Anaphylaxis Questions & Answers

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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Questions & Answers

Overview

What is anaphylaxis?

How does the presentation of anaphylaxis vary between children and adults?

What are the signs and symptoms of anaphylaxis?

What is the first priority in the physical exam for anaphylaxis?

Which physical findings are characteristic of anaphylaxis?

What is the role of lab studies in the diagnosis of anaphylaxis?

What is the role of skin testing and in vitro immunoglobulin E (IgE) testing in the diagnosis of anaphylaxis?

How is anaphylaxis managed?

What is included in the supportive care for suspected anaphylaxis?

Which medications are used in the treatment of anaphylaxis?

When is surgery indicated for the treatment of anaphylaxis?

What is the term anaphylaxis derived from?

What is anaphylaxis?

What are the most common organ systems involved in anaphylaxis?

How is anaphylaxis diagnosed?

Which lab tests are performed in the evaluation of anaphylaxis?

Why is immediate recognition of anaphylaxis important?

How is anaphylaxis categorized?

What is the pathophysiology of anaphylaxis?

What are the cardiovascular effects of anaphylaxis?

What are the classic symptoms of anaphylaxis?

Which mediators activate pathways of inflammation in the pathogenesis of anaphylaxis?

What is the role of cytokines in the pathogenesis of anaphylaxis?

What are lipid-derived mediators involved in the pathogenesis of anaphylaxis?

What is the role of histamine in the pathogenesis of anaphylaxis?

What are the cardiac complications of anaphylaxis?

What is the role of calcitonin gene-related peptide (CGRP) in the pathogenesis of anaphylaxis?

What is the physiologic response to hypovolemia in anaphylaxis?

What causes bradycardia in individuals with anaphylaxis?

What is the classic form of anaphylaxis?

Which types of anaphylaxis do not involve immunoglobulin E (IgE)?

Which mediators are released in anaphylaxis?

Which agents are believed to cause direct nonimmunologic release of anaphylaxis mediators from mast cells?

What are the most common inciting agents in anaphylaxis?

What are the common causes of immunoglobulin E (IgE)-mediated anaphylaxis?

What is the prevalence of anaphylaxis caused by hypersensitivity to foods?

Which foods are most likely cause anaphylaxis?

How frequently are foods the cause of anaphylaxis?

What are the guidelines for administration of the influenza vaccine in patients with egg allergies?

Which disorder may mimic anaphylaxis?

Which medications are the most common cause of drug-induced anaphylaxis?

How does penicillin cause anaphylaxis?

What is the prevalence of cephalosporin -caused anaphylaxis in individuals allergic to penicillin?

How does a penicillin allergy increase the risk of anaphylaxis from other drugs?

What are the guidelines for the use of cephalosporins in patients with a history of immunoglobulin E (IgE)-mediated reactions to penicillin?

Which drugs can cause immunoglobulin E (IgE)-mediated anaphylaxis?

What is the mortality rate associated with hymenoptera sting anaphylaxis in the US?

What precautions are needed following the treatment of hymenoptera sting anaphylaxis?

What is the mortality rate of allergen-specific subcutaneous immunotherapy (SCIT) caused anaphylaxis?

What are the risk factors for anaphylaxis due to immunotherapy?

How common are near-fatal reactions (NFRs) to immunotherapy caused anaphylaxis?

How are reactions to aspirin and NSAIDs classified?

What is the initial reactions in aspirin/NSAID anaphylaxis?

What is the mechanism for anaphylaxis after taking aspirin and NSAIDs?

How frequently is anaphylaxis caused by NSAIDs?

How frequently do ACE inhibitors cause anaphylaxis?

What immunologic immunoglobulin E (IgE)-independent reactions cause anaphylaxis?

What is exercise-induced anaphylaxis?

What is the etiological relationship between anaphylaxis and systemic mastocytosis?

Which agents cause direct, nonimmunologic release of anaphylaxis mediators?

How is an anaphylactoid reaction to radiocontrast agents managed?

Which patients are at an increased risk of an anaphylactoid reaction to radiocontrast agents?

What is the role of shellfish and iodine in the etiology of anaphylactoid reaction to radiocontrast agents?

What is the likelihood of anaphylactoid reaction to radiocontrast agents during GI procedures?

What is idiopathic anaphylaxis?

How does the prevalence of idiopathic anaphylaxis vary by sex?

What is catamenial anaphylaxis?

What is biphasic (recurrent) anaphylaxis?

What is persistent anaphylaxis?

How should patients with biphasic or persistent anaphylaxis be monitored following treatment?

