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Anaphylaxis
Classification and external resources

A rash on the back of a person with anaphylaxis.
ICD-10 T78.2
DiseasesDB 29153
eMedicine med/128
MeSH D000707
.Anaphylaxis is an acute multi-system severe type I hypersensitivity reaction.^ Severe allergic reaction - ANAPHYLAXIS .
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

^ A severe, often fatal, type I allergic reaction is known as anaphylaxis.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ Type of hypersensitivity reaction: .

.The term comes from the Greek words ανα ana (against) and φύλαξις phylaxis (protection).^ Phylaxis, a word seldom used, stands in the Greek for protection.

^ The term comes from the Greek words ανα ana (against) and φύλαξις phylaxis (protection).
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ They named this response anaphylaxis , which is derived from the Greek words a - ( against ) and – phylaxis ( immunity , protection ).
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[1]
.Due in part to the variety of definitions, between 1% and 15% of the population of the United States can be considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens.^ Due in part to the variety of definitions, between 1% and 15% of the population of the United States can be considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ It is considered the "shock" part of anaphylactic shock.
  • Goat-Link.com - Anaphylactic Shock 9 February 2010 12:37 UTC goat-link.com [Source type: General]

^ Due in part to the variety of definitions, between 1% and 15% of the population of the United States can be considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens, especially penicillin and insect stings.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.Of those people who actually experience anaphylaxis, up to 1% may die as a result.^ Of those people who actually experience anaphylaxis, up to 1% may die as a result.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ In the United States, it is estimated that more than 40 people per year die from insect sting anaphylaxis (1).
  • Case Based Pediatrics Chapter 10 February 2010 11:17 UTC www.hawaii.edu [Source type: Academic]

^ Records show that 20 people a year die as a result of anaphylaxis although allergy experts believe the true figure may be higher as it is likely that some deaths attributed to asthma may actually have been triggered by food allergies.
  • How a prawn salad at Royal Ascot nearly killed me, by TV news beauty Kate Silverton | Mail Online 9 February 2010 12:37 UTC www.dailymail.co.uk [Source type: General]

[2] .Anaphylaxis results in approximately 1,500 deaths per year in the U.S.[3][4] In England, mortality rates for anaphylaxis have been reported as up to 0.05 per 100,000 population, or around 10-20 a year.^ More than 100 deaths per year are reported in the United States.
  • Anaphylaxis: eMedicine Emergency Medicine 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ The rate of fatal anaphylaxis is approximately 4 deaths per 10 million people per year.

^ Anaphylaxis to foods and insect stings each account for about 100 deaths per year.
  • Cecil's Textbook of Medicine: Systemic Anaphylaxis, Food Allergy, and Insect Sting Allergy: Definition 10 February 2010 11:17 UTC www.merckmedicus.com [Source type: Academic]

[5] Anaphylactic reactions requiring hospital treatment appear to be increasing, with authorities in England reporting a threefold increase between 1994 and 2004.[6]
.Based on the pathophysiology anaphylaxis can be divided into "true anaphylaxis" and "pseudo-anaphylaxis" or "anaphylactoid reaction."^ Lieberman, P. Anaphylaxis and anaphylactoid reactions.
  • Pathophysiology of anaphylaxis 9 February 2010 12:37 UTC www.uptodate.com [Source type: Academic]

^ Lieberman P. Anaphylaxis and anaphylactoid reactions.
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

^ Based on the pathophysiology anaphylaxis can be divided into "true anaphylaxis" and "pseudo-anaphylaxis" or "anaphylactoid reaction."
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.The symptoms, treatment, and risk of death are the same, however "true" anaphylaxis is caused by degranulation of mast cells or basophils mediated by immunoglobulin E (IgE), and pseudo-anaphylaxis occurs without IgE mediation.^ Anaphylaxis - causes, symptom, treatment of Anaphylaxis diseasesatoz.com .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylaxis is mediated by immunoglobulin E (IgE), while anaphylactoid reactions are not.
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

^ Certain drugs cause IgE-mediated anaphylaxis.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[7]

Contents

Classification

Biphasic anaphylaxis

.Biphasic anaphylaxis is the recurrence of symptoms within 72 hours with no further exposure to the allergen.^ Anaphylaxis symptoms usually occur within minutes of exposure to an allergen.
  • OhioHealth - Anaphylaxis 10 February 2010 11:17 UTC www.ohiohealth.com [Source type: FILTERED WITH BAYES]

^ Biphasic anaphylaxis is the reoccurrence of symptoms within 72 hours with no further exposure to the allergen.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Fish Latex Penicillin or any drug or injection Muscle relaxants Alcohol Exercise, often after consumption of an allergy-provoking food Anaphylaxis occurs usually within minutes of exposure to the allergen and almost always within two hours.
  • GHI - Health & Wellness: Anaphylaxis (The Basics) 9 February 2010 12:37 UTC www.ghi.com [Source type: Academic]

.It occurs in between 1–20% of cases depending on the study examined.^ It occurs in between 1–20% of cases depending on the study examined.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ In our study this factor is related to 9% of the total episodes and in 20% of the cases occurring in patients more than 8 years old.
  • Anaphylaxis in Children: Clinical and Allergologic Features -- Novembre et al. 101 (4): e8 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ Food-dependent, exercise-induced anaphylaxis: a study on 11 Japanese cases.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

[8] .It is managed in the same manner as anaphylaxis.^ The same ABC mnemonic can be used for the pharmacologic management of anaphylaxis: .
  • World Allergy Organization | Allergic Diseases Resource Center 10 February 2010 11:17 UTC www.worldallergy.org [Source type: Academic]

[9]

Anaphylactic shock

.Anaphylactic shock is anaphylaxis associated with systemic vasodilation which results in low blood pressure.^ Low blood pressure d.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylactic shock is also characterized by a sudden drop in blood pressure.
  • NCH Healthcare ~ Health Information 9 February 2010 12:37 UTC www.nchmd.org [Source type: Academic]

^ Low blood pressure .
  • Treat for Shock 9 February 2010 12:37 UTC www.medtrng.com [Source type: Academic]

Pseudoanaphylaxis

.The presentation and treatment of pseudoanaphylaxis is similar to that of anaphylaxis.^ PubMed ] Netzel MC. Anaphylaxis: clinical presentation, immunologic mechanisms, and treatment.
  • Anaphylactic shock: mechanisms and treatment. 9 February 2010 12:37 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Furthermore, it is necessary to note that the present study looks at pretreatment with various drugs in anaphylaxis, and that the results might not be applicable to treatment of anaphylaxis after onset of shock.
  • Role of autacoids in cardiovascular collapse in anaphylactic shock in anesthetized dogs -- Mink et al. 43 (1): 173 -- Cardiovascular Research 9 February 2010 12:37 UTC cardiovascres.oxfordjournals.org [Source type: Academic]

^ Acute Management of Food Anaphylaxis Treatment of food-induced anaphylaxis is similar to treatment of anaphylaxis as a result of other causes.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

.It however does not involve an allergic reaction but is due to direct mast cell degranulation.^ It however does not involve an allergic reaction but is due to direct mast cell degranulation.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ S4 F ) and mast cell degranulation ( Fig.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

^ The basic mechanism underlying allergic reactions is mast cell degranulation and mediator release.

[10] .This can result from morphine, radiocontrast, aspirin and muscle relaxants.^ Earlier studies have suggested that episodes of anaphylaxis to intravenous muscle relaxants, aspirin, and latex are more common in women, while insect sting anaphylaxis is more common in men.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[11]

Active anaphylaxis

Active anaphylaxis is what is naturally observed. .Two weeks or so after an animal including human is exposed to certain allergens, active anaphylaxis (which is simply called "anaphylaxis") would be elicited upon exposure to the same allergens.^ Once you have anaphylaxis, you will not necessarily have it again even with exposure to the same allergen.
  • Anaphylaxis - Sevananda 10 February 2010 11:17 UTC www.sevananda.coop [Source type: FILTERED WITH BAYES]

^ Fish Latex Penicillin or any drug or injection Muscle relaxants Alcohol Exercise, often after consumption of an allergy-provoking food Anaphylaxis occurs usually within minutes of exposure to the allergen and almost always within two hours.
  • GHI - Health & Wellness: Anaphylaxis (The Basics) 9 February 2010 12:37 UTC www.ghi.com [Source type: Academic]

^ Anaphylactic shock, also called anaphylaxis, is a severe, life-threatening reaction to certain allergens.
  • NCH Healthcare ~ Health Information 9 February 2010 12:37 UTC www.nchmd.org [Source type: Academic]

Passive anaphylaxis

.Passive anaphylaxis is induced in naive animals which receive transfer of the serum experimentally from sensitized animals with certain allergens.^ Shock is said to evolve from reversible to irreversible in experimental hemorrhagic shock involving certain animal species (dogs, rats, mice) that develop intense vasoconstriction of the gut.

^ The allergological evaluation performed in our patient showed strong sensitivity to amoxycillin and to the minor determinants, which are the allergenic epitopes associated with systemic anaphylaxis.
  • BioMed Central | Full text | Acute ST-segment elevation myocardial infarction after amoxycillin-induced anaphylactic shock in a young adult with normal coronary arteries: a case report 9 February 2010 12:37 UTC www.biomedcentral.com [Source type: Academic]

^ Children with venom-induced anaphylaxis usually had negative skin tests to the allergens tested.
  • Anaphylaxis in Children: Clinical and Allergologic Features -- Novembre et al. 101 (4): e8 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

.Passive anaphylaxis would be provoked in the recipient animals after exposure to the same allergens.^ Fish Latex Penicillin or any drug or injection Muscle relaxants Alcohol Exercise, often after consumption of an allergy-provoking food Anaphylaxis occurs usually within minutes of exposure to the allergen and almost always within two hours.
  • GHI Your Health: Anaphylaxis Basics 10 February 2010 11:17 UTC www.ghi.com [Source type: Academic]

^ Anaphylaxis can be provoked by numerous agents, or allergens, most usefully categorised into drug or non-drug causes (Table 1).
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ The blood of tuberculous animals does not induce passive anaphylaxis.

