Anaphylaxis (allergic shock) is a serious, life-threatening systemic allergic reaction that involves the whole body. It develops most often as a result of food allergies, drug allergies and bee and insect stings. The diagnosis is mainly made with examination findings. It is an emergency that must be intervened very quickly. Therefore, families also need to know the first intervention in children at risk of developing anaphylaxis.

What is Anaphylaxis (Allergic Shock)?

Anaphylaxis is a systemic allergic reaction that begins suddenly by the action of various substances secreted from some cells in the body as a result of an allergen’s stimulation.

What is the Frequency of Anaphylaxis (Allergic Shock)?

Although there are not very healthy data on this subject for various reasons, its frequency is reported as 0.3% in Europe and 0.05-2% in the USA. However, it is seen that its frequency has been increasing in recent years.

What are the causes of anaphylaxis (allergic shock)?

Among the reasons that lead to anaphylaxis, foods come first. The second place comes with medications and then bee stings. The most common foods that cause anaphylaxis in children are milk, eggs, peanuts, nuts, fish and seafood. 

All drugs can cause anaphylaxis, but antibiotics, and beta lactam group antibiotics, including penicillin, are the most common drugs that cause anaphylaxis. The second place is the pain relieving antipyretic medication group called nonsteroidal anti-inflammatory agents.

Anaphylaxis due to bee sting can also be seen with both honey bee and wasp.

What are Findings of the Anaphylaxis (Allergic Shock)?

Anaphylaxis findings are quite variable. The skin, heart and circulatory and respiratory systems are most frequently affected. Findings appear shortly after encountering an allergen such as shortness of skin rash, itching, swelling of the tongue and lips, swelling in the larynx and narrowing of the bronchi, shortness of breath and asthma; low blood pressure, rapid heartbeat, fainting as a result of affecting cardiac circulation; as a result of involvement of the digestive system, symptoms of abdominal pain in the form of vomiting and cramping.

An important information to keep in mind is that anaphylaxis can be developed without skin findings.

How Is Anaphylaxis (Allergic Shock) Diagnosed?

The diagnosis of anaphylaxis is made as a result of a detailed history and examination findings. Laboratory tests are of little importance in the diagnosis of anaphylaxis.

The doctor should be informed about when and how the findings were, whether there was a similar picture before, whether he had any known allergies, and the drugs or foods he used a few hours before the findings developed.

What tests are used to detect allergens that cause anaphylaxis?

In patients developing anaphylaxis (allergic shock) allergens can be detected by blood and skin allergy tests. The results obtained in the tests should be evaluated together with the previous information. But tests should be carried out 4-6 weeks after the development of an allergic shock.

What are the conditions confused with anaphylaxis (allergic shock)?

Vasovagal syncope is the most important of these situations, usually  fainting and unconsciousness caused by low blood pressure in stress and fear situations.

Severe hives and asthma, foreign body ingestion can also be confused with allergic shock.

Severe hives and asthma, foreign body ingestion can also be confused with allergic shock.

What should you do if your child has had anaphylaxis (allergic shock)?

Anaphylaxis is a very important allergic reaction that is life-threatening. It can be confused with various diseases and conditions. Therefore, a pediatric allergy specialist should be consulted in order to evaluate the child in the most appropriate way and to determine the allergen that causes anaphylaxis.

How to prepare when going to the doctor for anaphylaxis (allergic shock)?

It will be useful to bring the previously used medicines and tests with you.

When going to a pediatric allergy specialist, it will be beneficial for the patient to bring the medication that you have used before and which may cause reaction and previous tests for evaluation of the patient. Allergy syrups and pills, cough and cold syrups should be discontinued 1 week before consultation. Because these drugs should be discontinued 1 week before the skin allergy tests so they can be done.

How should treatment be done in anaphylaxis?

Since anaphylaxis is a life-threatening emergency, intervention should be done as quickly as possible. If there is an adrenaline autoinjector given by your previous allergy doctor, it should be used immediately, the feet should be lifted to the air and artificial respiration should be done if there is a breathing problem. In the meantime, the nearest emergency room should be contacted.

What should be done to prevent anaphylaxis?

If an allergen causing anaphylaxis has been detected, it must be avoided. In food allergies, the list containing that food, you should take the list of medicines that have a similar structure to the drug that causes allergies in medicines, and keep them with you. In addition, this information should be given to family members and those in the school if the child goes to school.

The child should have an identifying ID for his allergic condition. This can be in the form of cards or jewelry worn on the body. Adrenaline autoinjectors should be prescribed for repeat of situation to use in children who have had anaphylaxis. Family members, nursery and school teachers and caregivers should be taught how to use.

Can anaphylaxis be prevented by allergy vaccine (immunotherapy)?

In children who develop anaphylaxis, this situation can be treated by allergy vaccination in some cases.

Prevention in bee allergy is not always possible and should be done in these patients, as the allergy vaccine is also highly successful. Although in a certain age in allergies of some foods, if there is still no improvement, there is still a discussion about its benefit, but it can be tried.

Allergy vaccines must be done by pediatric allergy specialists who are trained and experienced in this field.

As a result;

  • Anaphylaxis is a life-threatening systemic allergic reaction
  • Its frequency is gradually increasing
  • The most common cause of anaphylaxis in children is food. Then comes medicines and bee allergy
  • Anaphylaxis can affect all body systems. But the most common hives, respiratory symptoms and hypo-tension
  • The diagnosis of anaphylaxis is made by history and examination.
  • Allergens that cause anaphylaxis (allergic shock) can be detected by blood and skin allergy tests.
  • Since anaphylaxis is an emergency, you should go to the nearest emergency room immediately.
  • To prevent anaphylaxis, the allergen that causes it should be avoided and the patient should carry an introductory card that gives information about this condition.
  • The patient should carry an adrenaline auto-injector for use in an emergency
  • In children who develop anaphylaxis, bees and some food allergies can be treated with allergy vaccine therapy (immunotherapy).
  • Anaphylaxis is a serious condition. For this reason, children should be evaluated by pediatric allergists who are trained and experienced in this field.

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