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blood transfusion p. 110
complement and p. 104
epinephrine for p. 241
IgA-containing products p. 114
shock with p. 319
for anaphylactic reaction p. 112
Anaphylaxis comes from the greek word “ana-“ which roughly means against and “phylaxis” which means protection, implying that someone’s immune system has reacted to something in such a way that ends up damaging them, instead of protecting them.
It’s basically a severe type of allergic reaction that affects multiple organ systems and it’s potentially life-threatening.
Normally, the immune system recognizes and acts against pathogens that can cause disease.
These pathogens have specific molecules on their surface, called antigens, and they help trigger an immune response.
In some individuals, though, the immune system overreacts and starts targeting harmless molecules that don’t cause any problems for most people.
These include molecules found in foods like peanuts and shellfish, medications like antibiotics, and in the venom of insect bites.
In most cases, there might be a mild to moderate allergy, but sometimes things get really serious, involving two or more organ systems, and at that point it’s called anaphylaxis.
Anaphylaxis, just like any allergic response, happens in two steps, a first exposure, or sensitization, and then a subsequent exposure, which is when it actually gets a lot worse.
So, let’s say a person is stung by a bee from a nearby beehive, for the first time in their life.
When the bee pierces the skin with its stinger, its venom gets into the skin.
Part of that venom molecule can get picked up by a dendritic cell, which is a type of immune cell.
The dendritic cell gobbles up the foreign particle and presents it to a nearby lymphocyte, called a T cell.
If the T cell is activated, it starts to produce cytokines, which stimulate B cells, another group of lymphocytes, which produce IgE antibodies.
These IgE antibodies get released into the bloodstream and bind to the surface of mast cells and basophils, which are immune cells that are full of granules that contain proinflammatory molecules.
Okay now, let’s say that that same person is stung by a bee again, maybe a few months later, then it’s probably time for this person to move away from this beehive, because they’re obviously lousy neighbors.
Anaphylaxis is an acute, generalized, multi-systemic allergic reaction to an antigen such as a bee sting. Its symptoms can range from mild pruritus and skin flushing to severe respiratory distress and cardiovascular collapse. Anaphylaxis can lead to rapid deterioration, and without treatment, it can lead to respiratory failure and cardiovascular collapse, and then death.
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