Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Current estimates put the number of annual deaths in the U.S. due to anaphylaxis at approximately 1,500 per year. Although anaphylaxis can be due to different causes, there are
four major subtypes of anaphylaxis (reactions to food, drugs, latex, and insect stings). Depending on the substance causing anaphylaxis, the rate of anaphylaxis upon exposure to a substance has been estimated to be between less than 1% to up to 10%.
What are common causes of anaphylaxis?
The causes of anaphylaxis are divided into two major
groups:
IgE mediated: This form is the true anaphylaxis that requires an initial sensitizing exposure (for
example, an exposure to the substance that will later trigger the anaphylaxis) and occurs on a subsequent exposure. It involves the coating of mast cells and basophils (cells in the blood and tissue that secrete the substances that cause allergic reactions, known as mediators) by IgE, and the explosive release of chemical mediators upon reexposure.
Non-IgE mediated: These reactions, the so
called "anaphylactoid" reactions, are similar to those of
true anaphylaxis but do not require an IgE immune
reaction. They are usually caused by the direct stimulation
of the mast cells and basophils. The same mediators as
occur with true anaphylaxis are released and the same
effects are produced. This reaction can happen, and often
does, on initial as well as subsequent exposures, since no
sensitization is required.
The terms anaphylaxis and anaphylactoid (meaning "like anaphylaxis") are both used to describe this severe allergic reaction. Anaphylaxis is used to describe reactions that are initiated by IgE and anaphylactoid is used in reference to reactions that are not caused by IgE. The effects of the reactions are the same, however, and are generally treated in the same manner. Often, they can not be distinguished initially.
Although it may appear that IgE mediated anaphylaxis occurs upon a first exposure to a food, drug, or insect sting, there must have been a prior, and probably unwitting, sensitization from a previous exposure. You may not remember an uneventful sting or be aware of "hidden" allergens in foods.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Hives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an
allergic reaction. The allergy may be to food or medications, but usually the
cause of the allergy (the allergen) is unknown.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Mercury is a naturally occurring element found in water, soil, and the air. Mercury is also contained in some fish, some of the products we use in the home, school, or dentist. Information about sources of mercury exposure, potential health effects, symptoms of exposure, fish that may contain mercury, consumer products that contain mercury, and ways to reduce your exposure to mercury is important for the health of you, and your family.
The majority of spiders in the United States are harmless. Two exceptions include the black widow spider and the brown recluse spider. Symptoms of a harmless spider bite generally involve redness, irritation, and pain. alized symptoms of bites from black widow and brown recluse spiders may include: nausea and vomiting, fever, headache, abdominal pain, joint pain, and more. In general, a brown recluse spider bite or black widow spider bite may require medical attention. The information includes pictures of the brown recluse and black widow spiders for identification.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
Bees, wasps, and fire ants are related insects that belong to the Hymenoptera order. There are thousands of species of wasps found throughout the world. Common wasps are yellow jackets and hornets. Types of bees include honey bees, the Africanized honey bee (killer bee), and the bumble bee. There are four types of reactions to a bee or wasp sting; 1) local reaction, 2) systemic allergic reaction, 3) toxic reaction, and 4) delayed reaction. Individuals who have a systemic or toxic reaction generally require immediate medical treatment to prevent anaphylactic reaction, and possibly death.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
The majority of stinging insects in the United States are from Bees, Yellow Jackets, Hornets, Wasps and Fire Ants. Severity of reactions to stings varies greatly. Avoidance and prompt treatment are essential. In selected cases, allergy injection therapy is highly effective.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
Drug allergies are cause when the immune system mistakenly creates an immune response to a medication. Symptoms of a drug allergic reaction include hives, rash, itchy skin or eyes, dizziness, nausea, diarrhea, fainting and anxiety. The most common drug allergy is penicillin. Treatment may involve antihistamines or corticosteroids. An Epipen may be used for life-threatening anaphylactic symptoms.
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