[12]

Signs and symptoms

.Anaphylaxis can present with many different symptoms due to the systemic effects of histamine release.^ Anaphylaxis can present with many different symptoms due to the systemic effects of histamine release.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Due to the presence of histamine releasing cells in the heart coronary artery spasm may occur with subsequent myocardial infarction or dysrhythmia .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylaxis is an acute, life-threatening reaction, usually mediated by an immunologic mechanism involving immunoglobulin E, that results in sudden systemic release of mast-cell and basophil mediators such as histamine and tryptase.
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

[13] .These usually develop over minutes to hours.^ These usually develop over minutes to hours.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Symptoms Symptoms of anaphylaxis usually develop within seconds or minutes of contact with an allergen; although on rare occasion, delayed symptoms have occurred after 30 minutes.
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

^ If the antigen is ingested, symptoms usually occur within minutes to 2 hours.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[9] .The most common areas affected include: skin (80% to 90%), respiratory (70%), gastrointestinal (30% to 45%), heart and vasculature (10% to 45%), and central nervous system (10% to 15%).^ So ask yourself this question, “What are the systems, organs, and tissues necessary to sustain vital life support?” Did you think to include the heart and lungs and the skin?
  • Medsker Racing College 9 February 2010 12:37 UTC www.racingsmarter.com [Source type: FILTERED WITH BAYES]

^ Skin and respiratory symptoms are more common and earlier in onset than cardiovascular ones.
  • Anaphylaxis in Children: Clinical and Allergologic Features -- Novembre et al. 101 (4): e8 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ May also affect the liver (jaundice), urinary system/kidneys (difficulty urinating, albuminuria, hematuria, anuria), blood, endocrine system, respiration (respiratory obstruction, pulmonary edema, bronchiolar obstruction), cardiovascular system (hypotension), metabolism (metabolic acidosis), eyes (retinal changes, visual field changes), and behavior/central nervous system.
  • H1N1 Swine Flu Vaccine Insert Admits It Causes Guillain-Barre Syndrome, Vasculitis, Paralysis, Anaphylactic Shock And Death « Dprogram.net 9 February 2010 12:37 UTC dprogram.net [Source type: FILTERED WITH BAYES]

[9]

Skin

.Skin involvement may include generalized hives, itchiness, flushing, and swelling of the lips, tongue or throat.^ Skin involvement may include generalized hives , itchiness , flushing , and swelling of the lips, tongue or throat.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Reactions may include coughing, sneezing, runny nose, hives, diarrhea, facial swelling, shortness of breath, a swollen tongue, difficulty swallowing, lowered blood pressure, excessive perspiration, fainting, anaphylactic shock or even death.

^ Tingling of the mouth Hives, welts or body redness Swelling of the face, lips, eyes Vomiting, abdominal pain.
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

[14]

Respiratory

.Respiratory symptoms may include shortness of breath, wheezes or stridor, and low oxygen.^ Wheezing or shortness of breath .
  • Treat for Shock 9 February 2010 12:37 UTC www.medtrng.com [Source type: Academic]

^ Respiratory distress with wheezing or stridor .
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

^ Respiratory symptoms may include shortness of breath, wheezes or stridor , and low oxygen .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[14]

Gastrointestinal

.Gastrointestinal symptoms may include crampy abdominal pain, diarrhea, and vomiting.^ Gastrointestinal signs and symptoms of anaphylaxis include abdominal pain, vomiting, and diarrhea.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

^ Other symptoms may include: .
  • NCH Healthcare ~ Health Information 9 February 2010 12:37 UTC www.nchmd.org [Source type: Academic]

^ Gastrointestinal symptoms frequently follow, including nausea, colicky abdominal pain, vomiting, and diarrhea.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

[14]

Cardiovascular

.Due to the presence of histamine releasing cells in the heart coronary artery spasm may occur with subsequent myocardial infarction or dysrhythmia.^ Due to the presence of histamine releasing cells in the heart coronary artery spasm may occur with subsequent myocardial infarction or dysrhythmia .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Heart - coronary artery surgery .
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

^ Often due to damage of the heart muscle as a result of Myocardial Infarction.
  • Shock Management | Healthmad 9 February 2010 12:37 UTC healthmad.com [Source type: FILTERED WITH BAYES]

[9]

Nervous system

.A drop in blood pressure may result in a feeling of lightheadedness and loss of consciousness.^ Blood pressure may drop quickly, causing loss of consciousness.

^ Followed by a sense of fullness in the throat, anxiety, a sensation of chest tightness, shortness of breath, lightheadedness, and finally loss of consciousness.

^ Hemorrhage <20% : Blood loss less than 20% of circulating blood volume causes cool, clammy skin, delayed capillary refill, and decreased pulse pressure.

There may be a loss of bladder control and muscle tone.[14], and a feeling of anxiety and "impending doom".[15]

Causes

.Anaphylaxis can occur in response to any allergen.^ Anaphylaxis can occur in response to any allergen.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ For anaphylaxis to occur, a patient has usually been previously sensitised to the allergen.
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ This is usually due to a toxic reaction, rather than the immune system response that occurs with "true" anaphylaxis.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

.Common triggers include insect bites or stings, foods, medication and latex rubber.^ Causes of anaphylaxis include bee stings, medications, food, latex exposure, and exercise ( 1 ).
  • Journal of Clinical Investigation -- Anaphylactic shock depends on PI3K and eNOS-derived NO 9 February 2010 12:37 UTC www.jci.org [Source type: Academic]

^ Some of the more common triggers include: .
  • Anaphylaxis - Sevananda 10 February 2010 11:17 UTC www.sevananda.coop [Source type: FILTERED WITH BAYES]

^ Common triggers include: .
  • Health24 - First Aid, Shock 9 February 2010 12:37 UTC www.health24.com [Source type: General]

[16]

Food

.Many foods can trigger anaphylaxis.^ Many foods can trigger anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Food Eggs, nuts and seafood are the most common food triggers; however, any food can trigger anaphylaxis.
  • Health24 - First Aid, Shock 9 February 2010 12:37 UTC www.health24.com [Source type: General]

^ They are planning to find out how many children with food allergies under the age of 16 years actually die or nearly die from anaphylaxis per year.

.The most common are peanut, tree nuts, shellfish, fish, milk, and egg.^ Commonly implicated foods include peanuts, tree nuts, legumes, fish and shellfish, milk, and eggs.
  • Anaphylaxis: eMedicine Emergency Medicine 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ The most common are peanut, tree nuts, shellfish, fish, milk, and egg.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Peanuts, tree nuts, fish, and shellfish account for most severe food anaphylactic reactions.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

.Severe cases are usually the result of ingesting the allergen.^ However, in some cases, patients have ingested a number of foods before the onset of their anaphylactic reaction and have positive skin tests to several foods.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ Severe cases may result in complete obstruction of the airway, cardiovascular collapse, and death.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

^ Patients who are at risk for food anaphylaxis should be provided with liquid diphenhydramine for use in case of a reaction resulting from an accidental allergen ingestion.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

[9]

Medication

.Any medication may potentially trigger anaphylaxis.^ Any medication may potentially trigger anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The primary indication for prescription of self-injectable epinephrine is a history of anaphylaxis in an individual who may re-encounter the triggering agent outside of a medical setting or who has idiopathic anaphylaxis, which is uncommon in childhood.
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

^ Anaphylaxis is a medical emergency which may require resuscitation measures such as airway management , supplemental oxygen, large volumes of intravenous fluids , and close monitoring.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.The most common to do so include antibiotics (β-lactam antibiotics in particular), aspirin, ibuprofen, and other analgesics.^ The most common symptoms of shock include: .
  • Signs of Shock & Symptoms of Shock - Treating Shock Naturally 9 February 2010 12:37 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

^ The most common to do so include antibiotics ( β-lactam antibiotics in particular), aspirin, ibuprofen, and other analgesics.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Antibiotics (especially parenteral penicillins and other ß-lactams), aspirin and nonsteroidal anti-inflammatory drugs, and intravenous (IV) contrast agents are the most frequent medications associated with life-threatening anaphylaxis.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

[9] .Some drugs (polymyxin, morphine, x-ray dye and others) may cause an "anaphylactoid" reaction (anaphylactic-like reaction) on the first exposure.^ Some drugs ( polymyxin , morphine , x-ray dye and others) may cause an "anaphylactoid" reaction (anaphylactic-like reaction) on the first exposure .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Some drugs will cause volume depletion (i.e.

^ Anaphylactoid and anaphylactic reactions.

[17] .This is usually due to a toxic reaction, rather than the immune system mechanism that occurs with "true" anaphylaxis.^ Anaphylaxis A life-threatening, usually rapid, immune-mediated systemic reaction.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ Anaphylaxis is an acute, life-threatening allergic reaction in which a physiologic process that normally acts in a local and limited manner to protect against infection occurs massively and systemically.
  • Anaphylactic reaction induced by Toxoplasma gondii-derived heat shock protein 70 -- Fang et al. 18 (10): 1487 -- International Immunology 9 February 2010 12:37 UTC intimm.oxfordjournals.org [Source type: Academic]

^ Anaphylaxis is an acute, life-threatening reaction, usually mediated by an immunologic mechanism involving immunoglobulin E, that results in sudden systemic release of mast-cell and basophil mediators such as histamine and tryptase.
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

.The symptoms, risk for complications without treatment, and treatment are the same, however, for both types of reactions.^ The symptoms, risk for complications without treatment, and treatment are the same, however, for both types of reactions.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ However, those with a history of allergic reactions — mild, moderate, or severe — may be at greater risk of having a severe reaction in the future.
  • GHI Your Health: Anaphylaxis Detection & Treatment 10 February 2010 11:17 UTC www.ghi.com [Source type: Academic]

^ Complications Introduction Anaphylaxis is a potentially life-threatening allergic reaction with rapid onset of symptoms.
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

.Some vaccinations are also known to cause "anaphylactoid" reactions.^ Some vaccinations are also known to cause "anaphylactoid" reactions.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Some drugs ( polymyxin , morphine , x-ray dye and others) may cause an "anaphylactoid" reaction (anaphylactic-like reaction) on the first exposure .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylaxis and anaphylactoid reactions differ in the things which cause them.

[18]

Venom

.Venom from stinging or biting insects such as Hymenoptera or Hemiptera may induce anaphylaxis in susceptible people.^ Severe Reaction to Insect bites or stings i.e.

