9. Anaphylaxis

Anaphylaxis is an acute-onset, potentially fatal systemic allergic reaction. It is usually triggered by an agent such as an insect sting, food, or medication, through a mechanism involving IgE and the high-affinity IgE receptor on mast cells or basophils. Less commonly, it is triggered through other...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2008-02, Vol.121 (2), p.S402-S407
Main Author: Simons, F. Estelle R., MD, FRCPC
Format: Article
Language:English
Subjects:
adrenaline
Age
allergic reaction
Allergies
Allergy and Immunology
Anaphylaxis
Anaphylaxis - diagnosis
Anaphylaxis - etiology
Anaphylaxis - physiopathology
Anaphylaxis - therapy
basophil
epinephrine
Epinephrine - administration & dosage
Epinephrine - therapeutic use
Fatalities
FcɛRI
Food
food allergy
H 1-antihistamine
histamine
Humans
IgE
Immunologic Tests
Injections
mast cell
medication allergy
Pathogenesis
Risk assessment
Risk Reduction Behavior
tryptase
venom allergy
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Description
Summary:Anaphylaxis is an acute-onset, potentially fatal systemic allergic reaction. It is usually triggered by an agent such as an insect sting, food, or medication, through a mechanism involving IgE and the high-affinity IgE receptor on mast cells or basophils. Less commonly, it is triggered through other immunologic mechanisms, or through nonimmunologic mechanisms. It often occurs in community settings. Anaphylaxis episodes range in severity from those that are mild and resolve spontaneously to those that are fatal within minutes. The clinical diagnosis is based on a meticulous history and physical examination, sometimes, but not necessarily, supported by a laboratory test such as an elevated serum total tryptase level. Sensitization to allergen triggers suggested by the history needs to be confirmed by skin testing and measurement of allergen-specific IgE. In some sensitized individuals, additional tests are needed to assess the risk of future anaphylaxis episodes. Prompt injection of epinephrine is life-saving. H1 -antihistamines and inhaled β2 -adrenergic agonists cannot be depended on to prevent fatality. Long-term risk reduction is an integral part of management.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2007.08.061