DEAR DOCTOR K:

My sister-in-law has a bee-sting allergy. What happens if she gets stung? Can it be life-threatening?

DEAR READER:

For someone with such an allergy, a sting can be very serious -- yes, even life-threatening. If left untreated, an allergic person could die within minutes to hours after a bee sting.

Bee-sting allergies -- along with some other allergies, which we'll discuss -- are so serious because they can lead to anaphylaxis, a severe, sometimes life-threatening, allergic reaction. It occurs within minutes of exposure to an allergy-causing substance (allergen). It is also sometimes called anaphylactic shock.

The symptoms of allergies vary widely. They can be annoying but largely harmless -- a runny nose from hay fever, for example. Other times, symptoms can be much worse.

Anaphylaxis is the most severe allergic reaction. When this occurs, the immune system releases chemicals that cause potentially serious symptoms, including:

-- Rapid pulse;

-- Low blood pressure;

-- Dizziness and fainting;

-- Wheezing, difficulty breathing, coughing;v -- Itching or burning sensations of the skin, and hives;

-- Paleness, bluish skin color;

-- Swelling of the lips, tongue or eyes;v -- Chest tightness or chest pain;

-- Gastrointestinal problems;

-- Throat swelling, with a feeling of throat tightness, a lump in the throat or obstructed air flow;

The most dangerous symptoms include low blood pressure and chest pain or tightness. These symptoms can indicate that anaphylaxis has caused the arteries of the heart to go into spasm, a condition that can cause a heart attack. Above all, the swelling of the throat, if severe, can make it hard to breathe.v Bee-sting allergies aren't the only cause of anaphylaxis. Severe food allergies -- eggs, seafood, nuts and peanuts are common culprits -- can lead to anaphylaxis. So can drug allergies, especially to antibiotics in the penicillin and cephalosporin group.

Injected anesthetics, like procaine and lidocaine, can cause anaphylaxis. The same goes for some dyes used in medical diagnostic tests, and latex and rubber products used by health care workers.

Symptoms usually occur within seconds to minutes of the bee sting or other allergen exposure. For some people, symptoms are triggered only if an exposure is followed by vigorous exercise.

Anaphylaxis can improve quickly within a few hours if treated right away. With more serious symptoms, it may take a few days to fully recover after treatment.

Anaphylaxis is usually treated with an epinephrine (adrenaline) injection. Your sister-in-law probably already carries a syringe preloaded with epinephrine, or EpiPen. If she doesn't, she should. An epinephrine injection can keep her throat from swelling shut and suffocating her. I have several patients alive today because they always carried their EpiPen with them.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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