^ In the setting of insect venom anaphylaxis, this is incorrect.
  • bmj.com Rapid Responses for McLean-Tooke et al., 327 (7427) 1332-1335 10 February 2010 11:17 UTC www.bmj.com [Source type: Academic]

^ Golden DB. Insect sting anaphylaxis.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[9]

Pathophysiology

.Anaphylaxis is a severe, whole-body allergic reaction.^ A severe, often fatal, type I allergic reaction is known as anaphylaxis.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ Sudden severe allergic reaction to: .
  • Treat for Shock 9 February 2010 12:37 UTC www.medtrng.com [Source type: Academic]

^ Severe allergic reaction.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

.After an initial exposure "sensitizing dose" to a substance like bee sting toxin, the person's immune system becomes sensitized to that allergen.^ After being exposed to a substance like bee sting venom, the person's immune system becomes sensitized to that allergen.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ The allergic response occurs only when a person’s immune system is sensitized to the allergen.
  • Auckland Allergy Clinic – Reactions to Cosmetics 9 February 2010 12:37 UTC www.allergyclinic.co.nz [Source type: FILTERED WITH BAYES]

^ Causes of anaphylaxis include bee stings, medications, food, latex exposure, and exercise ( 1 ).
  • Journal of Clinical Investigation -- Anaphylactic shock depends on PI3K and eNOS-derived NO 9 February 2010 12:37 UTC www.jci.org [Source type: Academic]

.On a subsequent exposure "shocking dose", an allergic reaction occurs.^ On a subsequent exposure "shocking dose", an allergic reaction occurs.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylactic Shock: Caused by allergic reactions.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ On a later exposure, an allergic reaction may occur.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

.This reaction is sudden, severe, and involves the whole body.^ Sudden severe allergic reaction to: .
  • Treat for Shock 9 February 2010 12:37 UTC www.medtrng.com [Source type: Academic]

^ This reaction is sudden, severe, and involves the whole body.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ Anaphylaxis is a severe, whole-body allergic reaction.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

.Classified as a type I hypersensitivity, anaphylaxis is triggered when an antigen binds to IgE antibodies on mast cells based in connective tissue throughout the body, which leads to degranulation of the mast cells (the release of inflammatory mediators).^ Interleukin (IL)-33 induces the release of pro-inflammatory mediators by mast cells.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

^ Any antigen capable of activating IgE can be a trigger for anaphylaxis.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

^ Both lead to the release of mast cell and basophil immune mediators ( Table 1 ) .
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

[19] .These immune mediators cause many symptoms, including common symptoms of allergic reactions, such as itching, hives, and swelling.^ Lists common causes of anaphylaxis & anaphylactoid & allergic reactions .

^ Anaphylactic Shock: Caused by allergic reactions.
  • MoonDragon's Health & Wellness: Shock - Emergency & First Aid 9 February 2010 12:37 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ Hymenoptera stings are a common cause of allergic reaction and anaphylaxis.
  • Anaphylaxis: eMedicine Emergency Medicine 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

.Anaphylactic shock is an allergic reaction to an antigen that causes circulatory collapse and suffocation due to bronchial and tracheal swelling.^ Anaphylactic shock due to serum .
  • ICD-10: Block T80-T88 9 February 2010 12:37 UTC www.who.int [Source type: Academic]

^ Among the most common causes of anaphylactic shock are: .
  • GHI Your Health: Anaphylaxis Basics 10 February 2010 11:17 UTC www.ghi.com [Source type: Academic]
  • GHI - Health & Wellness: Anaphylaxis (The Basics) 9 February 2010 12:37 UTC www.ghi.com [Source type: Academic]

^ Anaphylaxis and allergic anaphylactic shock .
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

.Different classes of antibodies are produced by B cells to bind and destroy substances that the immune system has identified as potentially dangerous pathogens.^ An antigen stimulates the immune system into producing cells that attack it.

^ IgG (immunoglobulin G) A class of circulating antibodies predominant in serum, which are produced by plasma and memory cells in response to pathogens and other foreign substances.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ The Good Guy Antibody, Blocking An antibody that combines with an antigen without visible reaction but prevents another antibody from later combining with or producing its usual effect on that antigen Antibody Dependent Cell Mediated Cytotoxicity ADCC--An immune response in which antibodies bind to target cells, identifying them for attack by the immune system Antibody Positive [Seropositive] The presence in the blood of antibodies against a specific pathogen such as HCV Antibody Presenting Cell--APC A white blood cell that devours foreign bodies, breaks them down, and carries characteristic antigen peptides to it's surface.

.Each B cell produces thousands of identical antibodies that can attack a single, small part of a pathogen.^ Each B cell produces thousands of identical antibodies that can attack a single, small part of a pathogen.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Different classes of antibodies are produced by B cells to bind and destroy substances that the immune system has identified as potentially dangerous pathogens.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ IgG (immunoglobulin G) A class of circulating antibodies predominant in serum, which are produced by plasma and memory cells in response to pathogens and other foreign substances.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

.In susceptible individuals, antibodies may be produced against innocuous antigens or allergens, such as components of common foods or plants.^ The most common allergens which cause anaphylaxis are peanuts, tree nuts, bee/wasp stings or a drug, such as the antibiotic penicillin.
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

^ Although the pattern of peripheral effects may differ markedly in individual patients, common phenomena in anaphylaxis are a decrease in peripheral resistance and an increase in vascular permeability.
  • Anaphylactic Shock after Insect-Sting Challenge in 138 Persons with a Previous Insect-Sting Reaction — Ann Intern Med 9 February 2010 12:37 UTC www.annals.org [Source type: Academic]

^ PMID: 16190657 Database of Food Allergens in AgMoBiol – Common Allergenic Foods of Plant Origin - http://ambl.lsc.pku.edu.cn/yjwy/Allergens2.htm (April 4, 2006) Wang F, et al.
  • Anaphylactic Children - Canaries in the Public Health Mine Shaft? - Anaphylaxis, Allergies, and Asthma - Health Risks - Vaccination Risk Awareness Network 10 February 2010 11:17 UTC vran.org [Source type: Academic]
  • Anaphylactic Children - Canaries in the Public Health Mine Shaft? - Anaphylaxis, Allergies, and Asthma - Health Risks - Vaccination Risk Awareness Network 9 February 2010 12:37 UTC vran.org [Source type: Academic]

.One class, the IgE antibodies, can trigger anaphylaxis.^ One class, the IgE antibodies, can trigger anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Diagnostic food challenges are usually contraindicated in patients with a clear-cut history of anaphylaxis after the isolated ingestion of a food to which they have IgE antibodies.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ Any antigen capable of activating IgE can be a trigger for anaphylaxis.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

.Production of IgE antibodies may persist for months, even in the complete absence of the allergen.^ Insect stings, that is, venoms from Hymenoptera insects (eg, bees, yellow jackets, hornets, wasps, fire ants), can elicit an allergen-specific IgE antibody response.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ However, IgE antibodies also appear to contribute to anaphylaxis to B:9–23 peptides [ 15 ], and may also be involved in our model.
  • BioMed Central | Full text | Severe anaphylactic reactions to glutamic acid decarboxylase (GAD) self peptides in NOD mice that spontaneously develop autoimmune type 1 diabetes mellitus 9 February 2010 12:37 UTC www.biomedcentral.com [Source type: Academic]

^ The rapid decrease in body temperature was completely prevented by the inclusion of anti–IL-33 antibody or soluble ST2 (sST2, a decoy receptor for IL-33) in the IgE inoculums.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

.These IgE antibodies associate with a receptor on the surface of mast cells.^ The mast cell has binding sites on its surface for a special type of antibody called IgE .
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ The antigen-specific IgE antibodies then bind to mast cells and basophils.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ IL-33 induces IL-13 production by mouse mast cells independently of IgE-FcepsilonRI signals.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

.If the antibody binds to its specific antigen, then the antibody triggers degranulation of the mast cell.^ S4 F ) and mast cell degranulation ( Fig.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

^ B cells produce antibodies, which are proteins that bind to and destroy or neutralize antigens.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ Antigen binding to the mast cell-attached IgE then triggers the mast cell to respond.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

.Mast cells become the major effector cells for immediate hypersensitivity and chronic allergic reactions.^ Effector cells of anaphylaxis: mast cells and basophils.
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

^ Mast cells become the major effector cells for immediate hypersensitivity and chronic allergic reactions.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ It is well established that mast cells are key effector cells in triggering the immediate Type-I hypersensitivity in allergic patients.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

[20]
.Mast cells are large cells found in particularly high concentrations in vascularized connective tissues just beneath epithelial surfaces, including the submucosal tissues of the gastrointestinal and respiratory tracts, and the dermis that lies just below the surface of the skin.^ IgE molecules are bound to mast cells, which are found in loose connective tissue.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ In anaphylactic shock, circulatory collapse is caused by the release of mediators from tissue mast cells and peripheral blood basophils in a sensitized individual.
  • Effect of bolus epinephrine on systemic hemodynamics in canine anaphylactic shock -- Mink et al. 40 (3): 546 -- Cardiovascular Research 9 February 2010 12:37 UTC cardiovascres.oxfordjournals.org [Source type: Academic]

^ Platelets may mediate both allergen-induced vascular permeability and leukocyte recruitment in skeletal muscles in the absence of mast cells.
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

[19] .They contain large granules that store a variety of mediator molecules including the vasoactive amine, histamine.^ They contain large granules that store a variety of mediator molecules including the vasoactive amine, histamine.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The blood cells called basophils also harbor histamine-containing granules.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ Eosinophils may be inflammatory (release cytotoxic granule-associated proteins, for example) or anti-inflammatory (metabolize vasoactive mediators, for example).
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

.Histamine causes dilation of local blood vessels and smooth-muscle contraction.^ Nemoto K, Okamura T. Intracellular signals in IgG-mediated anaphylactic contraction of single smooth muscle cells.
  • Anaphylaxis - Sevananda 10 February 2010 11:17 UTC www.sevananda.coop [Source type: FILTERED WITH BAYES]

^ Once released from its granules, histamine produces many varied effects within the body, including the contraction of smooth muscle tissues of the lungs, uterus, and stomach; the dilation of blood vessels, which increases permeability and lowers blood pressure; the stimulation of gastric acid secretion in the stomach; and the acceleration of heart rate.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ When released locally and systemically, these mediators cause increased mucous membrane secretions, increased capillary permeability and leak, and markedly reduced smooth muscle tone in blood vessels (vasodilation) and bronchioles.
  • Part 10.6: Anaphylaxis -- 112 (24 Supplement): IV-143 -- Circulation 10 February 2010 11:17 UTC circ.ahajournals.org [Source type: Academic]

.Other molecules in the mast cell granules include lipid inflammatory mediators such as prostaglandin D2¬ and leukotriene C4 as well as tumor necrosis factor-α (TNF-α), a cytokine.^ Mast cells and other cells such as macrophages have been shown to mediate systemic anaphylaxis.
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

^ The mast cell and the cysteinyl leukotrienes.
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

^ IgE molecules on a mast cell or basophil .