What are the risk factors for anaphylaxis?

How does the interval between exposures affect the risk of anaphylaxis?

Which medications increase the risk of multiple organ system involvement in anaphylaxis?

What is the incidence of anaphylaxis?

What is the prevalence of anaphylaxis?

What is the relative risk for anaphylaxis in the US?

What is the incidence of anaphylaxis in the US?

How do the risk factors for anaphylaxis vary between locations?

What is the global incidence of anaphylaxis?

What are the age predilections of anaphylaxis?

How does the incidence of anaphylaxis vary by sex?

What are the mortality rates for anaphylaxis?

What is the prognosis of anaphylaxis caused by reactions to foods?

What is the prognosis of anaphylaxis caused by conventional radiocontrast media (RCM)?

What are common causes of anaphylaxis in the United Kingdom?

What causes death in anaphylaxis?

How quickly can death occur from anaphylaxis?

What are risk factors for fatal anaphylaxis?

How does posture affect anaphylaxis outcomes?

How likely are multiple episodes of anaphylaxis?

What are the available doses for epinephrine autoinjector for the emergent treatment of anaphylaxis?

What is the role of avoidance education in the prevention of food-related anaphylaxis?

What should be given to patients with sensitivity to multiple antibiotics to prevent anaphylaxis?

What should be included in anaphylaxis avoidance education for patients with hypersensitive to insect stings?

What is included in anaphylaxis education for patients sensitive to Hymenoptera?

What are the treatment guidelines for insect sting sensitivity?

What is included in the patient information for epinephrine autoinjector in the treatment of anaphylaxis?

What emergency medical information should patients receive about anaphylaxis?

What is the role of placebo syringes in the patient education of anaphylaxis?

Presentation

What is anaphylaxis?

What are the signs and symptoms of anaphylaxis?

What are the upper respiratory tract symptoms of anaphylaxis?

What is the progression of symptoms in anaphylaxis?

What is the onset of symptoms of anaphylaxis following exposure to trigger?

How is the causative agent identified in anaphylaxis?

What is the first priority in the physical exam of anaphylaxis?

What are the general appearance and vital signs characteristic of anaphylaxis?

What are the respiratory findings characteristic of anaphylaxis?

What are the cardiovascular findings characteristic of anaphylaxis?

What are the cognitive findings characteristic of anaphylaxis?

What is the classic cutaneous presentation of anaphylaxis?

What are the cutaneous findings characteristic of anaphylaxis?

What are the GI findings characteristic of anaphylaxis?

What are the possible complications of anaphylaxis?

DDX

What are the clinical criteria used to diagnosis anaphylaxis?

What is the risk of a delayed diagnosis of anaphylaxis?

Which conditions should be included in the differential diagnoses of anaphylaxis?

What are the differential diagnoses for Anaphylaxis?

Workup

How is anaphylaxis diagnosed?

When are lab studies performed for the diagnosis of anaphylaxis?

What is the role of histamine measurement in the diagnosis of anaphylaxis?

What is the role of serum mature tryptase measurement in the diagnosis of anaphylaxis?

What is the significance of baseline levels of total tryptase in the evaluation of anaphylaxis?

What is the correlation between histamine and tryptase levels in anaphylaxis?

What are useful biomarkers for the detection of anaphylaxis?

When is the measurement of 5-Hydroxyindoleacetic acid levels indicated in the evaluation of anaphylaxis?

When is skin testing for food allergens indicated in the evaluation of anaphylaxis?

What is the role of penicillin skin testing in the evaluation of anaphylaxis?

When skin testing for Hymenoptera venom sensitivity indicated in the evaluation of anaphylaxis?

What are the challenges in testing for suspected insect bite or sting causing anaphylaxis?

What is the role of skin testing and/or in vitro immunoglobulin E (IgE) tests in the evaluation of anaphylaxis?

What is the negative predictive value of food allergen skin testing in the evaluation of anaphylaxis?

What is the role of a controlled food challenge of in the evaluation of anaphylaxis?

In the NIAID treatment guidelines for food allergies, which tests are not recommended for the diagnosis of anaphylaxis?

What is the role of intradermal skin testing and IgG RAST tests in the diagnosis of anaphylaxis?

What actions should be taken once the results of a penicillin skin are known?

Which medications should be considered for skin testing in the evaluation of anaphylaxis?

When should skin testing and in vitro immunoglobulin E (IgE) tests be performed for the diagnosis of anaphylaxis?

Which tests are performed to diagnose immunoglobulin E (IgE)-independent reactions causing anaphylaxis?

