CASE DISCUSSION ON

ANAPHYLAXIS
Elaine V. Puno

Definition: Anaphylaxis
a serious, life-threatening
generalized or systemic
hypersensitivity reaction
a serious allergic reaction that is
rapid in onset and might cause
death.

*World Allergy Organization (WAO), Guidelines for

Management for the Assessment and Management of
Anaphylaxis, 2012

Etiology

Clinical Manifestations
Anaphylaxis typically presents many different
symptoms over minutes or hours with an
average onset of 5 to 30 minutes if
exposure is intravenous and 2 hours for
foods.
The most common areas affected include: skin
(8090%), respiratory (70%), gastrointestinal
(3045%), heart and vasculature (1045%),
and central nervous system (1015%)[5] with
usually two or more being involved.

*Tang et al. A Practical Guide to Anaphylaxis. American Academy

of Family Physicians, 2003

Clinical Criteria for Diagnosing

Anaphylaxis

*World Allergy Organization (WAO), Guidelines for Management for the

Assessment and Management of Anaphylaxis, 2012

Clinical Criteria for Diagnosing

Anaphylaxis

*World Allergy Organization (WAO), Guidelines for Management for the

Assessment and Management of Anaphylaxis, 2012

Management of
Anaphylaxis
Early recognition of anaphylaxis is important
since death occurs within minutes to hours
Administer 0.3 to to 0.5 mL of 1:1000 (1
mg/mL) epinephrine SC or IM, with repeated
doses as required at 5-10 min intervals.*
IV infusion should be initiated to provide a
route for administration of epinephrine
Volume expanders (e.g. normal saline) &
Vasopressor agents (i.e. Dopamine) if
intractable hypotension occurs.
* Harrisons Principles of Internal Medicine, 18th ed

Management of
Anaphylaxis
Oxygen via a nasal catheter may be helpful
Endotracheal intubation or tracheostomy is
mandatory for oxygen delivery if progressive hypoxia
develops
Antihistamine diphenhydramine, 50-100 mg IM
or IV, for urticaria & angiodema
Aminophylline 0.25-0.5 g IV may be given for
bronchospasm
Intravenous glucocorticoids (medrol 0.5-1 mg/kg)
are not effective for the acute event but may
alleviate later recurrence of bronchospasm,
hypotension or urticaria
* Harrisons Principles of Internal Medicine, 18th ed

*World Allergy Organization (WAO), Guidelines for Management for the

Assessment and Management of Anaphylaxis, 2012

*World Allergy Organization (WAO), Guidelines for Management for the

Assessment and Management of Anaphylaxis, 2012

References
Harrisons Principles of Internal
Medicine, 18th ed, 2012
World Allergy Organization (WAO),
Guidelines for Management for the
Assessment and Management of
Anaphylaxis, 2012
Tang et al. A Practical Guide to
Anaphylaxis. American Academy of
Family Physicians, 2003