[19] The importance of TNF-α is most noted in the activation of the endothelium. .TNF-α, the prototype of the TNF family cytokines, can induce endothelial cells to present E-selectin and ICAM-1, both of which are cell adhesion molecules (CAM) that mediate the “roll and stick” mechanism of leukocyte extravasation, termed diapedesis.^ Mast cell leukocyte cytokine cascade .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ Hypoxic vascular endothelial cells activate WBCs, which bind to the endothelium and release directly damaging substances (eg, reactive O 2 species, proteolytic enzymes) and inflammatory mediators (eg, cytokines, leukotrienes, tumor necrosis factor [TNF]).
  • Shock: Shock and Fluid Resuscitation: Merck Manual Professional 9 February 2010 12:37 UTC www.merck.com [Source type: Academic]

^ Platelets may mediate both allergen-induced vascular permeability and leukocyte recruitment in skeletal muscles in the absence of mast cells.
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

.While this process is essential for the recruit of leukocytes to a localized area during an inflammatory response, it can be catastrophic in cases of systemic infection.^ While this process is essential for the recruit of leukocytes to a localized area during an inflammatory response, it can be catastrophic in cases of systemic infection.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Systemic inflammatory response syndrome .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ Point in case, the presence of said infection in the bloodstream, or sepsis, is accompanied by the release of TNF-α by macrophages in liver, spleen, and other systemic sites.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.Point in case, the presence of said infection in the bloodstream, or sepsis, is accompanied by the release of TNF-α by macrophages in liver, spleen, and other systemic sites.^ Alfalfa is promoted as a detoxifier, said to cleanse the liver and bloodstream.

^ Mast cells and other cells such as macrophages have been shown to mediate systemic anaphylaxis.
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

^ Sepsis-systemic response to infection, manifested by two or more of the following-temp.

.The systemic release of TNF-α causes vasodilatation, which leads to a loss of blood pressure and increased vascular permeability, leading to a loss of plasma volume and eventually to shock.^ Hypertension An increase in blood pressure.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ Release of histamine caused widespread vasodilatation.
  • Shock Management | Healthmad 9 February 2010 12:37 UTC healthmad.com [Source type: FILTERED WITH BAYES]

^ The systemic release of TNF-α causes vasodilatation, which leads to a loss of blood pressure and increased vascular permeability, leading to a loss of plasma volume and eventually to shock.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[19]
.TNF-α, along with the other aforementioned mast cell granule contents become exocytosed upon activation of the mast cell.^ TNF-α, along with the other aforementioned mast cell granule contents become exocytosed upon activation of the mast cell.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ "Integrated signalling pathways for mast-cell activation".
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ On the other hand, it has been recently demonstrated that the effector cells responsible for regional anaphylactic responses are not necessarily mast cells but could be varied depending on the organs and tissues exposed to antigens ( 4 ).
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

.Activation is achieved only when IgE, bound to the high-affinity Fcε receptors (FcεR1), are cross-linked by multivalent antigen.^ Activation is achieved only when IgE, bound to the high-affinity Fcε receptors (FcεR1), are cross-linked by multivalent antigen.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Although anaphylaxis is classically mediated by histamine released in response to antigen cross-linking of IgE bound to high-affinity Ig-E receptors, Fc RI, on mast cells, both human and rodent studies indicate that this classical pathway does not account for all anaphylactic responses ( 3 , 10 , 21 , 26 ).
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

^ Although it is classically mediated by histamine released in response to antigen cross-linking of IgE bound to Fc RI on mast cells, both human and rodent studies indicate that this classical pathway does not account for all anaphylactic responses ( 11 – 16 ).
  • Anaphylactic reaction induced by Toxoplasma gondii-derived heat shock protein 70 -- Fang et al. 18 (10): 1487 -- International Immunology 9 February 2010 12:37 UTC intimm.oxfordjournals.org [Source type: Academic]

.The FcεR1 is a tetrameric receptor composed of a single α chain, responsible for binding the IgE, associated with a single β chain and a disulfide linked homodimer of γ chains that initiate the cell signal pathway.^ Although anaphylaxis is classically mediated by histamine released in response to antigen cross-linking of IgE bound to high-affinity Ig-E receptors, Fc RI, on mast cells, both human and rodent studies indicate that this classical pathway does not account for all anaphylactic responses ( 3 , 10 , 21 , 26 ).
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

^ Although it is classically mediated by histamine released in response to antigen cross-linking of IgE bound to Fc RI on mast cells, both human and rodent studies indicate that this classical pathway does not account for all anaphylactic responses ( 11 – 16 ).
  • Anaphylactic reaction induced by Toxoplasma gondii-derived heat shock protein 70 -- Fang et al. 18 (10): 1487 -- International Immunology 9 February 2010 12:37 UTC intimm.oxfordjournals.org [Source type: Academic]

^ Nemoto K, Okamura T. Intracellular signals in IgG-mediated anaphylactic contraction of single smooth muscle cells.
  • Anaphylaxis - Sevananda 10 February 2010 11:17 UTC www.sevananda.coop [Source type: FILTERED WITH BAYES]

[21] .Once the FcεR1 are aggregated by the cross-linking process, the immunoreceptor tryrosine-based activation motifs (ITAMs) in both the β and γ chains are phosphorylated by LYN, a protein tryrosine kinase (PTK) belonging to the Src family.^ Once the FcεR1 are aggregated by the cross-linking process, the immunoreceptor tryrosine-based activation motifs (ITAMs) in both the β and γ chains are phosphorylated by LYN, a protein tryrosine kinase (PTK) belonging to the Src family.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Their phosphorylation in the β and γ chains provide high-affinity docking sites for the SH2 domains of additional LYN and the SYK (spleen tyrosine kinasse), respectively.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Myosin light chain kinase-regulated endothelial cell contraction: the relationship between isometric tension, actin polymerization, and myosin phosphorylation.
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

.The ITAM domain is simply conserved sequence motif generally composed of two YXXL/I sequences separated by about six to nine amino acids, where Y is tyrosine, L is leucine, I isoleucine and X any amino acid.^ The ITAM domain is simply conserved sequence motif generally composed of two YXXL/I sequences separated by about six to nine amino acids, where Y is tyrosine, L is leucine, I isoleucine and X any amino acid.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Essential amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine) cannot be manufactured by the body and must be supplied in the diet or ill-health results.

^ It is an autosomal recessive disease generally manifesting during childhood Alanine Nonessential amino acid, alpha-aminopropanoic acid, occurring in proteins.

[19] .Their phosphorylation in the β and γ chains provide high-affinity docking sites for the SH2 domains of additional LYN and the SYK (spleen tyrosine kinasse), respectively.^ Their phosphorylation in the β and γ chains provide high-affinity docking sites for the SH2 domains of additional LYN and the SYK (spleen tyrosine kinasse), respectively.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ "Phosphorylation and dephosphorylation of the high-affinity receptor for immunoglobulin E immediately after receptor engagement and disengagement".
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[22] .These SH2 domains (Src homology 2 domian) are found in a numerous cell-signaling proteins and bind to phosphotyrosine through a very specific sequence.^ These SH2 domains (Src homology 2 domian) are found in a numerous cell-signaling proteins and bind to phosphotyrosine through a very specific sequence.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ IgE binding to FcεR1 in the absence of a specific antigen still induces the up-regulation of FcεR1 surface expression in mast cells through autocrine signaling of cytokines.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ If the antibody binds to its specific antigen, then the antibody triggers degranulation of the mast cell.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[19] .As the signal continues to propagate through the pathway, the membrane bound molecule, named linker for activation of T cells (LAT), is phosphoyraleted by the LYN and SYK and acts as a scaffold protein, organizing other molecules that complete the degranulation of mast cells, as well as promote further cytokine production.^ Mast cell degranulation See degranulation .
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ IgE molecules on a mast cell or basophil .

^ Mast cell leukocyte cytokine cascade .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

[23] The most notable of these LAT affected molecules is Phospholipase C (PLC). .As in many cell signaling pathways PLC hydrolyzes the phosphodiester bond in phosphoatidylinositol-4,5-bisphosphate [PI(4,5)P¬¬2] to yield diacylglycerol (DAG) and inositol-1,4,5-triphosphate (IP¬¬3)¬.^ "Integrated signalling pathways for mast-cell activation".
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The G proteins G q /G 11 couple receptors to β isoforms of phospholipase C resulting in inositol-1,4,5-trisphosphate–mediated mobilization of intracellular Ca 2+ and diacylglycerol-dependent activation of protein kinase C, whereas G 12 /G 13 couple receptors to the activation of the Rho/Rho kinase–mediated signaling pathway.
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

^ This pathway is normally well regulated by signal transduction pathways linked to cell-surface receptors for vasodilators such as acetylcholine and histamine.

