The Australasian Society of Clinical Immunology and Allergy

Anaphylaxis is the most severe form of allergic reaction and is potentially life-threatening. Anaphylaxis should be treated as a medical emergency, requiring immediate treatment.

ANAPHYLAXIS AFFECTS THE ENTIRE BODY

Anaphylaxis occurs after exposure to an allergen (foods like peanuts or tree nuts, insect stings or some medicines), to which a person is already extremely sensitive. It results in potentially life-threatening symptoms, which include:

• Difficulty/noisy breathing
• Swelling of tongue
• Swelling/tightness in throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Loss of consciousness and/or collapse
• Pale and floppy (in young children)

In some cases, anaphylaxis is preceded by less dangerous allergic symptoms. Symptoms can include:

• Swelling of face, lips and eyes
• Hives or welts on the skin
• Stomach pain, vomiting

Several factors can influence the severity of anaphylaxis, including exercise, heat, alcohol and in food allergic people, the amount eaten, how it is prepared and consumed.

IDENTIFYING THE CAUSE OF ANAPHYLAXIS IS IMPORTANT

Your doctor will normally ask a series of questions that may help to narrow down the list of likely causes such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with anaphylaxis like fainting attacks or epileptic fits. If allergy is suspected, this may be followed by allergy tests, usually by blood tests (CAP/RAST) or skin prick tests, to help confirm or exclude potential triggers.

It is important to note that some methods which claim to test for allergies, including vega testing, Alcat tests, kinesiology, pulse testing, provocation/neutralization testing, allergen elimination, pulse testing and Rinkel's intradermal testing, are not medically or scientifically proven methods to confirm allergy.

EFFECTIVE MANAGEMENT OF ANAPHYLAXIS SAVES LIVES

If you have severe allergy and are at risk of anaphylaxis, you will require a comprehensive management plan from your doctor, which should include:

• REFERRAL TO AN ALLERGY SPECIALIST
• IDENTIFICATION OF THE ANAPHYLACTIC TRIGGER(S)
  This will include a comprehensive medical history and clinical examination followed by interpretation of allergy test results.
• EDUCATION ON THE AVOIDANCE OF TRIGGER (S)
  This is particularly important with food anaphylaxis and may also involve advice from an experienced allergy dietitian.
• PROVISION OF AN ANAPHYLAXIS ACTION PLAN *
  Since episodes of anaphylaxis are often unpredictable, an Action Plan is essential, which should document the following;
  
  • Name
  • Allergic triggers
  • Symptoms and signs indicating when to use the EpiPen®**
  • Instructions on how to use the EpiPen
  • Ambulance contact details (to be called immediately after giving EpiPen)
  • Carer contact details (to be called after giving EpiPen)
• REGULAR FOLLOW-UP VISITS TO AN ALLERGY SPECIALIST

* Anaphylaxis action plans EpiPen are located at http://www.allergy.org.au/content/view/10/3/

** EpiPen is a pre-loaded auto-injecting pen containing an exact dose of adrenaline.

This works rapidly to reverse the effects of anaphylaxis and should be considered "First Aid" for its treatment. An EpiPen should only be prescribed as part of a comprehensive anaphylaxis management plan. As of 1 November 2003 EpiPen is now available by authority prescription on the Pharmaceutical Benefits Scheme in Australia. Where 'EpiPen' is stated in this document it refers to EpiPen® or EpiPen Junior® which are distributed in Australia and New Zealand by CSL Pharmaceuticals.

Having anaphylaxis yourself or in the family can sometimes be hard to cope with. Anaphylaxis support groups provide useful and supportive information from other people in the same situation. The ASCIA website http://www.allergy.org.au/ includes a list of patient support groups, including:

• Anaphylaxis Australia Inc. - a national support organisation for those with life threatening allergy.
  Website: www.allergyfacts.org.au
  Ph: 1300 728 000 (toll-free)

Disclaimer:

The content of this brochure has been reviewed by ASCIA members, represents the available published literature at the time of review, is not influenced by its sponsors and is not intended to replace professional medical advice. Any questions regarding a medicaldiagnosis or treatment should be directed to a medical practitioner.

For further information on allergy, asthma or immune diseases visit www.allergy.org.au - the website of ASCIA is the peak professional body of Clinical Allergists and Immunologists in Australia and New Zealand.

Contact details
PO Box 450 Balgowlah NSW 2093
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© ASCIA 2004