Allergies and allergic reactions occur when the immune system reacts to a usually harmless substance, known as an allergen. These reactions can range from mild to life-threatening (anaphylaxis).
Causes:
- Environmental Allergens: Pollen, dust mites, mold spores, pet dander.
- Foods: Nuts, shellfish, eggs, milk, wheat, soy.
- Insect Stings: Bees, wasps, hornets.
- Medications: Penicillin and other antibiotics, aspirin, NSAIDs.
- Latex: Found in some medical and consumer products.
Diagnosis:
- Medical History: Identifying symptoms and potential exposure to allergens.
- Skin Prick Test: Introducing small amounts of allergens into the skin to observe reactions.
- Blood Test (RAST Test): Measuring the level of IgE antibodies in response to specific allergens.
- Elimination Diet and Oral Food Challenge: Primarily for food allergies.
Differential Diagnosis:
- Non-Allergic Rhinitis: Symptoms similar to hay fever but not caused by an allergic reaction.
- Food Intolerances: Such as lactose intolerance, which is different from an allergic reaction.
- Autoimmune Disorders: Some symptoms can overlap with allergic reactions.
- Infections: Some can mimic allergic reactions, like skin rashes.
Management of Allergies:
- Avoidance of Allergens: Primary treatment for allergies is to avoid known allergens.
- Medications:
- Antihistamines for mild to moderate symptoms.
- Nasal corticosteroids for allergic rhinitis.
- Bronchodilators and inhaled corticosteroids for asthma associated with allergies.
- Allergen Immunotherapy (Desensitization): Gradually increasing doses of the allergen, which may reduce sensitivity over time.
- Emergency Medications: Adrenaline auto-injectors for severe reactions.
Management of Anaphylaxis:
Anaphylaxis is a severe, potentially life-threatening allergic reaction that requires immediate medical attention.
- Adrenaline Administration: The first line of treatment. Patients with known severe allergies should carry an epinephrine auto-injector.
- The adrenaline dose is 0.01mg/kg up to 0.5mg IM
- Repeat every 5 minutes if required
- Call Emergency Services: Immediate medical help is crucial.
- Lay the Person Down: Raise their legs if possible and loosen tight clothing. Avoid sitting or standing if breathing is difficult.
- Perform CPR if Necessary: If the person is not breathing or has no pulse.
- After Adrenaline: The person should go to the emergency room for further observation and treatment, as symptoms may recur.
- Post-Anaphylaxis Follow-Up:
- Allergist Consultation: To identify the allergen and discuss long-term treatment strategies.
- Education: On allergen avoidance and proper use of adrenaline auto-injectors.
- Medical Alert Identification: Wearing a bracelet or carrying a card that identifies the allergy.
- Prevention:
- Allergy Education: Understanding triggers and management strategies.
- Allergen Avoidance: Based on known allergies.
- Regular Medical Review: To monitor allergies and adjust treatments.
In summary, managing allergies involves identifying and avoiding allergens, using appropriate medications, and being prepared for emergency situations like anaphylaxis. Anaphylaxis management is immediate and focused on stabilizing the patient and preventing further exposure.