.A well-characterized second messenger, IP¬3¬, signals the release of calcium from the endoplasmic reticulum.^ A well-characterized second messenger, IP¬3¬, signals the release of calcium from the endoplasmic reticulum.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ B - Basophil A type of white blood cell; basophils release histamine and leukotrienes as well as other active chemicals and messenger molecules, and may be involved in allergic reactions.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

The influx of cytosolic Ca2+ and phosphoatidylserine further active Phosphokinase C (PKC) bound to DAG. Together, it is the cytosolic Ca2+ and PKC signal the degranulation of the mast cell.4
Although less well mapped, similarly prevailing cell signaling molecules, such as Ras, a monomeric G protein, SOS (son of sevenless homologue) and MAPK (mitogen-activated protein kinase) lead to the upregulation of cytokines and the previously mentioned eicosanoids, prostaglandin D2¬ and leukotriene C4.[22]
.While this cell single pathway is sufficient to induce degraluation, it is not the only effective mechanism.^ While this cell single pathway is sufficient to induce degraluation, it is not the only effective mechanism.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The FcεR1 is a tetrameric receptor composed of a single α chain, responsible for binding the IgE, associated with a single β chain and a disulfide linked homodimer of γ chains that initiate the cell signal pathway.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The cell signaling pathway then initiates and appears to involve components used in the alternative mechanisms.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.Studies with LYK deficient mice have shown that degranulation is still inducible.^ Studies with LYK deficient mice have shown that degranulation is still inducible.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The total number of mice is shown in parentheses, numbers above the time points indicate the number of mice still alive at the indicated times.
  • Journal of Clinical Investigation -- Anaphylactic shock depends on PI3K and eNOS-derived NO 9 February 2010 12:37 UTC www.jci.org [Source type: Academic]

^ In contrast, none of the eNOS-deficient mice died (Figure 4 C; not shown for the OVA model).
  • Journal of Clinical Investigation -- Anaphylactic shock depends on PI3K and eNOS-derived NO 9 February 2010 12:37 UTC www.jci.org [Source type: Academic]

[23] .Consequently, several alternative pathways leading to mast cell degranulation have been mapped.^ Consequently, several alternative pathways leading to mast cell degranulation have been mapped.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Mast cell degranulation See degranulation .
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ The severity of the reactions is reflected in the profound reduction in systemic vascular resistance that occurs due to the release of histamine and other vasoactive substances associated with mast cell degranulation and may lead to cardiac arrest secondary to electromechanical dissociation.
  • bmj.com Rapid Responses for McLean-Tooke et al., 327 (7427) 1332-1335 10 February 2010 11:17 UTC www.bmj.com [Source type: Academic]

.The first of which, dubbed the “complementary” pathway, determined that the crosstalk between LYK and another Src family PTK, called FYN, is an essential interaction to degranulation, along with the preferential activity of Phosphoatidylinositol 3-kinase (PI-3K) over PLC. Studies have also elucidated subsequent pathways that utilize the integration of G-protein-coupled receptors to mediate the degranulation and cytokine production mechanism of activated mast cells.^ "Integrated signalling pathways for mast-cell activation".
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ S4 F ) and mast cell degranulation ( Fig.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

^ This phosphorylation is mediated by the PI3K/Akt pathway, which can be activated by receptor tyrosine kinases, G protein–coupled receptors, or mechanical forces such as shear stress.
  • Journal of Clinical Investigation -- Anaphylactic shock depends on PI3K and eNOS-derived NO 9 February 2010 12:37 UTC www.jci.org [Source type: Academic]

[22]
.IgE binding to FcεR1 in the absence of a specific antigen still induces the up-regulation of FcεR1 surface expression in mast cells through autocrine signaling of cytokines.^ The mast cell has binding sites on its surface for a special type of antibody called IgE .
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ IgE molecules on a mast cell or basophil .

^ Antigen binding to the mast cell-attached IgE then triggers the mast cell to respond.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

[24] .However, not all IgE are equally capable of inducing such as secretion.^ However, not all IgE are equally capable of inducing such as secretion.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ However, both studies showed that anaphylaxis can be induced in such mice upon subsequent re-challenge with preparations of the peptides used for immunization [ 15 ].
  • BioMed Central | Full text | Severe anaphylactic reactions to glutamic acid decarboxylase (GAD) self peptides in NOD mice that spontaneously develop autoimmune type 1 diabetes mellitus 9 February 2010 12:37 UTC www.biomedcentral.com [Source type: Academic]

^ However, total IgE levels, which were undetectable in the sera of control and CFA-injected NOD and C57BL/6 mice, were elevated in all HEL-immunized mice.
  • Acute Shock Induced by Antigen Vaccination in NOD Mice — Diabetes 9 February 2010 12:37 UTC diabetes.diabetesjournals.org [Source type: Academic]

.Therefore, researchers have divided all invariant IgEs into two major categories: highly cytokinergic(HC), where the production and secretion of various cytokines and other activation events including degranulation is inducible, and poorly cytokinergic (PC) in which no autocrine signaling is observed.^ Therefore, researchers have divided all invariant IgEs into two major categories: highly cytokinergic(HC), where the production and secretion of various cytokines and other activation events including degranulation is inducible, and poorly cytokinergic (PC) in which no autocrine signaling is observed.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ As the signal continues to propagate through the pathway, the membrane bound molecule, named linker for activation of T cells (LAT), is phosphoyraleted by the LYN and SYK and acts as a scaffold protein, organizing other molecules that complete the degranulation of mast cells, as well as promote further cytokine production.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ While the exact structural features that account for the function differences between HC and PC IgE has yet to be determined their effects are thought to be the result of intracellular cell signaling.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

The former, HC IgE, brings forward a reaction in which cytokines are exocytosed and act as autocrine and paracrine signaling molecules. .As such, mast cells with bound HC IgE attract other mast cells even in the absence of antigen crosslinking.^ Antigen binding to the mast cell-attached IgE then triggers the mast cell to respond.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ As such, mast cells with bound HC IgE attract other mast cells even in the absence of antigen crosslinking.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The antigen-specific IgE antibodies then bind to mast cells and basophils.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

[21] .While the exact structural features that account for the function differences between HC and PC IgE has yet to be determined their effects are thought to be the result of intracellular cell signaling.^ Statistics The significance of differences between groups was determined by Student's t -test.
  • Anaphylactic reaction induced by Toxoplasma gondii-derived heat shock protein 70 -- Fang et al. 18 (10): 1487 -- International Immunology 9 February 2010 12:37 UTC intimm.oxfordjournals.org [Source type: Academic]

^ Allergic reactions with immediate effects are the result of antibody-antigen responses (i.e., they are the products of B-cell stimulation).
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ Reactogenicity and potential side effects of combined antigens not yet determined?
  • Anaphylactic Children - Canaries in the Public Health Mine Shaft? - Anaphylaxis, Allergies, and Asthma - Health Risks - Vaccination Risk Awareness Network 10 February 2010 11:17 UTC vran.org [Source type: Academic]
  • Anaphylactic Children - Canaries in the Public Health Mine Shaft? - Anaphylaxis, Allergies, and Asthma - Health Risks - Vaccination Risk Awareness Network 9 February 2010 12:37 UTC vran.org [Source type: Academic]

[24] .IgE binding to FcεR1 leads to a greater stability of the mast cell and increased production of surface receptors.^ Histamine works by binding to histamine receptors on the surface of cells.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

^ These IgE antibodies associate with a receptor on the surface of mast cells .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Antigen binding to the mast cell-attached IgE then triggers the mast cell to respond.
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

.The newly expressed FcεR1 then aggregate on the surface, independent of antigen binding.^ Basophils express high-affinity Ig-E receptors (Fc RI), which bind Ig-E-antigen complexes and cause anaphylactic reaction ( 9 ).
  • The roles of mast cells and Kupffer cells in rat systemic anaphylaxis -- Shibamoto et al. 293 (6): R2202 -- AJP - Regulatory, Integrative and Comparative Physiology 9 February 2010 12:37 UTC ajpregu.physiology.org [Source type: Academic]

.The cell signaling pathway then initiates and appears to involve components used in the alternative mechanisms.^ The cell signaling pathway then initiates and appears to involve components used in the alternative mechanisms.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ A molecular switch changes the signalling pathway used by the Fc gamma RI antibody receptor to mobilise calcium.
  • The cytokine interleukin-33 mediates anaphylactic shock 9 February 2010 12:37 UTC ukpmc.ac.uk [Source type: Academic]

^ "Integrated signalling pathways for mast-cell activation".
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

Mast cell migration is dependent on soluble factors such as adenosine, leukotriene B¬4 and other chemokines, whose secretion is dependent upon the activity of LYN and SYK. The degranulation of mast cells in the absence of antigen, can then be initiated by G-protein-couple receptors (GPCR) stimulated by soluble factors agonists and completed by downstream activity of PI3K.[21]

Diagnosis

.Anaphylaxis is diagnosed with high likelihood based on clinical criteria.^ Anaphylaxis is diagnosed with high likelihood based on clinical criteria.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Three clinical criteria for anaphylaxis based on symptoms and history were also proposed at the symposium.
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

^ The authors based their conclusion on death certificates and clinical reports, both of which have been shown to underestimate the true prevalence of anaphylaxis.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

These criteria are fulfilled when any one of the following three is true:[14]
.
  1. Symptom onset within minutes to several hours of allergen exposure with involvement of the skin or mucosal tissue and any of the following: hives, itchiness, or swelling of the airway; plus either respiratory difficulty or a low blood pressure.
  2. Any two or more of the following symptoms within minutes to several hours of allergen exposure: a.^ Skin and respiratory symptoms are more common and earlier in onset than cardiovascular ones.
    • Anaphylaxis in Children: Clinical and Allergologic Features -- Novembre et al. 101 (4): e8 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

    ^ If the antigen is ingested, symptoms usually occur within minutes to 2 hours.
    • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

    ^ Symptoms usually develop within five minutes of exposure to vibration and resolve within an hour.
    • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

    .Involvement of the skin or mucosa b.^ Involvement of the skin or mucosa b.
    • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

    Respiratory difficulties c. .Low blood pressure d.^ A person in shock has extremely low blood pressure.
    • Shock | LIVESTRONG.COM 9 February 2010 12:37 UTC www.livestrong.com [Source type: General]

    ^ In medicine, shock is a life-threatening medical emergency characterized by profoundly low blood pressure and tissue hypoperfusion.

    ^ Anaphylaxis can produce: An itchy nettlerash (urticaria, hives) Faintness and unconsciousness due to very low blood pressure.

