Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- An acute, widely distributed form of shock that occurs within minutes of exposure to antigen in a sensitized individual
- ∼500–1,000 deaths are attributed annually in the US to anaphylaxis. There are ∼10,000 ER visits per month for anaphylaxis in the US
- Involves release of bioactive molecules such as histamine, leukotrienes, and prostaglandins from inflammatory cells:
- Mediator release results in increased vascular permeability, vasodilation, smooth-muscle contractions, and increased epithelial secretion.
- Physiologically, this is manifested in a decrease in total peripheral resistance, venous return, and cardiac output, as well as intravascular volume depletion.
- IgE mediated:
- Antibiotics, particularly penicillin family
- Venoms, especially bee and wasp
- Foodstuffs (shellfish, soybeans, peanuts, tree nuts, wheat, milk, eggs, nitrates/nitrites)
- Monoclonal antibody therapeutics
- Non-IgE mediated:
- Iodine contrast media
In children, foods are an important trigger for IgE-mediated anaphylaxis:
- Milk, egg, wheat, and soy (MEWS) are the most common food allergens.
- Peanut allergies are increasingly common and can be more potent; children can develop anaphylaxis from residual peanut in a candy bar.