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Anaphylaxis
Anaphylaxis is a severe, life-threatening generalised or systemic hypersensitivity reaction
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Main signs are utricaria (hives), angiodema, flush, pruritis without rash
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The release of histamine and other
agents causes capillary leak, wheeze, cyanosis, oedema, and
utricaria
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It can be immunologic (IgE mediated) or non-immunologic
(mast cell degranulation without the involvement of
antibodies e
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Both cause the
release of inflammatory mediators such as histamine,
tryptase and prostaglandins
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Phaeochromocytoma can mimic the signs of an anaphylactic shock
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Examination – they will have signs of facial oedema, tachycardia, stridor (due to laryngeal oedema),
bronchospasms and will also be hypOtensive
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Immediate management – the first thing is to ensure the airway is clear and to establish a large bore
IV access
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Then give Oxygen 35%, unless they are hypoxic in which case give 100%
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5mg Adrenaline intramuscularly and repeat after 5 minutes if still hypotensive
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5mg nebulised or IV
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Measure mast cell tryptase 1-6h after suspected anaphylaxis and suggest an IgE skin prick
test to show specific allergens to avoid
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It peaks
at 1-2 hours and has a short half life

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