Anaphylaxis criteria?

Question

I had a bad allergic reaction to diclofenac in the summer. Itching, flushing, red eyes, hoarseness, wheezing, feeling faint. I took a piriton immediately and my mother phoned an ambulance. I was given oxygen (I was blue lipped apparently) by the paramedics and taken to hospital. However I was recovering quite quickly by then so after some basic health checks was sent home.
My GP just said to avoid diclofenac in the future, nothing else. What I wondered was, did I have anaphylaxis or just an allergic reaction? When is an allergic reaction classed as anaphylaxis?

Answer 1

Apparently there is no set guideline to follow in order to pin point what is definitely anaphylaxis, but here is a list of clinical criteria that has currently been recommended as a reference to assist doctors/emergency personnel who suspect a potential anaphylaxis reaction:

Clinical Criteria for Diagnosing Anaphylaxis

Anaphylaxis is highly likely when any one of the following 3 criteria is fulfilled:

1. Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both (e.g. generalized hives, pruritus or flushing, swollen lips-tongue-uvula) AND AT LEAST ONE OF THE FOLLOWING:
Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)
Reduced BP or associated symptoms of end-organ dysfunction (e.g., hypotonia [collapse], syncope, incontinence)
2. Two or more of the following that occur rapidly after exposure to a likely allergen for that patient (minutes to several hours):
Involvement of the skin/mucosal tissue (e.g., generalized hives, itch-flush, swollen lips-tongue-uvula)
Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)
Reduced BP or associated symptoms (e.g., hypotonia [collapse], syncope, incontinence)
Persistent gastrointestinal symptoms (e.g., crampy abdominal pain, vomiting)
3. Reduced BP after exposure to known allergen for that patient (minutes to several hours)
Infants and children: low systolic BP (age specific) or greater than 30% decrease in systolic BP*
Adults: systolic BP of less than 90 mm Hg or greater than 30% decrease from that person’s baseline
PEF, Peak expiratory flow; BP, blood pressure.
*Low systolic blood pressure for children is defined as less than 70 mm Hg from 1 month to 1 year, less than (70 mm Hg + [2 x age]) from 1 to 10 years, and less than 90 mm Hg from 11 to 17 years.

Answer 2

Usually allergic reactions take place just at the area where the allergen came into contact with the body - e.g. itchy eyes and nose when a hay fever suffering comes into contact with air that's laden with pollen.

Anaphylactic reactions, however, are reactions where the allergic response occurs throughout the body - these are far deadlier than the ordinary kind. What happens is that the blood vessels throughout the body dilate - this causes swelling in the face and lips and throat and can cause wheezing and secretion of mucus in the lungs. Sometimes the GI tract is affected - abdominal pain and nausea. Also, the blood vessles throughout the body can become so dilated that not enough blood gets to the brain and this causes lightheadedness and passing out.

It certainly sounds like the reaction you had was anaphylactic given the hoarseness, wheezing, feeling faint, and having blue lips.

That being said, you should definitely avoid the diclofenac in the future. To be safe, you may want to exercise caution whenever you take a new drug that's related to diclofenac - this would be a class of medications that, in the US, are called NSAID's (non steroidal anti inflammatory drugs). This class includes aspirin, ibuprofen, naproxen, and many other prescription medicines (acetaminophen, however, is NOT an NSAID).

Some people also opt to carry an injection of epinephrine around with them in case they get another reaction - it's sold under the name Epipen in the US. Basically, if you get another reaction, you administer the medication and then proceed (quickly, now!) to the nearest hospital for further treatment. This is generally carried by people who have an allegy to something that might catch them by surprise - such as bees or peanuts (not necessarily diclofenac). If you're nervous about the reaction you had, you might ask your GP if he'd prescribe it for you as well.

Answer 3

You certainly have an adverse allergy to diclofenic.

Anaphylaxis combines your symptons with a life threatening drop in blood pressure causing you to collapse and requiring immediate treatment with adrenaline, then further management with antihistamines, without this treatment the collapse can lead to cardiac arrest.

The advice you have been given is very sound and you should always tell any doctor that you are allergic to diclofenic, this will ensure that you are not given any drugs which contain it or any drugs that are contraindicated in people with this sensitivity.

Should you inadvertantly have this drug again then you could indeed have an anaphylaxis as this usually occurs following the first allergic reaction..but not always!.

Answer 4

i have allergy problems and would like to give a litle advice
MEDIC ALERT is a charity from which you can get a world widw recognised bracelet to wear identifying you as having a problem.
in the UK their tel no is 02074072818. if you rang them or looked them up ehwere you live it will give you added peace of mind and protection.
i went on holiday this year and felt more relaxed knowing i had this backup
because they are a charity there are many circumstances when they dont even charge you ,it is provided free of charge for your whole life (and may save your life in an accident)

i think anaphalaxic is when the allergy reaction is so severe that it is life threatening

Answer 5

my daughter has Anaphylactic reactions to soya, peanuts, all seeds, she carries an eppipen and wears a medic alert bracelet also has a card in her wallet telling people whats wrong with her.

When she has had an reaction, her throat starts to close up, she is very noisy in breathing, her heart beats fast, and she is generally very unwell. Very scary stuff

Answer 6

Anaphylaxisis involves the airway and since oyu had wheezing and hoarseness, I would classify your reaction as anaphylactic.