Editing Anaphylaxis (section)

==Signs and symptoms==
[[File:Signs and symptoms of anaphylaxis.svg|thumb|upright=1.5|Signs and symptoms of anaphylaxis]]
Anaphylaxis typically presents many different symptoms over minutes or hours<ref name=EAACI2014/><ref>{{cite journal |vauthors=Oswalt ML, Kemp SF |title=Anaphylaxis: office management and prevention |journal=Immunol Allergy Clin North Am |volume=27 |issue=2 |pages=177–91, vi |date=May 2007 |pmid=17493497 |doi=10.1016/j.iac.2007.03.004|quote=Clinically, anaphylaxis is considered likely to be present if any one of three criteria is satisfied within minutes to hours}}</ref> with an average onset of 5 to 30&nbsp;minutes if exposure is intravenous and up to 2&nbsp;hours if from eating food.<ref name=Rosen2010/> The most common areas affected include: skin (80–90%), [[Respiratory system|respiratory]] (70%), [[Human gastrointestinal tract|gastrointestinal]] (30–45%), heart and [[Circulatory system|vasculature]] (10–45%), and central nervous system (10–15%)<ref name=Review09>{{cite journal |author=Simons FE |title=Anaphylaxis: Recent advances in assessment and treatment |journal=The Journal of Allergy and Clinical Immunology |volume=124 |issue=4 |pages=625–36; quiz 637–8 |date=October 2009 |pmid=19815109 |doi=10.1016/j.jaci.2009.08.025}}</ref> with usually two or more being involved.<ref name=World11/>

===Skin===
[[File:Rash on the chest of a person with anaphylaxis.jpg|thumb|upright=1.3|[[Urticaria]] and flushing on the chest of a person with anaphylaxis]]
Symptoms typically include generalized [[Urticaria|hives]], [[itch]]iness, [[Flushing (physiology)|flushing]], or [[Swelling (medical)|swelling]] ([[angioedema]]) of the affected [[Tissue (biology)|tissues]].<ref name="Samp2006" /> Those with angioedema may describe a burning sensation of the skin rather than itchiness.<ref name=Rosen2010/> Swelling of the tongue or throat occurs in up to about 20% of cases.<ref name=Shock10/> Other features may include a runny nose and swelling of the [[conjunctiva]].<ref name=Aus06/> The skin may also be [[Cyanosis|blue tinged]] because of [[Hypoxia (medical)|lack of oxygen]].<ref name=Aus06/>

===Respiratory===
Respiratory symptoms and signs that may be present include [[Dyspnea|shortness of breath]], [[wheeze]]s, or [[stridor]].<ref name="Samp2006" /> The wheezing is typically caused by spasms of the [[Bronchus|bronchial]] muscles<ref name=Cardio08/> while stridor is related to upper airway obstruction secondary to swelling.<ref name=Aus06>{{cite journal|last=Brown|first=SG|author2=Mullins, RJ |author3=Gold, MS|title=Anaphylaxis: diagnosis and management|journal=The Medical Journal of Australia|date=Sep 4, 2006|volume=185|issue=5|pages=283–9|pmid=16948628|doi=10.5694/j.1326-5377.2006.tb00563.x|hdl=2440/23292|s2cid=39009649|hdl-access=free}}</ref> Hoarseness, pain with swallowing, or a cough may also occur.<ref name=Rosen2010/>

===Cardiovascular===
While [[Tachycardia|a fast heart rate]] caused by low blood pressure is more common,<ref name=Aus06/> a [[Bezold–Jarisch reflex]] has been described in 10% of people, where a [[Bradycardia|slow heart rate]] is associated with [[Hypotension|low blood pressure]].<ref name=CEA11/> A drop in [[blood pressure]] or [[Shock (circulatory)|shock]] (either [[Distributive shock|distributive]] or [[Cardiogenic shock|cardiogenic]]) may cause the feeling of lightheadedness or [[Unconsciousness|loss of consciousness]].<ref name=Cardio08/> Rarely very low blood pressure may be the only sign of anaphylaxis.<ref name=Shock10/>

[[Angina pectoris|Coronary artery spasm]] may occur with subsequent [[myocardial infarction]], [[Cardiac dysrhythmia|dysrhythmia]], or [[cardiac arrest]]<!--  even in the absence of epinephrine use -->.<ref name=World11/><ref name=Review09/> Those with underlying coronary disease are at greater risk of cardiac effects from anaphylaxis.<ref name=Cardio08/> The coronary spasm is related to the presence of [[histamine]]-releasing cells in the heart.<ref name=Cardio08/>

===Other===
Gastrointestinal symptoms may include severe crampy [[abdominal pain]], and vomiting.<ref name="Samp2006" /> There may be confusion, a loss of bladder control or pelvic pain similar to that of [[Uterus|uterine]] cramps.<ref name="Samp2006" /><ref name=Aus06/> Dilation of blood vessels around the brain may cause [[headache]]s.<ref name=Rosen2010/> A feeling of [[anxiety (mood)|anxiety]] or of "impending doom" has also been described.<ref name=World11/>