The 42-year-old fitness instructor had been shopping alone when she experienced what she knew were the tell-tale signs of an allergic reaction

The 42-year old fitness instructor was shopping alone when she noticed what she believed were signs of an allergic reaction.

After dutifully using the supplied hand sanitiser in a shop last summer, Emma Bennett’s hands started swelling, becoming noticeably bigger as well as incredibly itchy within minutes.

The 42-year-old fitness instructor was shopping alone when she felt what she believed were the signs of an allergic reaction. She asked the shop manager for the ingredients of the sanitizer, but she was unable to find any of her known allergens.

Emma had already experienced an unexpected reaction many times before. It had been happening for years, with unknown triggers.

Yet endless visits to doctors failed to provide a conclusive answer to what Emma was allergic to — a condition known as idiopathic (i.e. No known cause. In Emma’s case, this results in life-threatening reactions that affect the respiratory system within minutes.

From the age of seven, Emma — who lives in Bolton with her husband Stephen, 49, a software engineer, and their son Seon, 11 — has experienced allergic reactions with no obvious cause, which sometimes become life-threatening.

Her first memories of the condition are red, itchy rashes all over her chest.

‘At times the rash would come on three or four times a week, but back then it was not really anything you talked about,’ she says.

She also suffered another attack at age 15, when she was just 15 years old. This time, she went into full anaphylactic stress, again without any obvious cause (known in Idiopathic Anaphylaxis).

Anaphylaxis can be life-threatening and causes the immune system to go into overdrive.

The body then releases powerful chemicals called histamines. These can cause hives, difficulty breathing and swelling of the mouth, tongue, and throat. These chemicals can also lower blood pressure quickly by widening blood vessels. This can lead to loss of consciousness.

Alarmingly though, anaphylaxis can sometimes occur without an allergic cause.

Over the years, doctors advised Emma that her reactions could be triggered by a variety of factors — even the sun — but nothing was ever proven.

It is not that there is no cause, explains Dr Shuaib Nasser, a consultant in asthma and allergic disease at Cambridge University Hospitals, it’s just we haven’t been able to find it yet.

From the age of seven, Emma ¿ who lives in Bolton with her husband Stephen, 49, a software engineer, and their son Seon, 11 ¿ has experienced allergic reactions with no obvious cause, which sometimes become life-threatening

From the age of seven, Emma — who lives in Bolton with her husband Stephen, 49, a software engineer, and their son Seon, 11 — has experienced allergic reactions with no obvious cause, which sometimes become life-threatening

‘Idiopathic simply means that you haven’t defined the cause — all anaphylaxis has a cause whether we are able to recognise it or not,’ he says.

‘It might be that it’s an allergic cause that hasn’t been identified — or that it is a non-allergic cause, such as specific hormone interactions in the body.’

Many people experience minor symptoms of allergic reactions without any clear cause. However, very few suffer from severe idiopathic anaphylaxis.

It’s not clear exactly how many are affected by the condition, ‘but we know it accounts for about a quarter of anaphylaxis in adults’, says Dr Pamela Ewan, a consultant allergist at Addenbrooke’s Hospital in Cambridge.

(Dr Nasser suggests, however, that patients would likely be subject to more extensive testing for triggers in the near future.

Emma experienced a breakthrough diagnosis when she was in her 20s while attending a first-aid course. ‘After doing CPR on the mannequin, I went into full-blown anaphylaxis and became unconscious within a few minutes,’ she recalls. ‘Luckily, doctors had given me an adrenaline auto-injector, an EpiPen, a couple of years earlier.

I was then given an injection by someone and taken to the hospital. This led to my first specific allergy diagnosis — to latex.’

Emma was also diagnosed with an allergy to kiwi several years later. After eating the fruit, Emma experienced an anaphylactic reaction. She was then told that she also has an allergy for some opioid painkillers like morphine or codeine.

Many of her reactions since then, both severe and mild, have not been linked to a cause.

She had many reactions throughout her 20s, 30s, and one of her most memorable was when she was in the supermarket with Stephen.

‘I just felt really, really unwell all of a sudden,’ she says. ‘I said to Stephen, “Something is not right, my hands are itchy and swollen.” I could feel it in my chest and I was clearing my throat a lot. We went straight to the hospital.’

Stephen, her parents, as well as her young son, are EpiPen-trained. (The injections come with instructions so that anyone can use them, but it is often passed on to family members.

The adrenaline injection helps to reverse the symptoms of anaphylaxis — tightening the dilated blood vessels and increasing blood pressure.

The hormone can also relax tightened muscles that make it difficult to breathe. However, this should relieve the symptoms. Patients are advised not to wait to be monitored.

It is very unusual for patients to experience anaphylaxis that is both idiopathic at times, yet also has an identified allergic trigger — as in Emma’s case.

Concerns about idiopathic anaphylaxis were raised after two such reactions to Pfizer’s Covid vaccine in December 2020.

These concerns have led to recent guidance from the Government for caution before using the jab, for anyone with a known allergy to any of its ingredients — notably polyethylene glycol (PEG), a plastic-based compound used in many drugs and healthcare products.

The advice also states that patients who are due to receive the vaccine should take special precautions, such as discussing the inoculation first with an allergy specialist and looking into the possibility of a PEG allergic reaction.

However, Dr Nasser says allergies to PEG are very rare, and not there in ‘the vast majority’ of idiopathic anaphylaxis patients.

Many people with this condition will need to take an antihistamine daily to manage their symptoms. Emma has tried different antihistamines throughout her life. This is because her body gets used to them.

‘I am very cautious — playing it safe all the time,’ says Emma. ‘It’s very scary but one of those things you get used to.’ 

Revolting remedies

You might be surprised at the medical treatments available. This week: Blood to prevent dry vision

About one in seven people over 40 suffers from dry eyes, which can cause pain, discomfort and — in extreme cases — even loss of vision.

Standard treatment is with drops to lubricate the eye, but these can’t completely mimic the protein-rich composition of natural tears.

In fact, a much closer match is blood serum — a yellowish liquid that makes up more than half of our blood.

And in a 2017 trial at Moorfields Private Eye Hospital in Bedford, applying a drop of blood (taken from the patient’s finger) to the eyes was found to improve clarity of sight and reduce inflammation in patients with dry eyes.

Consultant ophthalmologist Anant Sharma, who led the research, says: ‘Serum is expensive but your own blood can be provided cheaply, and immediately.’  

This is what you can do

Premax anti-friction balm (£19.99, 50g, contains natural antibacterial ingredients, including aloe vera extract, to prevent chafing, blisters and infection.

Food for mood

How food can impact your mind. This week: Curry

Curry contains high levels of turmeric — the active ingredient of which, curcumin, has been shown to improve mood.

Murdoch University in Australia found that 500mg of the spice twice daily reduced depression symptoms in as little as four to eight weeks.

‘Turmeric is anti-inflammatory and inflammation is associated with depression,’ says Dr Alexander Sumich, a biological psychologist at Nottingham Trent University.

‘Inflammation affects the brain’s conversion of tryptophan into the mood-boosting serotonin — instead, turning it into picolinic acid, associated with depression.’

As little as a half teaspoon of turmeric a day can reduce inflammation, but for a true anti-depressive effect you’ll need far higher levels via a supplement.