Anaphylaxis is a severe allergic reaction, and it requires emergency attention: Untreated anaphylactic episodes can result in death. Patients with systemic mastocytosis (SM) are at a higher risk of developing anaphylaxis. Knowing the signs can help you recognize when you need to find help — and can’t wait.
Read more about systemic mastocytosis testing and diagnosis
Understanding anaphylaxis and systemic mastocytosis
In SM, the risk of anaphylaxis is significantly higher than it is in the general population. While in most people anaphylaxis occurs as a reaction to food or drugs, in patients with SM anaphylaxis can be due to a long list of triggers, especially insect stings and exercise.
This is because anaphylaxis in SM is driven by a high mast cell burden. When triggered, these overactive mast cells release histamines into the body, causing a continuous allergic reaction.
What is a mast cell?
Mast cells are specialized cells of the immune system that mediate inflammatory responses and allergic reactions. They are found in the body’s connective tissue.
For the most part, once people without a mast cell disorder know something might cause anaphylaxis, they can avoid it — such as someone with a shellfish allergy steering clear of scallops and shrimp. In SM, however, a longer list of symptom triggers and the body’s response to them can mean recurrent episodes of anaphylaxis are much more common.
When to go to the ER for anaphylaxis
Even with careful avoidance of triggers, anaphylaxis can still happen.
You may be suffering from anaphylaxis if you have:
- Difficulty breathing, including throat tightness.
- Swelling of the skin, itching and redness.
- A rapid heart rate, possibly accompanied by dizziness and fainting.
- Nausea and vomiting.
- Feeling a sense of panic and impending doom.
Some of these symptoms may be completely unrelated to an allergic reaction. For example, many patients with SM have periodic episodes of itching. Similarly, nausea and vomiting can be caused by something as innocuous as car sickness.
The danger is when most of these symptoms appear all at once. If you already know that you have allergies, new symptoms such as difficulty breathing are a huge red flag.
If these symptoms appear suddenly, call emergency services immediately. You don’t need to be a medical expert or have an anaphylaxis diagnosis to know that getting help is the safest choice.
Do not attempt to go to the hospital yourself, because you may face traffic delays or worsening symptoms on the way. In anaphylactic episodes, time is of the essence.
If you have an EpiPen, now is the time to use it. An epinephrine autoinjector is a medical device containing adrenaline that you can inject into your thigh or abdomen to halt the progression of a severe allergic reaction. If you use an EpiPen, you still need to go to the hospital: An EpiPen can help buy you time, but it doesn’t mean the danger has passed.
Once you are in emergency care, doctors will administer therapies to rapidly stabilize your condition. After you have recovered, your doctor will discuss the likely causes of your symptoms and ways to avoid them in the future.
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