Following the publication of the Journal of Investigational Allergology and Clinical Immunology, we recently learned of the case of a 55-year-old Spanish lady who lost her life due to an allergic reaction to a wasp sting. In connection with articles that also appeared in the Hungarian press, many also questioned the veracity of the case, as they do not understand how it is possible for someone to have an allergic reaction for the first time at such an old age. We are going around this issue Prof. Kristóf Nékám, with the help of the doctor of the Buda Allergy Center, the president of the Hungarian Allergy Association.
No one is born allergic
Allergy sufferers only inherit the tendency, at the moment of birth it is not possible to tell anyone, even if this disease develops in him later, in what exact form it will happen. An allergic parent also increases the risk, but in two cases (depending on other factors: environmental pollution, lifestyle) the chances of the child developing symptoms may be as high as 80 percent. Explains Professor Nékám. However, this does not mean that a child of a parent who is allergic to ragweed, for example, will also be allergic to ragweed. Allergic predisposition can lead to food allergies, eczematous skin, and later respiratory allergies, we cannot predict this, nor can we predict exactly when the first symptoms will appear.
Insect venom allergy: can develop at any age
It is also one of the most dangerous allergies, as it causes severe, life-threatening symptoms, so-called can also cause anaphylactic shock. Anaphylaxis can occur at any age due to, for example, bee stings or the consumption of peanuts.
We cannot detect the risk of anaphylaxis with a preliminary screening test, because if someone has no complaints, does not remember contact, it is unlikely that IgE antibody is produced in their body. Insect venom allergy can often only be diagnosed after the patient has previously developed symptoms. However, risk analysis can be helpful: anaphylaxis is more common in certain occupations, diseases and lifestyle characteristics.
The more stings, the more likely you are to have allergies?
According to the case reported in the journal, the Spanish lady it was treated with apitherapy, ie it was treated with bee stings at specified intervals. The use of bee venom for therapeutic purposes, primarily for the treatment of diseases related to the functioning of the immune system, dates back to ancient times, but its effects are still disputed by many. According to the author of a study examining the harmful effects of apitherapy the lady may have developed some natural resistance to the toxin during treatment, However, Professor Meek emphasizes that the appearance of allergies does not depend primarily on the number of bites! Anyone, at any age, no matter how many bee bites they have had in their lifetime, can have a severe allergic reaction.
What are the symptoms of anaphylaxis?
Anaphylaxis can occur shortly (up to minutes) after an insect bite. The first symptoms are usually a sudden onset of severe weakness, confusion, palpitations and chest tightness, possibly shortness of breath, panic symptoms followed by nausea, nausea, abdominal cramps, defecation, pallor. Heavy sweating is also observed in many patients.
The symptoms are mainly caused by a drop in blood pressure, which can eventually lead to fainting and cardiac arrest. A little later, swelling, the development of edema, leading to a characteristic change in the tissues around the eyes and lips, tongue. However, edema can occur not only externally but also in the airways, and with frequent convulsive narrowing of the airways, it can even cause the patient to drown.
What to do if you feel unwell after a bee sting?
If symptoms occur, call an ambulance or doctor. Only professional help can prevent the development of life-threatening symptoms and provide adequate care for the patient. Until help arrives, stay with the patient, but do not drink or offer anything. Do not give him calcium either, it will not help relieve swelling and itching. On the contrary, it further lowers the patient’s blood pressure, making it even worse.
Antihistamines and steroids should not be given on site, as there are few minutes before the person’s fate can be decided.. The first, often only, option for effective drug intervention in the treatment of anaphylaxis is: if available, immediate administration of adrenaline, even if the full symptom spectrum has not (yet) developed, explains Professor Nékám. This helps prevent the symptoms from getting worse, but it is not a substitute for the patient’s medical care, so an ambulance should be called in this case as well to get the patient to emergency care as soon as possible.
If there is no medicine available on site (this is usually the case), heart massage and air injection should be started immediately, which hopefully more and more people have mastered, they are mastering. This should be started after the telephone help call, even if no further help is available.
For life-saving anaphylaxis: self-injecting adrenaline injection
“Under our current policy, it is mandatory to offer the possibility of obtaining self-injecting adrenaline injections for patients who have already suffered from anaphylaxis. The patient must then always carry this with him. ” In practice, therefore, this means that if you are with a previously diagnosed patient who is experiencing symptoms of anaphylaxis, you should also ask about the adrenaline injection, which should be nearby, in your bag or coat.
The self-injection should be given deep into the thigh muscle, as this is the only way to maximize its effects. Little is known, but more importantly, the needle should only be withdrawn after 8 to 10 seconds (!) After the self-injection has started. Remember that medical help is still needed. Depending on the patient’s condition, additional interventions, such as fluid replacement, oxygenation, may be needed, or the above symptoms may recur after a temporary improvement.
Source: Buda Allergy Center