A girl aged 18 years, one day had taken
some cheese in her lunch at 3pm. After 1hour she felt some discomfort
in her abdomen with itching in whole body and mild breathlessness.
The sequences are given below with the treatment.
nausea, followed by vomiting of food eaten. Then itching of some
parts of body followed by small eruptions. Presence of little
thirst. The patient is restless and full of anxiety with breathlessness.
She had experienced such types of reactions earlier after taking
prawn, egg etc. Arsenic alb 30 one dose was given.
There is no vomiting,
only nausea associated with severe abdominal cramps, which lasts
for ten minutes and stopped. Itching of whole body with eruptions
of increasing size continued. More the itching more the chilliness
felt with hot flushing from the body. Ars 200 one dose was given,
waited for 30 minutes but no improvement marked.
All the complaints
were same .Gradually it was marked that when there was severe
spasm with nausea in abdomen there was no itching. Pulsatilla
200 was given, due to spasm in abdomen and itching of whole body
alternate, more the pain and itching more the chilliness internally
but the patient needed open air due to suffocation, no thirst
and evening aggravation.
marked. Gradually the internal chilliness disappeared. There is
hot flushing from the body due to severe itching and red urticarial
eruptions & the patient needs cool air to get relief. Itching
of whole body was continued, the small eruptions coalesces and
big urticarial (angioneurotic oedema) eruptions were formed. Stinging
pain in whole body. There was no thirst. Apis mel 200, one dose
was given. Surprisingly within 20 t030 minutes the hands had taken
rest, the patient became sleepy after great exhaustion. The abdominal
spasm diminished. Towards 9pm the size of the eruptions gradually
started to diminish. At 11pm the urticarias gradually disappeared
& to the next morning there was normal skin.
Gastrointestinal anaphylaxis is a Type
1 hypersensitivity reaction. The sequences of events of Type1
hypersensitivity reactions are, first the antigen is introduced
in the host’s body for the first time in life, no hypersensitivity
reactions occur. After a few weeks, a second dose of same antigen
is repeated, hypersensitivity reactions occur. The reactions clinically
may be anaphylactic shock, urticaria, and so on.
The allergen introduced for the first time
begins to produce IgE antibodies which attach to the surface of
mast cells and basophils forming a complex. Next time when another
dose of antigen is given, the antigen binds with these complex
and degranulation of mast cells or basophils takes place causing
release of histamine, prostaglandine, leukotrienes etc. Histamines
produce vasodilatation and bronchospasm. When histamine release
is small they produce merely local reactions like urticaria. But
when massive amount is released there is massive vasodilatation
producing sharp fall of blood pressure and severe bronchospasm,
which is called anaphylactic shock. For gastrointestinal anaphylaxis
some type foods produce such types of reactions with diarrhea