics arrive. 8. Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to recur. Monitoring in a hospital setting for several hours is usually necessary.
  23. 23. References  phylaxis/DS00009  497498_8  185/5/2-anaphylaxis-diagnosis-and- management