Even traces of the allergen in a food are enough to trigger a serious reaction. The only life-saving drug is self-injectable adrenaline
It could have been an anaphylactic shock to kill Martina Quadrino, 13, after an evening spent with friends in Fondi (Latina). The girl had eaten a sandwich: the hypothesis that it contained a substance that caused her a deadly allergy.
Cardio-respiratory arrest
Traces of the allergen may in fact be enough to trigger the reaction. In some very rare cases, even the smell alone can be fatal. We speak of anaphylactic shock – or anaphylaxis – when the allergic crisis, with sudden onset, involves all organs in a few minutes and risks leading to cardio-respiratory arrest. What could have happened to Martina, but the autopsy will determine it. The foods most frequently responsible for reactions are milk, eggs, peanuts and fish. The likelihood of shock increases if the patient suffers from asthma.
Symptoms of shock
How is anaphylaxis recognized? The warning symptoms are itchy palms, soles of the feet and scalpthen come the most serious ailments, that is edema of the glottis (which can cause choking), wheezing e respiratory failure. In some cases there is a lowering of blood pressure with cardio-circulatory collapse. Abdominal pain and diarrhea are also possible.
Self-injectable adrenaline
Is there a cure? S, and a life-saving drug: self-injectable adrenaline. The European Medicine Agency has recommended that all patients at risk be prescribed two devices (provided free of charge by the National Health Service), to be kept with them at all times for any emergencies. Unfortunately, sometimes it does not happen: it happens that adrenaline is not prescribed, or that the patient leaves it at home. The drug works in eight minutes and in the most serious situations both doses must be administered. This is the only life-saving remedy in the case of anaphylactic shock.
Cortisone and antihistamines
After the adrenaline, other therapies are needed by the medical staff: fluids to support the bloodstreambecause the pressure drops, corticosteroids and antihistamines intravenous and / or intramuscular to counteract allergic inflammation and therapies to support the respiratory system: bronchodilators, oxygen and in some cases also intubation and mechanical ventilation. Finally, the use of the defibrillator and the administration of drugs that act on the recovery of the heart rhythm. It is a standardized therapy according to international guidelines.
One third of patients do not improve
Usually the allergies present in childhood heal spontaneously with the passage of time, but a third of patients do not improve and on the contrary go towards a persistent and severe form. Over 90% of those with food allergies do not risk serious reactions such as anaphylactic shock. Antihistamines, oral steroids and bronchodilator sprays are generally used to treat allergies. But there is still little awareness that one can die of allergy, even food allergies.
Immunotherapy
Is it possible to recover from a food allergy? Yes, with immunotherapy, a kind of vaccine. Studies are ongoing for allergies to milk, egg, peanut and fish. Immunotherapy increases the body’s reaction threshold and in some cases it allows to reach full tolerance towards the food. The patient, a little at a time, it no longer reacts to small traces of allergen, but only at higher dosages. These treatments – in oral, sublingual, epicutaneous form (with patches applied to the back) or with biological drugs – are now available only in highly specialized centers and last 3-4 years.
April 16, 2022 (change April 16, 2022 | 20:27)
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