Anaphylaxis
(Severe Allergic Reaction)
Revising Medical Author: Jerry R. Balentine, DO, FACEP
Revising Medical Editor: Melissa Conrad Stöppler, MD
Introduction to anaphylaxis
Anaphylaxis refers to a rapidly developing and serious
allergic reaction that affects a number of different areas
of the body at one time. Severe anaphylactic reactions can
be fatal. Most people experience allergy
symptoms only as a minor annoyance. However, a small number of people are
susceptible to a reaction that can lead to shock or even death.
Anaphylaxis is often triggered by substances that are
injected or ingested and thereby gain access into the blood
stream. An explosive reaction involving the skin, lungs,
nose, throat, and gastrointestinal tract can then result.
Although severe cases of anaphylaxis can occur within
seconds or minutes of exposure and be fatal if untreated,
many reactions are milder and can be ended with prompt
medical therapy.
What does anaphylaxis mean?
To fully understand this term, we need
to go back almost 100 years. The story begins on
a cruise aboard Prince Albert I of Monaco's
yacht. The Prince had invited two Parisian scientists to
perform studies on the toxin produced by the tentacles
of a local jellyfish, the Portuguese Man of War. Charles Richet
and Paul Portier were able to isolate the
toxin and tried to vaccinate dogs in the hope
of obtaining protection, or "prophylaxis," against the toxin.
They were horrified to find that subsequent very small doses
of the toxin unexpectedly resulted in a new dramatic
illness that involved the rapid onset of breathing
difficulty and resulted in death within 30 minutes.
Richet and Portier termed this "anaphylaxis" or "against protection."
They rightly concluded that the immune system first becomes sensitized to the allergen over several weeks and upon re-exposure to the same allergen may result in a severe reaction. An allergen is a substance that is foreign to the body and can cause an allergic reaction in certain people.
Allergy Facts
- The first documented case of presumed anaphylaxis
occurred in 2641 B.C. when Menes, an Egyptian pharaoh, died
mysteriously following a wasp or hornet sting. Later, in
Babylonian times, there are two distinct references to
deaths due to wasp stings.
- Charles Richet was awarded the Nobel Prize in 1913 for
his work on anaphylaxis.
Richet went on to suggest that the allergen must result
in the production of a substance, which then sensitized the
dogs to react in such a way upon re-exposure. This
substance turned out to be IgE.
In the first part of the 20th century, anaphylactic
reactions were most commonly caused by tetanus diphtheria
vaccinations made from horse serum. Today, human serum is
used for tetanus prevention, and the most common causes of
anaphylaxis are now penicillin and other antibiotics,
insect stings, and certain foods.
Allergy
Fact
In 1956, Mary Hewitt Loveless showed that the injection
of wasp venoms could cause anaphylaxis in individuals
allergic to wasps. She subsequently used wasp extracts to
successfully immunize such individuals.
Next: How common is anaphylaxis? »
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