Not all allergic reactions are alike

Gail Larkin/Emergency By Gail Larkin/Emergency Staten Island Advance
on September 07, 2010 at 8:19 AM, updated September 07, 2010 at 8:22 AM

STATEN ISLAND, N.Y. — Over-the-counter (non-prescription) allergy medications are a popular item, especially this time of year as ragweed and mold levels rise. Allergies are, at best, uncomfortable. At their worst, they can be the source of severe and life-threatening reactions.

Not too long ago, my partner and I received a call for a woman with an anaphylactic reaction. Anaphylaxis is the body’s extreme response to an allergen. In many cases, an anaphylactic reaction can lead to shock and death if not treated promptly.

The patient was at work, went to lunch with a co-worker and purchased a fruit that she neither recognized nor had eaten before. A short time after eating it, she began to experience tightness in her throat, severe itching on her hands, torso, and neck, and swelling of her face and lips.

Fortunately, her co-workers quickly recognized the allergic reaction and called 911, met us at the entrance to her workplace, and escorted us right to the patient. After just one injection of medication, she felt relief.

While extreme reactions such as this don’t happen too often, allergies are a common ailment. How can you tell the difference? When is it time to call 911?

When a substance enters the body, either by mouth, injection, or other route, the body sometimes interprets that substance as harmful and releases chemicals into the blood to fight against it. Not everyone has allergies and, of course, not everyone has the same reaction to an allergen (substance causing the allergy).

Many pollens, dust, and other airborne allergens cause sneezing, itchy eyes, and maybe slight wheezing, but this type of allergy doesn’t often lead to anaphylaxis — a severe overreaction on the body’s part.

When we have an allergy, one of the substances the body will use to fight against it is a chemical called histamine. With simple allergies, the histamine is limited to just a small part of the body. For example, when you inhale pollen, the cells inside the nose may release histamine and cause swelling in an attempt to limit your response to the pollen.

With a more severe reaction, the body releases histamine in much larger quantities and throughout the body. This may cause a much greater reaction and swelling may now occur all over the body, including the airway, throat and lungs. It also may cause the blood vessels throughout the body to dilate (get larger), causing an extreme drop in blood pressure.

Hives and itching, watery eyes, sneezing, itchy throat, and wheezing can also be blamed on a histamine response.

Most people take something to limit the body’s histamine release: antihistamines. In some cases, though, this is done too late or the response is so great that over-the-counter antihistamines just aren’t enough.


Most of us have experienced the annoying sneeze and runny nose or itchy eyes. How is an anaphylactic reaction different? First, it can be life threatening. If you suspect you are having an extreme allergic (anapylactic) reaction, call 911 immediately.

Some signs that your allergy may be more than the usual reaction:

*Sudden onset of hives, often all over the body;

*Redness or flushing of the face, neck, torso;

*Swelling of the face, tongue, lips, throat, or a sensation of this swelling (it may be all internal and difficult to see);

*Sudden onset of wheezing or trouble breathing;


*Ringing in the ears


Any substance can cause a severe allergic reaction, even if you’ve never been allergic to it before.

Some of the more common substances include:



*Peanuts, peanut butter, other peanut products;
    Pit fruit (i.e., peaches, plums, avocado, etc);

*Seeds and tree nuts (i.e., cashews, walnuts, hazelnuts, etc);

*Bees and other stinging insects/animals including some jellyfish, wasps, fire ants;


Reactions can occur through inhalation, ingestion, injection and skin contact. In general, the faster the onset, usually the more severe the reaction may be.