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Acute Systemic Anaphylaxis

Acute Systemic Anaphylaxis

Anaphylaxis is a systemic allergic reaction involving the respiratory and/or the cardiovascular system; it has a rapid onset with the possibility of causing death. However, less severe reaction may be also defined as “anaphylaxis” if there is a high index of suspicion for allergic reaction in the setting of previously diagnosed allergy (Sanchez et al. 1999; Simons et al. 2007; Tang and Liew, 2008). It was observed by Simons (2006) that anaphylaxis is a disease of modern times; sporadic cases report of anaphylaxis were only published in 17th, 18th and 19th centuries and within the past four decades, the rates of allergic diseases have been increasing dramatically. The most common identifiable triggers of anaphylaxis would be food, insect venom or medication while less commonly by allergen such as natural rubber latex or physical factor such as exercise (Simons, 2006). It is usually mediated by immunological mechanism which could result in the sudden systemic release of mast cells and basophils mediator. It will consist of some or all of the following signs and symptoms with the onset within 5 – 30 minutes; diffuse erythema, pruritus, urticaria and/or angioedema; brochospasm; laryngeal edema; hyperperistalsis; hypotension and/or cardiac arrhythmias. Other symptoms that might occur would be nausea, vomiting, lightheadedness, headache, feeling of impending doom and unconscious. However, it must be noted that reaction sometimes might not develop for several hours (Kemp and Lockey, 2002).
In many individual, anaphylaxis is mediated by the expansion of T helper 2 cell (TH2-cell), a subset of T cells, together with isotype switching of B cells to generate IgE antibodies specific for common environment allergens (Holgate and Polosa, 2008). Thus, IgE is seen as having a crucial role in anaphylaxis where it would be synthesized in response to an allergen exposure and becoming fixed to FcεRI on the surface of mast cells and basophils. Then,...