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 DEFINITION
The anafilaxia is a general reaction of the organism to the contact with an allergen (protein that produces allergy) with the one that previously had already reacted. It needs immediate medical attention since, if it is not controlled, it can lead to irreversible situations, including the death. It takes place for the rapid liberation of a few substances that are inside the cells responsible for the immune answer.
CLINIC
This reaction of the organism can take place at three intensity levels:
Set sail: - Hives: Eruption of rapid and progressive appearance, with spots and accompanied by intense itch.
- I itch in hands and feet.
- General heat.
- Angioedema: edema located in the face, with distension of eyelids, lips, language and certain difficulty to swallow.
- Nasal congestion.
- Itch in the palms of the hands and plants of the feet.
Moderate: - Broncoespasmo: Make difficult to breathe, cough, hisses in the breast and fatigue.
- Laryngeal edema: Inflammation in the gullet that makes the respiration difficult and swallowing. Changes in the voice.
- Vomiting, intestinal movements and diarrhea.
- Anxiety.
Seriously: - Laryngeal stridency: Typical noise that produces the larynx as a result of being closed. The patient scarcely can express words.
- Extreme respiratory difficulty.
- Cianosis: Violet coloration of the lips and the skin of the fingernails.
- Respiratory unemployment.
- Diarrhea.
- Uncontrollable desire of urinating.
- Cramps and convulsions.
- Low blood pressure and cardiac arrhythmia.
- Shock.
- Comma.
These symptoms also can appear in other occasions without an apparent desencadenante appearing and are called "anafilactoides". They differ from the allergic reactions in which an immune mechanism does not intervene.
The incidence of anafilaxia (allergic shock) is known as regards the penicillin from 10 to 50 by every 100.000 injections. And of these fatal reactions are from 100 to 500 per year in USA. The anafilaxia incidence for stings of bees or wasps is 0,4 % of the population, having between 25 to 40 annual deaths in USA. It was not possible to have seen the anafilaxia conditional for sex, age, race or atopia previous.
CAUSES OF THE ANAFILAXIA
- ANTIBIOTICS
- ANTI-INFLAMMATORY NOT ESTEROIDEOS
This group of medicines includes the aspirin, analgesics and the majority of anti-inflammatory used in pains you will articulate.
- EXTRACTS ALERGÉNICOS FOR DIAGNOSIS / TREATMENT
It includes the extracts used for tests and the vaccines.
- STING OF INSECTS:
Wasps or bees
- HORMONES
Insulin, progesterone
- ENZYMES
Quimotripsina, quimopapaína
- BLOOD PRODUCTS
Heparina, wheys, gammaglobulinas
- FOOD PARASITES
Anisakis simplex that is in diverse fish
- ANESTHETIC PLACES
- MIORRELAJANTES
Medicines used in anesthesia.
- FOOD
Vegetables, egg, fish, seafood, milk, fruits, meats, etc.
- ADDITIVES
Sulfites, tartracina, parabenos, glutamate, etc.
- OTHER MEDICINES
Anti-cancer, vitamins, antiseptic
- MEANS OF CONTRAST
Substances used in radiology.
- LATEX
Gum used as the manufacture of numerous objects like, for example, the condoms.
- PHYSICAL MECHANISMS
I fry, struggle, water, etc...
- BREAK OF CYST HIDATIDICO
- I OXIDIZE OF ETHYLENE (sterilizer)
- IDIOPATICOS
It refers to those cases in which we do not know the origin.
When a situation of this type takes place an urgent medical care is needed. The prognosis of recovery of the patient depends on the rapidity in the attention that receives.
TREATMENT OF THE ANAFILAXIA
It is a potentially mortal picture, what forces to look for medical help with rapidity:
- If the patient impresses of gravity matter for yourself, must request him sanitary help to the emergency phone of his community (Spain: 911, 112, 061...), that will send specializing sanitary help.
- If there is no nearby specializing help, his transfer must begin to the most nearby sanitary center without delay.
- If one can, there must be suspended the agent that causes the picture, and pay special attention to the maintenance of a suitable airline and administer oxygen to high flow for mask if he gets ready of him.
- If the allergen has been injected into an arm (injection, bee sting...), a tourniquet can be realized to try to delay his action. It must come loose every 5 minutes to avoid later complications.
- Also it can use medicines aerosols betamiméticos that they will produce broncodilatación.
- Some patients have had previous similar reactions, and carry with it adrenaline roads for subcutaneous autoadministration, which is the election medicine for these situations.
- If it exists shock, it will talk each other by means of the expansion of the volume intravascular with the administration of wheys I.V.
- Other effective medicines are the corticoids and the antihistamines, although his effect is more late.
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