Anaphylaxis: Name: Gyang Hanandita Gusti Putri Legion Name: Immunology

Name : Gyang Hanandita Gusti Putri
Legion Name : Immunology
ANAPHYLAXIS
Anaphylaxis is often used to describe an acute, progressive, and life-

threatening allergic reaction.1 Anaphylaxis is a severe systemic hypersensitivity
reaction that is rapid in onset; characterized by life-threatening airway, breathing
and/or circulatory problems; and usually associated with skin and mucosal
changes.2 The allergens in this allergic reaction vary, from food to insect venom.
Human anaphylaxis is generally thought to be mediated by IgE, with mast

cells and basophils as key players.3 Anaphylaxis is initiated by an allergen
interacting with allergen-specific IgE bound to the FcRI receptor on mast cells,
basophils, or both.3 The interaction between the allergens and the IgE molecules
occurs on 2 or more receptors of the cell surface, causing cross-linking which leads
to receptor aggregation and initiates intracellular signalling. If the signalling goes
vigorous, mast cells/basophil activation and degranulation develop and release
preformed mediators which act directly in tissues, causing allergic symptoms and
activate other inflammatory cells. These activated cells release more mediators,
leading to amplification of the allergic reaction.3
The IgE-mediated anaphylaxis itself is broken down into two; IgE-

dependent, and IgE-independent, in which the circulating allergen-specific IgE is
in an undetectable level. Lacking in detection of allergen-specific IgE does not
make the experience of IgE-dependent anaphylaxis completely impossible in such
patients. Anaphylaxis can also be mediated by IgG, however, with higher dose of
antigen or allergen.
The signs and symptoms of anaphylaxis include respiratory distress,

hypotension, tachycardia, cyanosis, urticaria, angioedema, nausea, vomiting,
diarrhoea, and abdominal pain.4 In general, cutaneous manifestations are observed
in most cases, followed in frequency by cardiovascular and respiratory symptoms.4
Diagnosis is more challenging when cutaneous symptoms are absent.4 Respiratory
(e.g., inspiratory difficulty, dysphonia, and hypersalivation) and cardiovascular
manifestations (e.g., sudden reduced blood pressure and tachycardia) are potentially
life-threatening features of anaphylaxis and should be considered warning signs.4
If someone is seen with this signs and symptoms, perform these immediate
actions:
1. Remove allergen(s) if still present.
2. Call for assistance, it can be a medical staff, or call 911.
3. Lay patient flat, do not allow them to stand, let alone walk. If breathing
is difficult, allow them to sit.
4. Give Intramuscular Injection (IMI) of Adrenaline (epinephrine) without
delay using an adrenaline autoinjector if available or adrenaline
ampoules and syringe with the right dosage.
5. Call ambulance if the patient is not in a hospital.5
References
1. Shandy, P.P., and Saturti, T.I.A. 2016. Reaksi Anafilaksis. (Online)

(https://simdos.unud.ac.id/uploads/file_penelitian_1_dir/4c45da3ce1ffeb6
1261ea06661f62fb7.pdf, accessed August 11, 2019).
2. Reber, L.L., Hernandez J.D., and Galli, S.J. 2017. The pathophysiology of
anaphylaxis. J Allergy Clin Immunol 140 (2): 335. (Online)
(https://www.jacionline.org/article/S0091-6749(17)31020-5/pdf, accessed
August 11, 2019).
3. Muñoz-Cano, R., Picado, C., Valero, A., and Bartra, J. 2016. Mechanisms
of Anaphylaxis Beyond IgE. J Investig Allergol Clin Immunol 26 (2): 73-
74. (Online) (http://www.jiaci.org/issues/vol26issue2/1.pdf, accessed
August 11, 2019).
4. Alvarez-Perea, A., Tanno, L.K., and Baeza, M.L. 2017. How to manage
anaphylaxis in primary care. Clinical and Transitional Allergy 7 (45): 2.
(Online) (https://ctajournal.biomedcentral.com/track/pdf/10.1186/s13601-
017-0182-7, accessed August 11, 2019)
5. Australasian Society of Clinical Immunology and Allergy. 2016. Acute
management of anaphylaxis.
(https://www.allergy.org.au/images/stories/pospapers/ASCIA_Guidelines_
Acute_Management_Anaphylaxis_Dec2016.pdf, accessed August 11,
2019).

Anaphylaxis: Name: Gyang Hanandita Gusti Putri Legion Name: Immunology

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Anaphylaxis: Name: Gyang Hanandita Gusti Putri Legion Name: Immunology

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Copyright:

Available Formats

Name : Gyang Hanandita Gusti Putri

Legion Name : Immunology

Anaphylaxis is often used to describe an acute, progressive, and life-

Human anaphylaxis is generally thought to be mediated by IgE, with mast

The IgE-mediated anaphylaxis itself is broken down into two; IgE-

The signs and symptoms of anaphylaxis include respiratory distress,

1. Shandy, P.P., and Saturti, T.I.A. 2016. Reaksi Anafilaksis. (Online)

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