Treatment

What are the treatment approaches for anaphylaxis?

What should be included in prehospital treatment of severe anaphylaxis?

When is hospitalization indicated in the treatment of anaphylaxis?

Where can guidelines for the diagnosis and management of anaphylaxis be found?

What are the guidelines for initial treatment of anaphylaxis in the emergency department (ED)?

What is included in the initial assessment of anaphylaxis?

How is the airway maintained in patients with anaphylaxis?

What is the role of standard rapid sequence induction (RSI) techniques in the treatment of anaphylaxis?

What is the role of cricothyrotomy or catheter jet ventilation in the treatment of anaphylaxis?

How is wheezing or stridor managed in patients with anaphylaxis?

What is the role of corticosteroids in the treatment of anaphylaxis?

How is bradykinin-mediated angioedema managed in patients with anaphylaxis treated?

When is cardiac monitoring indicated in the management of anaphylaxis?

Why is IV access needed in the treatment of anaphylaxis?

What is the role of epinephrine in the treatment of anaphylaxis?

How is epinephrine administered in the treatment of anaphylaxis?

What is the role of antihistamine therapy in the treatment of anaphylaxis?

How are histamine blockers administered for the treatment of anaphylaxis?

What is the immediate effect of corticosteroids on anaphylaxis?

What is the prognosis of anaphylaxis treated with antihistamines and steroids?

Which outpatient medications should be administered following treatment of anaphylaxis?

What is the role of prednisone in the treatment of anaphylaxis?

Which medication regimens are commonly used in the treatment of anaphylaxis?

What is the corticosteroid treatment regimen commonly used in the treatment of anaphylaxis?

What is the histamine 2 (H2)-blocker antihistamine treatment regimen for anaphylaxis?

How is frequent idiopathic anaphylaxis treated?

What is included in antihistamine therapy for anaphylaxis?

Why is it important to maintain a proper blood pressure during treatment of anaphylaxis?

Which intervention should follow epinephrine in the treatment of anaphylaxis?

What are the treatment precautions for patients with preexisting heart disease and anaphylaxis?

What medications are used to manage blood pressure during the treatment of anaphylaxis?

What are the role of glucagon in the treatment of anaphylaxis?

How are GI symptoms managed during the treatment of anaphylaxis?

What is the role of short-term desensitization procedures in the treatment of anaphylaxis?

Which specialist should be consulted for the administration of short-term desensitization protocols in the treatment of anaphylaxis?

What is a typical desensitization protocol for the treatment of anaphylaxis?

What are the limitations to desensitization for the treatment of anaphylaxis?

What is the role of anti-immunoglobulin (IgE) in the treatment of anaphylaxis?

What is the indication for inpatient care of anaphylaxis?

When is treatment of anaphylaxis considered successful?

When is hospital admission indicated for the treatment of anaphylaxis?

When is ICU admission indicated for the treatment of anaphylaxis?

How are persistent bronchospasm managed during the treatment of anaphylaxis?

What is the duration of antihistamine and oral glucocorticoid therapy for the treatment of anaphylaxis?

How is anaphylaxis prevented?

What is the role of anti-immunoglobulin E (IgE) in the prevention of anaphylaxis?

What is the role of premedication regimens in the prevention of anaphylaxis?

What measures should be taken by patients at risk of recurrent anaphylaxis?

What are the options for patients at risk of anaphylaxis caused by radiocontrast media?

What is the efficacy of prophylactic corticosteroids and antihistamines regimens against anaphylaxis caused by radiocontrast media?

What is the prophylaxis regimen against anaphylactic reactions to radiocontrast media?

What are the dietary considerations for patients with anaphylaxis?

Which specialist consultations are needed for the management of anaphylaxis?

What is the most important aspect of outpatient follow-up after treatment of anaphylaxis?

What must be emphasized in the long-term monitoring following treatment of anaphylaxis?

Medications

What are the primary drug treatments for acute anaphylaxis?

Which medications in the drug class Vasopressors are used in the treatment of Anaphylaxis?

Which medications in the drug class Positive Inotropic Agents are used in the treatment of Anaphylaxis?

Which medications in the drug class Corticosteroids are used in the treatment of Anaphylaxis?

Which medications in the drug class Bronchodilators are used in the treatment of Anaphylaxis?

Which medications in the drug class H2 Receptor Antagonists are used in the treatment of Anaphylaxis?

Which medications in the drug class Antihistamines are used in the treatment of Anaphylaxis?

Which medications in the drug class Adrenergic Agonists are used in the treatment of Anaphylaxis?