    Gastrointestinal symptoms
  3. Low blood pressure within minutes to several hours after exposure to known allergen
.Apart from its clinical features, blood tests for tryptase (released from mast cells) might be useful in diagnosing anaphylaxis.^ Anaphylaxis in children: clinical and allergologic features.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ Clinical features of anaphylaxis .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ Effector cells of anaphylaxis: mast cells and basophils.
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

[25]
.Allergy testing may help in determining what triggered the anaphylaxis.^ Laboratory testing may help if the diagnosis of anaphylaxis is uncertain.
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

^ The immunobiology and pathophysiology of anaphylaxis are basically the same, irrespective of the initial trigger, although there may be subtle differences in the responses.
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ Epinephrine should be prescribed for children who have experienced anaphylaxis who may re-encounter the trigger outside of a health care setting.
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

.In this setting, skin allergy testing (with or without patch testing) or RAST blood tests can sometimes identify the cause.^ R - RAST A radioallergosorbent test (RAST) is an allergy test performed on a sample of blood.
  • The Mastocytosis Society: Glossary 10 February 2010 11:17 UTC www.tmsforacure.org [Source type: Academic]

^ In this setting, skin allergy testing (with or without patch testing ) or RAST blood tests can sometimes identify the cause.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ One common blood test is called RAST or radioallergosorbent test .
  • Fogle Business - Allergies - Allergy to Pollen - Anaphylactic Shock - Dust, Foods, Drugs, fur, molds - Allergens - Asthma - Itching Dermatitis - Urticaria - Eczema 9 February 2010 12:37 UTC www.foogle.biz [Source type: FILTERED WITH BAYES]

Prevention

.Immunotherapy with Hymenoptera venoms is effective against allergies to bees, wasps, hornets, yellow jackets, white faced hornets, and fire ants.^ Insect stings, that is, venoms from Hymenoptera insects (eg, bees, yellow jackets, hornets, wasps, fire ants), can elicit an allergen-specific IgE antibody response.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ Another common cause of anaphylaxis is a sting from a fire ant or Hymenoptera (bee, wasp, hornet, yellow jacket, and sawfly).
  • A Practical Guide to Anaphylaxis - October 1, 2003 - American Family Physician 10 February 2010 11:17 UTC www.aafp.org [Source type: Academic]

^ Insect stings from bees, yellow jackets, wasps, hornets, and fire ants are a common cause of anaphylaxis.
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

[26]
.The greatest success with prevention of anaphylaxis has been the use of allergy injections to prevent recurrence of sting allergy.^ Bee Sting anaphylaxis can be prevented by reducing the allergy response by a series of 13 injections.
  • PaulHonanMD anaphylaxis 10 February 2010 11:17 UTC www.paulhonanmd.com [Source type: FILTERED WITH BAYES]

^ The greatest success with prevention of anaphylaxis has been the use of allergy injections to prevent recurrence of sting allergy.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]
  • Anaphylactic shock - Psychology Wiki 9 February 2010 12:37 UTC psychology.wikia.com [Source type: Academic]

^ Allergy injections are a common trigger for anaphylaxis.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

.The risk to an individual from a particular species of insect depends on complex interactions between likelihood of human contact, insect aggression, efficiency of the venom delivery apparatus, and venom allergenicity.^ The risk to an individual from a particular species of insect depends on complex interactions between likelihood of human contact, insect aggression, efficiency of the venom delivery apparatus, and venom allergenicity.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]
  • Anaphylactic shock - Psychology Wiki 9 February 2010 12:37 UTC psychology.wikia.com [Source type: Academic]

^ The more contact the individual has with the allergen the greater the risk of sensitization.
  • Auckland Allergy Clinic – Reactions to Cosmetics 9 February 2010 12:37 UTC www.allergyclinic.co.nz [Source type: FILTERED WITH BAYES]

^ It will depend on the amount of allergen ingested and sensitivity of the individual to that particular allergen.

.Venom immunotherapy reduces risk of systemic reactions below 3%.^ Venom immunotherapy reduces risk of systemic reactions below 3%.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Such patients appear to be at increased risk for food and venom reactions.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ Goldberg, A, Confino-Cohen, R. (2000) Insect sting-inflicted systemic reactions: attitudes of patients with insect venom allergy regarding after-sting behaviour and proper administration of adrenaline.
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

[citation needed] .One simple method of venom extraction has been electrical stimulation to obtain venom, instead of dissecting the venom sac.^ One simple method of venom extraction has been electrical stimulation to obtain venom, instead of dissecting the venom sac.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Of several methods of stimulating the nerves at the sides of the spine, I prefer to use a double-headed electric vibrator down the back.
  • PaulHonanMD anaphylaxis 10 February 2010 11:17 UTC www.paulhonanmd.com [Source type: FILTERED WITH BAYES]

.A vaccine has been in the works to prevent anaphylaxis from peanuts and tree nuts.^ A vaccine has been in the works to prevent anaphylaxis from peanuts and tree nuts.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Atopic dermatitis · Allergic urticaria · Hay fever · Allergic asthma · Anaphylaxis · Food allergy ( Milk , Egg , Peanut , Tree nut , Seafood , Soy , Wheat ), Penicillin allergy .
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The most common allergens which cause anaphylaxis are peanuts, tree nuts, bee/wasp stings or a drug, such as the antibiotic penicillin.
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

.Despite showing significant promise to prevent individuals with the allergy from developing anaphylaxis if eating a small amount of the food, the FDA has not yet approved the vaccine.^ Despite showing significant promise to prevent individuals with the allergy from developing anaphylaxis if eating a small amount of the food, the FDA has not yet approved the vaccine.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Allergy - anaphylaxis - avoiding food allergens .
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

^ Second symposium on the definition and management of anaphylaxis: summary report–Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium.
  • Anaphylaxis following quadrivalent human papillomavirus vaccination -- Brotherton et al. 179 (6): 525 -- Canadian Medical Association Journal 10 February 2010 11:17 UTC www.cmaj.ca [Source type: Academic]
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

[27]

Management

.Anaphylaxis is a medical emergency which may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring.^ Any medication may potentially trigger anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylaxis is a medical emergency which may require resuscitation measures such as airway management , supplemental oxygen, large volumes of intravenous fluids , and close monitoring.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Emergency management of anaphylaxis .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

[9] .Administration of epinephrine is the treatment of choice with antihistamines and steroids often used as adjuncts.^ Administration of epinephrine is the treatment of choice with antihistamines and steroids often used as adjuncts.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Lieberman P. Use of epinephrine in the treatment of anaphylaxis.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ Other treatments for anaphylaxis Antihistamines, steroids, other.

.A period of in hospital observation for between 6 and 24 hours is recommended for people once they have returned to normal due to concerns of biphasic anaphylaxis.^ A period of in hospital observation for between 6 and 24 hours is recommended for people once they have returned to normal due to concerns of biphasic anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Six to twelve hours observation in hospital.

^ Just how often such reactions happen is controversial, but experts on anaphylaxis recommend that the patient should be kept under observation overnight or for at least six hours.

[8][28]

Epinephrine

.Epinephrine (adrenaline) is the primary treatment for anaphylaxis with no absolute contraindication to its use.^ The use of adrenaline in the treatment of acute anaphylaxis is well established.
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ Treatment of anaphylaxis: adrenaline .
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ The use of epinephrine in the treatment of anaphylaxis.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

[9] .Epinephrine improves airway patency, improves blood pressure, and may be life-saving.^ Epinephrine improves airway patency, improves blood pressure, and may be life-saving.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ For less severe signs, such as decreasing blood pressure without hypotension, symptomatic dyspnea, abdominal cramps, and urticaria, subcutaneous SC epinephrine can be given.

^ In addition to endogenous norepinephrine and epinephrine, blood pressure maintenance in insect-sting anaphylactic shock may be regulated by a dopamine system [33] and by the renin-angiotensin system [7, 9, 34, 35] .
  • Anaphylactic Shock after Insect-Sting Challenge in 138 Persons with a Previous Insect-Sting Reaction — Ann Intern Med 9 February 2010 12:37 UTC www.annals.org [Source type: Academic]

.The recommended dose is 500 µg (or 0.5 mL adrenaline injection 1 in 1000) given intramuscularly.^ Recommended doses of adrenaline, based on age .
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ If a repeat IM injection is required, it has been recommended to be given with medical monitoring, where possible (Simons et al, 1998).
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ But adrenaline (epinephrine) needs to be given as an injection, and is dangerous if used incorrectly.

[29] .A dose of 300 µg (0.3 mL adrenaline injection 1 in 1000) may be appropriate for immediate self-administration.^ As such I would not recommend administration of adrenaline without electrocardiographic monitoring or in the presence of appropriately trained staff, and I would certainly not give these patients an adrenaline auto-injector.
  • bmj.com Rapid Responses for McLean-Tooke et al., 327 (7427) 1332-1335 10 February 2010 11:17 UTC www.bmj.com [Source type: Academic]

^ Hydrocortisone (200 mg intravenous) was administrated and an intramuscular adrenaline 1 mg preparation (1:1000) was administered intravenously in error.
  • bmj.com Rapid Responses for McLean-Tooke et al., 327 (7427) 1332-1335 10 February 2010 11:17 UTC www.bmj.com [Source type: Academic]

^ Even in an emergency department (where intravenous infusion is an option), intramuscular injection of adrenaline is an appropriate first-line treatment for anaphylaxis (T/F) .
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

[29] .The dose is repeated if necessary at 5-minute intervals according to blood pressure, pulse and respiratory function.^ The intramuscular dose can be repeated after 3–5 minutes if required.
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ Hemorrhage <20% : Blood loss less than 20% of circulating blood volume causes cool, clammy skin, delayed capillary refill, and decreased pulse pressure.

^ The most dangerous allergic reactions involve the respiratory system (breathing) and/or cardiovascular system (heart and blood pressure).
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

[29] .If necessary, it can also be given intravenously using dilute solution.^ In the sham shock protocol , the same epinephrine and placebo doses and protocol were used, but allergen was not given (just normal saline solution).
  • Effect of bolus epinephrine on systemic hemodynamics in canine anaphylactic shock -- Mink et al. 40 (3): 546 -- Cardiovascular Research 9 February 2010 12:37 UTC cardiovascres.oxfordjournals.org [Source type: Academic]

^ Intravenous volume (6% hetastarch in normal saline solution) was given as needed to maintain a constant LVEDP tm .
  • Effect of bolus epinephrine on systemic hemodynamics in canine anaphylactic shock -- Mink et al. 40 (3): 546 -- Cardiovascular Research 9 February 2010 12:37 UTC cardiovascres.oxfordjournals.org [Source type: Academic]

^ In a view of this, the expert use of high dilution intravenous adrenaline in hospitals with appropriate monitoring may be more optimal care for a patient with severe anaphylaxis.
  • bmj.com Rapid Responses for McLean-Tooke et al., 327 (7427) 1332-1335 10 February 2010 11:17 UTC www.bmj.com [Source type: Academic]

[29] .Epinephrine autoinjector is provided for self-prescription.^ Some "high-risk" circumstances that may justify prescription of self-injectable epinephrine in the absence of previous anaphylaxis are summarized in Table 3 .
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

^ PRESCRIPTION OF SELF-INJECTABLE EPINEPHRINE .
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

Intravenous fluids

.Anaphylaxis can lead to massive losses of intravascular fluids.^ Anaphylaxis can lead to massive losses of intravascular fluids.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

Thus large amounts of intravenous fluids maybe required.[28]

Adjuncts

Antihistamines
.Antihistamines while commonly used and assumed effective based on theoretical reasoning are poorly supported by evidence.^ Antihistamines Antihistamines well commonly used and assumed effective based on theoretical reasoning are poorly supported by evidence.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Evidence supporting the early use of adrenaline emphasises that the more advanced the reaction, the less likely adrenaline is to reverse it (Bautista et al, 2002).
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ This is another reason why antihistamines used alone will not save life in some really serious attacks of anaphylaxis.

