IgE-Mediated Systemic Anaphylaxis And Its Association With Gene Polymorphisms Of ACE, Angiotensinogen And Chymase
Guidelines recommend prompt use of intramuscular epinephrine as first-line treatment for anaphylaxis 1-5. Patients at-risk of anaphylaxis are generally couselled by medical professionals to carry epinephrine in the form of an epinephrine auto-injector (EAI) to treat a severe allergic reaction. Despite its critical role as a life-saving medication, availability of EAIs differs around the world. Shortages of EAIs have compounded this problem.
The School Access to Emergency Epinephrine Act was signed into law by President Obama on November 13, 2013 with bipartisan support (Public Law 113-48). The law amended the Public Health Service Act to increase the preference given to certain asthma-related grants in states that allow trained school personnel to administer epinephrine and maintain a stock epinephrine supply to treat suspected anaphylaxis. To qualify, states are also required to provide civil liability protection to trained staff acting in good faith at the elementary and secondary levels.
ConclusionIn this case control-study, severe AR were rarely observed. Exposure to BB or ACE-I did not significantly influence AR frequency or severity; however, most BB were cardioselective. Our findings imply cardioselective BB or ACE-I suspension is not warranted in association with CC.
Cow's Milk allergy (CMA) is the most common cause of food allergy in young children. Although a common problem in the pediatric population, some cases of CMA can be challenging in the setting of IgE mediated reactions and the risk of morbidity and mortality high.
This report describes an episode of anaphylaxis in an infant during a POFC while implementing the NIAID Guidelines. This case raises considerations regarding dosing and emergency preparedness.
Food allergy is common, with a reported prevalence in adults of up to 10%. Unintended exposures in food-allergic individuals can cause anaphylaxis. When individuals experience frequent episodes of anaphylaxis with unclear food triggers, it is imperative to evaluate for alternative causes. Comprehensive evaluation seeks objective evidence of anaphylaxis, and consideration of a broad differential diagnosis, including rare etiologies such as systemic mastocytosis.
Standard food blood IgE and skin testing may be negative in patients with convincing histories of food-induced anaphylaxis. Food specific component blood testing may be useful in these cases.
A 5-year-old girl with history of significant eczema, severe dog allergy (IgE>100), and anaphylactic allergy to egg and treenuts developed urticaria on her bilateral arms after preparing hamburger patties. No other ingredients, such as egg, were handled. She had previously tolerated cooked beef and had no history of milk allergy.
Epinephrine autoinjector is a prescription medication used for anaphylaxis. A study showed 55% of parents were afraid/somewhat afraid to administer epinephrine due to incorrect use (32.5%) or fear of a bad outcome (24.5%). This quality improvement project sought to evaluate if providers were addressing these concerns.
We examined the barriers to optimal anaphylaxis management in adolescents (12-18 years), specifically in social situations without direct adult supervision.