Anaphylaxis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Dushka Riaz, MD

Overview

The hallmark of anaphylaxis is to find a possible causative allergen. Often the history may rely on friends and family who can help with the temporal relationship between symptoms and the inciting event. [1]

The diagnosis is likely when any one of the following criteria is met: [2]

History and Symptoms

Symptoms of anaphylaxis are related to the histamine release from mast cells (degranulation). Histamine induces vasodilation of arterioles and constriction of bronchioles in the lungs. [3]

History

Patients with anaphylaxis may have a positive history of: [4] [5]

  • Ingestion of certain foods, drinks or medications within 8 hours before the event
  • Exposure to heat or cold before the event
  • Sting or bite prior to the event
  • Recurrence of symptoms following initial resolution
  • Recent infection or illness
  • Recent relevant exposure or travel history
  • Prior similar episodes

Common Symptoms

Common symptoms of anaphylaxis include:

Less Common Symptoms

Less common symptoms of anaphylaxis include:

The time between ingestion of the allergen and anaphylaxis symptoms can vary for some patients depending on the amount of allergen consumed and their reaction time. Symptoms can appear immediately or can be delayed by half an hour to several hours after ingestion. However, symptoms of anaphylaxis usually appear very quickly once they do begin.

References

  1. Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/S0091-6749(18)30572-4 Check |pmid= value (help).
  2. Bjornsson HM, Graffeo CS (2010). "Improving diagnostic accuracy of anaphylaxis in the acute care setting". West J Emerg Med. 11 (5): 456–61. PMC 3027438. PMID 21293765.
  3. LoVerde D, Iweala OI, Eginli A, Krishnaswamy G (2018). "Anaphylaxis". Chest. 153 (2): 528–543. doi:10.1016/j.chest.2017.07.033. PMC 6026262. PMID 28800865.
  4. Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1542/peds.2016-4006 Check |pmid= value (help).
  5. Commins SP (2017). "Outpatient Emergencies: Anaphylaxis". Med Clin North Am. 101 (3): 521–536. doi:10.1016/j.mcna.2016.12.003. PMC 5381731. PMID 28372711.

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