.A 2007 Cochrane review did not find any good quality studies upon which to base recommendations.^ The figures were based on a review of the medical records of Olmsted County inhabitants followed in the Rochester Epidemiology Study from 1983 to 1987.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ In that study, we also did not find that indomethacin increased PVR preshock in this model.
  • Role of autacoids in cardiovascular collapse in anaphylactic shock in anesthetized dogs -- Mink et al. 43 (1): 173 -- Cardiovascular Research 9 February 2010 12:37 UTC cardiovascres.oxfordjournals.org [Source type: Academic]

[30]
Steroids
.Corticosteroids, are unlikely to make a difference in the current episode of anaphylaxis, but may be used in the hope of decreasing the risk of biphasic anaphylaxis.^ Am I at Risk You may have an increased risk of anaphylaxis if: .
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

^ The immunobiology and pathophysiology of anaphylaxis are basically the same, irrespective of the initial trigger, although there may be subtle differences in the responses.
  • Adrenaline use in anaphylaxis:friend or foe? 10 February 2010 11:17 UTC www.priory.com [Source type: Academic]

^ Fainting and Anaphylaxis: clues which may help you tell the difference (this guide is not perfect; you need a doctor if in doubt.

.How effective they are at achieving this, however, is uncertain.^ How effective they are at achieving this however is uncertain.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[8]

Preparedness

.People prone to anaphylaxis are advised to have an "allergy action plan", and parents are advised to inform schools, etc., of their children's allergies and what to do in case of an anaphylactic emergency.^ People prone to anaphylaxis are advised to have an "allergy action plan", and parents are advised to inform schools, etc., of their children's allergies and what to do in case of an anaphylactic emergency.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Anaphylaxis Action Plan for adults and children .
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

^ Provision of a written anaphylaxis action plan.
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

[31] .The action plan usually includes use of an epinephrine auto-injectors, the recommendation to wear a medical alert bracelet, and counseling on avoidance of triggers.^ Inform the doctor if an epinephrine auto-injector was used.
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

^ Prevention If you know you have a serious allergy, wear an emergency alert bracelet or necklace.
  • Anaphylaxis & Anaphylactic Shock - Orlando & Central Florida Urgent Care - Patient Education Library 9 February 2010 12:37 UTC www.centracare.org [Source type: Academic]

^ They often wear a bracelet or necklace identifying them as food allergic and carry injectable epinephrine wherever they go.
  • Vital Signs - Salon.com 10 February 2010 11:17 UTC www.salon.com [Source type: FILTERED WITH BAYES]

[32]. .Immunotherapy is available for certain triggers to prevent future episodes of anaphylaxis.^ Immunotherapy is available for certain triggers to prevent future episodes of anaphylaxis.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ When relevant, specific preventive measures should be recommended (eg, for venom anaphylaxis, allergen-specific immunotherapy should be instituted to provide long-lasting protection).
  • Self-injectable Epinephrine for First-Aid Management of Anaphylaxis -- Sicherer et al. 119 (3): 638 -- AAP Policy 10 February 2010 11:17 UTC aappolicy.aappublications.org [Source type: Academic]

^ Venom immunotherapy prevents anaphylaxis to insect stings and significantly improves quality of life compared with carrying injectable adrenaline (EpiPen) alone (Level II).
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

.A multi–year course of subcutaneous desensitization has been found effective against stinging insects well oral desensitization is effective for many foods.^ Ceramic Magnets N-1 and N-2 ceramic magnets work very well on insect bites or bee stings.
  • Medsker Racing College 9 February 2010 12:37 UTC www.racingsmarter.com [Source type: FILTERED WITH BAYES]

^ Niacin is a B complex vitamin found in a many foods such as liver, poultry, fish, nuts and dried beans.
  • Shock | LIVESTRONG.COM 9 February 2010 12:37 UTC www.livestrong.com [Source type: General]

^ They are planning to find out how many children with food allergies under the age of 16 years actually die or nearly die from anaphylaxis per year.

[9]

Epidemiology

.The rate of anaphylaxis appears to be increasing.^ The incidence of anaphylaxis in Australia also appears to be increasing.
  • Anaphylaxis following quadrivalent human papillomavirus vaccination -- Brotherton et al. 179 (6): 525 -- Canadian Medical Association Journal 10 February 2010 11:17 UTC www.cmaj.ca [Source type: Academic]

^ The rate of anaphylaxisis appears to be increasing.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The incidence rate of anaphylaxis to cephalosporins in penicillin-anaphylactic patients appears to be much less than the 10% frequently quoted.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

.The rate in the 1980s was 21 per 100,000 per year well in the 1990s it had increased to 50 per 100,000 per year.^ Two cases occurred after the second dose (91 289 doses administered), giving a rate of anaphylaxis of 2.2 per 100 000 people vaccinated (95 % CI 0.3–7.9).
  • Anaphylaxis following quadrivalent human papillomavirus vaccination -- Brotherton et al. 179 (6): 525 -- Canadian Medical Association Journal 10 February 2010 11:17 UTC www.cmaj.ca [Source type: Academic]

^ If we include these cases, the anaphylaxis rate is 0.4 cases per 100 000 doses (95% CI 0.1–1.1).
  • Anaphylaxis following quadrivalent human papillomavirus vaccination -- Brotherton et al. 179 (6): 525 -- Canadian Medical Association Journal 10 February 2010 11:17 UTC www.cmaj.ca [Source type: Academic]

^ From the 269 680 HPV vaccine doses administered in schools, 7 cases of anaphylaxis were identified, which represents an incidence rate of 2.6 per 100 000 doses (95% CI 1.0–5.3 per 100 000).
  • Anaphylaxis following quadrivalent human papillomavirus vaccination -- Brotherton et al. 179 (6): 525 -- Canadian Medical Association Journal 10 February 2010 11:17 UTC www.cmaj.ca [Source type: Academic]

[9] .The risk is greatest in young people and females.^ The risk is greatest in young people and females.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

.The trigger in the young is usually food related while in adults, medications and insect venoms are more common causes.^ The trigger in the young is usually food related while in adults, medications and insect venoms are more common causes.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ Common triggers of anaphylaxis include food, stinging insects and medication.
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ Common triggers include insect bites or stings, foods, medication and latex rubber.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

[9]
.Due in part to the variety of definitions, between 1% and 15% of the population of the United States can be considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens, especially penicillin and insect stings.^ Underlying atopy does not appear to be a risk factor for reactions to penicillin or insect stings.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

^ It can be induced by insect venoms, food, drugs, latex, and other allergens and may affect as much as 1–15% of the population with an increasing prevalence ( 1 – 4 ).
  • Anaphylactic shock depends on endothelial Gq/G11 -- Korhonen et al. 206 (2): 411 -- The Journal of Experimental Medicine 9 February 2010 12:37 UTC jem.rupress.org [Source type: Academic]

^ The most common allergens which cause anaphylaxis are peanuts, tree nuts, bee/wasp stings or a drug, such as the antibiotic penicillin.
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

.Most of these people successfully avoid their allergens and will never experience anaphylaxis.^ Allergy - anaphylaxis - avoiding food allergens .
  • Anaphylaxis - Everybody - Health Information for New Zealanders 10 February 2010 11:17 UTC www.everybody.co.nz [Source type: Academic]

^ The most common allergens which cause anaphylaxis are peanuts, tree nuts, bee/wasp stings or a drug, such as the antibiotic penicillin.
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

^ The best treatment for anaphylaxis is avoiding the allergen to which you are allergic, especially if you have had a previous serious reaction.
  • Anaphylaxis and allergic anaphylactic shock 9 February 2010 12:37 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

.Of those people who actually experience anaphylaxis, up to 1% may die as a result.^ Of those people who actually experience anaphylaxis, up to 1% may die as a result.
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ In the United States, it is estimated that more than 40 people per year die from insect sting anaphylaxis (1).
  • Case Based Pediatrics Chapter 10 February 2010 11:17 UTC www.hawaii.edu [Source type: Academic]

^ Records show that 20 people a year die as a result of anaphylaxis although allergy experts believe the true figure may be higher as it is likely that some deaths attributed to asthma may actually have been triggered by food allergies.
  • How a prawn salad at Royal Ascot nearly killed me, by TV news beauty Kate Silverton | Mail Online 9 February 2010 12:37 UTC www.dailymail.co.uk [Source type: General]

[2] .Anaphylaxis results in approximately 1,500 deaths per year in the U.S.[3] (one out of every 1,600 of the 2.4 million deaths from all causes each year in the U.S.;[4]).^ Without vaccines millions would die every year.
  • H1N1 Swine Flu Vaccine Insert Admits It Causes Guillain-Barre Syndrome, Vasculitis, Paralysis, Anaphylactic Shock And Death 9 February 2010 12:37 UTC www.prisonplanet.com [Source type: General]

^ The rate of fatal anaphylaxis is approximately 4 deaths per 10 million people per year.

^ All of these result in shock, which can lead to complete organ system failure, and death.

.The most common presentation includes sudden cardiovascular collapse (88% of reported cases of severe anaphylaxis).^ The most common presentation includes sudden cardiovascular collapse (88% of reported cases of severe anaphylaxis).
  • Anaphylaxis Information & Anaphylaxis Links at HealthHaven.com 10 February 2010 11:17 UTC wiki.healthhaven.com [Source type: Academic]

^ The most common causes of severe anaphylaxis are antibiotics and radiocontrast agents.

