Quick reaction in an emergency: Why you should know exactly what you are allergic to
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Animal hair, pollen, mold, house dust mites: Numerous triggers can cause swelling, itching or nausea in allergy sufferers. In the worst case, the cycle breaks down. What happens in the body during an allergic reaction and what allergy sufferers should definitely pay attention to.
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Exactly what allergy sufferers fear happened to best-selling author Dorothee Achenbach: During a walk, she suffered an acute allergy shock with severe shortness of breath. She is traveling alone, there is no direct help available. Doctors can only help the allergy sufferer in the hospital.
Celery is said to have been the trigger for the body’s violent reaction. The vegetable is found as a spice extract in many foods and must therefore be labeled. We don’t know whether Ms. Achenbach had noticed the celery – a so-called hidden food allergen – before. And this is probably the case for many allergy sufferers.
This is what happens when an allergic reaction occurs in the body
In the case of an allergy, the body’s immune system responds to harmless environmental stimuli with an exaggerated reaction. The immune system of allergy sufferers then recognizes certain allergens, mostly animal or plant proteins, as foreign and hostile – and fights them with full force. This allergic reaction surprises the body in different places and affects various organs – with different strengths.
The skin and mucous membranes, gastrointestinal tract, respiratory tract or cardiovascular system can react, and usually several organs as well. A rule can often be identified: the more sensitive the affected person’s immune system is to the allergen and the larger the amount ingested – sometimes even traces are too much – the more dramatic the reaction can develop. Certain stresses, such as physical exertion, alcohol or painkillers, are known to even increase such reactions.
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Fatal consequences
Events with severe hives and grotesque facial swelling, itching in the oral cavity or nausea can trigger even worse reactions upon renewed contact with the allergen: circulatory collapse and life-threatening cardiac arrest are among the fatal consequences of the most severe form of allergy. Doctors then speak of “anaphylactic shock”.
But allergies can threaten life not only because of this dangerous hypersensitivity: people with severe asthma often also have allergic triggers that can worsen their illness. Allergens – often animal hair, pollen, mold or house dust mites – then unexpectedly provoke asthmatic symptoms.
People suffering from severe asthma often suffer from a significantly reduced quality of life because chronic asthma can break out even with trivial infections or the slightest stress. However, this doesn’t have to be the case if you receive proper therapy and care.
Cross allergies: The immune system reacts to different triggers
Fortunately, there are enough specialists, lung specialists and some special centers in Germany – but more in our cities than in the countryside. The diagnosis of asthma is certainly not proof of an allergic reaction to certain triggers: However, unidentified allergens – for example celery in mugwort pollen allergy sufferers – can cause reactions or worsen known allergies. Cross allergy is the name given to this connection between structurally similar triggers of an allergic reaction.
Class E antibodies (immunoglobulin E or IgE for short) in the body that are directed against certain allergens often confuse substances from different sources and trigger unnecessary allergic reactions upon contact. For example, it may be that the immune system not only reacts to mugwort pollen causing allergic rhinitis in July and August, but also to celery because it contains a similar protein.
There are also cross-reactions to shellfish and crustaceans, for example to muscle proteins: then not only shrimp, but all crustaceans, shrimp and many other delicacies from the sea are banned. Birch pollen allergy sufferers are familiar with the most common cross-allergies with sneezing attacks and allergies in April: However, the allergic symptoms to pome and stone fruits, nuts, carrots and sometimes soy drinks are usually limited to the oral cavity. The allergens are not stable and are destroyed by heat (during cooking) and stomach acid – it rarely becomes dangerous.
Check with your doctor about possible allergy triggers
In order to deal with the allergy and to prevent a serious allergic reaction, it is advisable that those affected have the triggers examined carefully and know which substances can trigger their allergy. Blood tests can directly detect IgE against suspected allergens.
In the so-called prick test on the skin, the allergens react indirectly with the IgE in the skin: after a short time, a small wheal appears.
Allergy sufferers can do this
Allergy sufferers should carefully avoid contact with known allergens and carry emergency medication with them.
Really at risk allergy sufferers need an adrenaline injection, which they have to give themselves in an emergency.
In addition, specialists often recommend hyposensitization for symptoms caused by pollen or mites, which can alleviate symptoms and the need for medication and prevent the allergies from progressing. Purified allergen preparations are available for injection or for use under the tongue.
Although the costs are covered by health insurance companies, too few allergy sufferers endure the three-year treatment. For very severe cases of asthma, there are now biologically engineered, expensive protein preparations, so-called “biologicals”. They have to be injected regularly and block messenger substances from the immune system or signaling molecules in the body. In this way, allergic reactions are intercepted or asthma inflammation is specifically alleviated.
One thing is certain: a debilitating allergy or suspected asthma should always be diagnosed by a doctor and treated properly. In this way, dangerous health consequences can sometimes be minimized. Individual therapy should also be discussed with an allergy specialist and determined together. The goal is a tailor-made solution for every allergy and asthma sufferer.
About the expert
Jörg Kleine-Tebbe is a doctor and press spokesman for the German Society for Allergology and Clinical Immunology. He is an allergist at the Westend Allergy and Asthma Center in Berlin and advises patients on, among other things, allergies, allergic reactions and the consequences of anaphylactic shock.