idiopathic anaphylaxis information center

a resource for people with ia and other mast cell disorders

Anaphylaxis: What are the symptoms?

How can we tell if someone is having anaphylaxis?

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Anaphylaxis can affect at least four systems in the body: Skin, respiratory, cardiovascular, and digestive.

Most frequently, an episode of anaphylaxis will begin with symptoms that involve the skin or breathing. Reference [Ring J, Behrendt H, de Weck A. History and classification of anaphylaxis. Chem Immunol Allergy. 2010; 95:6]. The general rule is that once symptoms like these appear in two or more systems of the body (for example, skin and circulation), what is happening should be identified as anaphylaxis. Reference [Ring J, Brockow K, Behrendt H. History and classification of anaphylaxis. In: Bock G, Goode J, eds. Anaphylaxis. Novartis Foundation Symposium 257. Hoboken, NJ: John Wiley & Sons, Ltd. 2004; 6–16; discussion –24].

Illustration of 4 bodily systems affected by anaphylaxis — skin, respiratory, cardiovascular, and digestive — created by Candace Van Auken using figure from Wikimedia Commons

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The symptoms of anaphylaxis are listed below. Most often a person will have a subset of these symptoms rather than every single one.

Table: Symptoms of anaphylaxis

Body systemSpecific symptoms
Skin General Flushing. Itching. Hives. Swelling. A measles-like rash. Goose bumps or raised hair on neck, back, arms, etc.
Mouth Itchiness or tingling of lips, tongue, and roof of mouth. Metallic taste in mouth. Swelling of lips, tongue, palate, or dangling edge of soft palate (uvula).
Eyes Itchiness, redness, and swelling around eyes. Red, itchy eyes. Tearing.
Breathing Laryngeal Itching and tightness in the throat. Swallowing difficult or impossible. Hoarseness or difficulty speaking. A dry, disjointed cough. A high-pitched sound when inhaling. An inability to take in enough oxygen. Itchiness in the ears.
Lung Shortness of breath. Labored breathing. Chest tightness. Deep cough and wheezing. Lack of oxygen.
Nose Itching. Congestion. Runny nose. Sneezing.
Circulation Blood pressure Symptoms of low blood pressure (dizziness, light headedness, blurred vision, increased pulse). Collapse. Loss of bladder or bowel control.
Faintness Feeling of faintness. Fainting. Confusion.
Heart Chest pain. Abnormal heart rhythm.
Digestion GI Sick to stomach (nausea). Painful abdominal cramps. Throwing up (vomiting). Diarrhea.
Other Labor-like uterine contractions (in women). A feeling of impending doom. Seizures.

References for the table: Sampson-05 [Sampson HA, Muñoz-Furlong A, Bock SA, Schmitt C, Bass R, Chowdhury BA, et al. Symposium on the definition and management of anaphylaxis: Summary report. J Allergy Clin Immunol 2005; 115:8], Wyatt [Wyatt R. Anaphylaxis: How to recognize, treat, and prevent potentially fatal attacks. Postgraduate Medicine Online 1996; 100:87–104], Sampson-06 [Sampson HA, Muñoz-Furlong A, et al. Second symposium on the definition and management of anaphylaxis: Summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006; 117:7], Simons [Simons FER. Anaphylaxis. J Allergy Clin Immunol. 2010; 125:S161–81], and Alcoceba [Alcoceba E, Gonzalez M, Gaig P, Figuerola E, Auguet T, Olona M. Edema of the uvula: Etiology, risk factors, diagnosis, and treatment. [Case report] J Investig Allergol Clin Immunol. 2010;20(1):80–83].

For a more in-depth discussion of these symptoms and the diagnosis of anaphylaxis, please see the article, "But is it anaphylaxis?" in the Articles section of this web site.

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Page last updated: May 16, 2011

All information contained in this site is one layperson's interpretation of medical journal articles, textbooks, seminars, presentations, and other materials. Nothing that is stated here should carry more weight than the informed and considered opinions of your own highly trained and qualified medical caregivers. The author of this site is not a doctor and has absolutely no authority to prescribe or diagnose.

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