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ANAPHYLAXIS
DEFINITION
• Anaphylaxis: “An acute, systemic, immediate hyper-sensitivity reaction
caused by IgE-mediated immunologic release of mediators from mast
cells and basophils.”

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INCIDENCE
• The exact incidence of anaphylaxis is unknown
• Based on data gleaned from real-time prescriptions for automatic
epinephrine injectors, as much as 1% of the population may be at risk
for anaphylaxis
• Risk Factor: presence of atopy, asthma, menarche, female gender,
geographic location (more frequent in higher latitudes in the upper
hemisphere and lower latitudes in the lower hemisphere -> diminishing
exposure to sunlight)

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PATHOGENESIS AND PATHOPHYSIOLOGY
• Mediators: histamine, neutral, proteases, proteoglycans,
chemoattractants, nitric oxide, interleukins, and other cytokines
• Effect: vasodilatation, increased vascular permeability, smooth muscle
constriction, irritation of afferent sensory nerves, and chemotaxis

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CLINICAL MANIFESTATION

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DURATION
• Uniphasic: rapid onset, and symptoms subside within an hour or two and
do not return
• Biphasic: recurrence of symptoms after resolution of the initial episode.
• Protracted: last hours and, in rare instances, even days

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SUBSTANCES

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COMMON TYPES OF ANAPHYLAXIS
• Natural rubber latex-induced anaphylaxis
• Exercise-induced anaphylaxis
• Idiopathic anaphylaxis
• Radiocontrast media
• Systemic mastocytosis

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LABORATORY TEST

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MANAGEMENT
1. Approach to the patient with anaphylaxis following the event

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MANAGEMENT
2. Prevention

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MANAGEMENT
3. Treatment of the acute event

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• Equipment

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DRUGS

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SOURCES
• Manual of Allergy and Immunology – Lippincott, 5th Edition
• Robbins and Cotran Pathologic Basis of Disease, 9th Edition

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