^ The most common causes of death are cardiovascular collapse and respiratory compromise.
  • Anaphylaxis: eMedicine Allergy and Immunology 10 February 2010 11:17 UTC emedicine.medscape.com [Source type: Academic]

.In England, mortality rates for anaphylaxis have been reported as up to 0.05 per 100,000 population, or around 10-20 a year.^ Deaths from anaphylaxis are uncommon, estimated to occur at a rate of 1 per 3 million population per year.
  • eMJA: 2. Anaphylaxis: diagnosis and management 10 February 2010 11:17 UTC www.mja.com.au [Source type: Academic]

^ In Denmark, Sorensen et al 8 reported 3.2 cases of anaphylaxis per 100 000 inhabitants per year with a fatality rate of 5%.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

^ In a more recent US survey, Yocum et al 5 reported an annual incidence of food-induced anaphylaxis of 7.6 cases per 100 000 person-years and a food-induced anaphylaxis occurrence rate of 10.8 per 100 000 person-years.
  • Anaphylaxis and Emergency Treatment -- Sampson 111 (6): 1601 -- Pediatrics 10 February 2010 11:17 UTC pediatrics.aappublications.org [Source type: Academic]

[5] Anaphylactic reactions requiring hospital treatment appear to be increasing, with authorities in England reporting a threefold increase between 1994 and 2004.[33]

References

  1. ^ "anaphylaxis". merriam-webster.com. http://www.merriam-webster.com/dictionary/anaphylaxis. Retrieved 2009-11-21. 
  2. ^ a b Neugut AI, Ghatak AT, Miller RL (January 2001). "Anaphylaxis in the United States: an investigation into its epidemiology". Arch. Intern. Med. 161 (1): 15–21. doi:10.1001/archinte.161.1.15. PMID 11146694. http://archinte.ama-assn.org/cgi/content/full/161/1/15. 
  3. ^ a b Matasar MJ, Neugut AI (January 2003). "Epidemiology of anaphylaxis in the United States". Curr Allergy Asthma Rep 3 (1): 30–5. PMID 12542990. 
  4. ^ a b "Deaths/Mortality". National Center for Health Statistics. 2008-03-31. http://www.cdc.gov/nchs/fastats/deaths.htm. Retrieved 2008-04-22. 
  5. ^ a b A Review of Services for Allergy. Department of Health. 2006. See sections 2.60-63 and 2.86.
  6. ^ A Review of Services for Allergy. Department of Health. 2006. See sections 2.54-55.
  7. ^ Limmer D, Mistovich JJ, Krost WS (November 17, 2005). "Anaphylactic and Anaphylactoid Reactions -- Prehospital Pathophysiology". EMSResponder.com. http://publicsafety.com/article/article.jsp?id=2165&siteSection=6. Retrieved 2007-11-27. 
  8. ^ a b c Lieberman P (September 2005). "Biphasic anaphylactic reactions". Ann. Allergy Asthma Immunol. 95 (3): 217–26; quiz 226, 258. PMID 16200811. 
  9. ^ a b c d e f g h i j k l Simons FE (October 2009). "Anaphylaxis: Recent advances in assessment and treatment". J. Allergy Clin. Immunol. 124 (4): 625–36; quiz 637–8. doi:10.1016/j.jaci.2009.08.025. PMID 19815109. 
  10. ^ Joris, Isabelle; Majno, Guido (2004). Cells, tissues, and disease: principles of general pathology. Oxford [Oxfordshire]: Oxford University Press. pp. 538–539. ISBN 0-19-514090-7. 
  11. ^ "John Libbey Eurotext : Éditions médicales et scientifiques France : revues, médicales, scientifiques, médecine, santé, livres - Texte intégral de l'article" (PDF). http://www.john-libbey-eurotext.fr/e-docs/00/04/38/60/vers_alt/VersionPDF.pdf. 
  12. ^ Sell S (1991). "Immunopathology," In Dulbecco R (ed.) Encyclopedia of Human Biology, Vol. 4. pp. 401-413, San Diego; Academic Press, ISBN 0122267540.
  13. ^ Oswalt ML, Kemp SF (May 2007). "Anaphylaxis: office management and prevention". Immunol Allergy Clin North Am 27 (2): 177–91, vi. doi:10.1016/j.iac.2007.03.004. PMID 17493497. 
  14. ^ a b c d e Sampson HA, Muñoz-Furlong A, Campbell RL, et al. (February 2006). "Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium". J. Allergy Clin. Immunol. 117 (2): 391–7. doi:10.1016/j.jaci.2005.12.1303. PMID 16461139. 
  15. ^ "Anaphylaxis (Severe Allergic Reaction) Symptoms, Causes, Diagnosis, Treatment, and Prevention on MedicineNet.com". http://www.medicinenet.com/anaphylaxis/page3.htm. 
  16. ^ Ewan PW (May 1998). "Anaphylaxis". BMJ 316 (7142): 1442–5. PMID 9572760. 
  17. ^ "Mastocytosis: Allergic Reactions: Merck Manual Home Edition". http://www.merck.com/mmhe/sec16/ch185/ch185e.html. Retrieved 2007-11-27. 
  18. ^ National Advisory Committee on Immunization (NACI) - SUPPLEMENTARY STATEMENT MMR VACCINE AND ANAPHYLACTIC HYPERSENSITIVITY TO EGG OR EGG-RELATED ANTIGENS - CCDR Volume 22
  19. ^ a b c d e f Murphy, Kenneth (November 27, 2007). Janeway's Immunobiology (7th edition ed.). New York: Garland Science. ISBN 0-8153-4123-7. 
  20. ^ Kitaura J, Kinoshita T, Matsumoto M, et al. (April 2005). "IgE- and IgE+Ag-mediated mast cell migration in an autocrine/paracrine fashion". Blood 105 (8): 3222–9. doi:10.1182/blood-2004-11-4205. PMID 15637135. http://bloodjournal.hematologylibrary.org/cgi/content/full/105/8/3222. 
  21. ^ a b c Paolini R, Jouvin MH, Kinet JP (October 1991). "Phosphorylation and dephosphorylation of the high-affinity receptor for immunoglobulin E immediately after receptor engagement and disengagement". Nature 353 (6347): 855–8. doi:10.1038/353855a0. PMID 1834946. 
  22. ^ a b c Gilfillan AM, Tkaczyk C (March 2006). "Integrated signalling pathways for mast-cell activation". Nat. Rev. Immunol. 6 (3): 218–30. doi:10.1038/nri1782. PMID 16470226. 
  23. ^ a b Parravicini V, Gadina M, Kovarova M, et al. (August 2002). "Fyn kinase initiates complementary signals required for IgE-dependent mast cell degranulation". Nat. Immunol. 3 (8): 741–8. doi:10.1038/ni817. PMID 12089510. 
  24. ^ a b Kitaura J, Song J, Tsai M, et al. (October 2003). "Evidence that IgE molecules mediate a spectrum of effects on mast cell survival and activation via aggregation of the FcepsilonRI". Proc. Natl. Acad. Sci. U.S.A. 100 (22): 12911–6. doi:10.1073/pnas.1735525100. PMID 14569021. http://www.pnas.org/cgi/content/full/100/22/12911. 
  25. ^ Schwartz LB (August 2006). "Diagnostic value of tryptase in anaphylaxis and mastocytosis". Immunology and allergy clinics of North America 26 (3): 451–63. doi:10.1016/j.iac.2006.05.010. PMID 16931288. 
  26. ^ Bousquet J, Müller UR, Dreborg S, et al. (1987). "Immunotherapy with Hymenoptera venoms. Position paper of the Working Group on Immunotherapy of the European Academy of Allergy and Clinical Immunology". Allergy 42 (6): 401–13. doi:10.1111/j.1398-9995.1987.tb00355.x. PMID 3310714. 
  27. ^ Peanut Allergy. Website of the Allergic Child Publishing Group.
  28. ^ a b "Emergency treatment of anaphylactic reactions -- Guidelines for healthcare providers" (PDF). Resuscitation Council (UK). January 2008. http://www.resus.org.uk/pages/reaction.pdf. Retrieved 2008-04-22. 
  29. ^ a b c d e-radiography.net > Allergic Emergencies (From BNF Website) Last Update 11/01/10
  30. ^ Sheikh A, Ten Broek V, Brown SG, Simons FE (August 2007). "H1-antihistamines for the treatment of anaphylaxis: Cochrane systematic review". Allergy 62 (8): 830–7. doi:10.1111/j.1398-9995.2007.01435.x. PMID 17620060. 
  31. ^ "Asthma and Allergy Foundation of America - Information About Asthma, Allergies, Food Allergies and More!". http://www.aafa.org/display.cfm?id=4&sub=81&cont=392. Retrieved 2007-11-27. 
  32. ^ "Anaphylaxis - ACAAI". http://www.acaai.org/public/advice/anaph.htm. 
  33. ^ A Review of Services for Allergy. Department of Health. 2006. See sections 2.54-55.

External links


Simple English

Anaphylaxis is a severe and fast multi-system allergic reaction. Anaphylaxis is triggered by a substance, called an allergen, that the body believes is bad. Very small amounts of allergens can still cause anaphylaxis. Anaphylaxis is a very bad medical emergency, as the airway quickly closes. The brain can not survive more than a few minutes without oxygen. Death within minutes is possible. The worst type, called anaphylactic shock, will cause death very quickly if not treated.

Emergency treatment

Calling for help is very important when dealing with anaphylaxis because medical help is needed immediately. CPR or Rescue breathing may be necessary if the patient stops breathing on their own. Epinephrine should be given to the person right away, because the epinephrine prevents the airway from narrowing even more and keeps the heart beating. Most people who have been diagnosed with anaphylaxis carry an EpiPen (pictured) or something similar to use in the event of anaphylactic shock. EpiPens contain epinephrine.

Symptoms

The symptoms of anaphylaxis are:

  • respiratory distress, or difficulty breathing,
  • hypotension (low blood pressure),
  • fainting,
  • unconsciousness,
  • urticaria (hives), or itchy spots on the body,
  • flushed appearance,
  • angioedema (swelling of the face, neck and throat),
  • tears(due to angioedema and stress),
  • vomiting,
  • anxiety, including a sense of impending doom

Causes

Common causes of anaphylaxis are:


Citable sentences

Up to date as of December 30, 2010

Here are sentences from other pages on Anaphylaxis, which are similar to those in the above article.








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