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Anaphylaxis and Serious Allergies

Part 2 of a series on allergies focuses on life-threatening allergies. When should you worry about them and what should you do for them?

By
Rob Lamberts, MD,
Episode #046

Last week I discussed seasonal allergies and the condition called allergic rhinitis, in which pollen, a substance that is not at all a threat to the body, is mistaken for something that is dangerous. As the immune system mistakenly defends us from pollen, it releases substances make us sneeze, itch, and basically feel lousy.

But some allergies are much more than a nuisance; they can kill.  Imagine what would happen if the armed forces suddenly thought all men named Larry within our borders were dangerous and so started raiding New Jersey, bombing Idaho, or sending paratroopers to capture Amarillo, Texas. The consequences of such a mistake would be a threat to the country, and likewise the consequences of the mistaken allergic response can also be life-threatening. 

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Why are Allergies Getting Worse?

Before discussing the specific allergies, I need to back up and answer a question that we discussed on Facebook: Why are allergies are getting worse? Scientific data supports the fact that more people are having allergies, and these levels are increasing over time. Why, in a world where we are more clean and sterile, where we are exposed to less serious disease than ever in human history, are our immune systems getting confused and attacking things that aren’t even a threat?

One of the most popular theories as to why allergies are on the rise is the hygiene hypothesis, which suggests that the relative sterility of our environment is causing worse allergies. It seems that we are not keeping our immune systems busy enough and so they are inventing things to do. Evidence supporting this theory includes:

  • Immigrants from developing countries see a sharp rise in allergies when coming to industrialized countries

  • Children in larger families have less allergies than do only children

  • People with certain parasitic infections have a much lower rate of allergies and asthma (A very interesting episode of This American Life describes a man who was cured of severe allergies by getting a hookworm infection on purpose!)

So am I suggesting that we should imitate that gross guy at work who doesn’t believe in hygiene? No, but I am suggesting that perhaps our obsession with avoiding all germs is extreme. 

What Is Anaphylaxis?

The most serious and potentially life-threatening allergic reaction is a condition known as anaphylaxis. Anaphylaxis happens when an allergen is recognized by antibodies, which you’ll recall from last week’s article are special proteins in the body that recognize invaders. When antibodies mistakenly identify a normally benign substance—like peanuts-- as an invader in the body, the antibodies immediately combine with certain white blood cells, releasing histamine and other substances that have a profound effect on the body.

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