Anaphylaxis

Abstract

Key Points Anaphylaxis is a systemic reaction that could be mediated by immunologic as well as non-immunologic mechanisms.Anaphylaxis can present with mild symptoms, such as facial swelling and abdominal cramping, to severe symptoms with life-threatening complications, such as respiratory distress and hemodynamic compromise.Diagnosis is clinical and laboratory evaluation is rarely required.Patient may be referred to allergist to identify the inciting or triggering agents and for immunotherapy.Mainstay of treatment is epinephrine 0.01 mg/kg/dose of the 1 mg/mL concentration with maximum dose of 0.3 mg in the prepubertal child and 0.5 mg in the adolescent given intramuscularly, and should be repeated every 5 to 15 minutes as needed.H1-receptor antagonist may be used to treat cutaneous manifestations.Steroids may be useful in patients with lower airway obstruction, asthma, rebound anaphylaxis, or severe anaphylaxis.