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CMAJ • August 19, 2003; 169 (4)
© 2003 Canadian Medical Association or its licensors

Review
Synthèse

Diagnosis and management of anaphylaxis

Anne K. Ellis and James H. Day

Both authors are with the Department of Medicine, Queen's University, and the Division of Allergy and Immunology, Kingston General Hospital, Kingston, Ont.

Correspondence to: Dr. Anne K. Ellis, c/o Dr. James H. Day, Division of Allergy and Immunology, Kingston General Hospital, Kingston ON K7L 2V7; fax 613 546-3079; ellisa{at}kgh.kari.net

Abstract

ANAPHYLAXIS IS A SEVERE SYSTEMIC ALLERGIC reaction that is potentially fatal. It requires prompt recognition and immediate management. Anaphylaxis has a rapid onset with multiple organ–system involvement and is mostly caused by specific antigens in sensitized individuals. Reactions typically follow a uniphasic course, however, 20% will be biphasic in nature. The second phase usually occurs after an asymptomatic period of 1–8 hours, but there may be a 24-hour delay. Protracted anaphylaxis may persist beyond 24 hours. Concurrent ß-blocker therapy may adversely affect the response to management. Epinephrine is the treatment of choice and should be administered immediately. Secondary measures include circulatory support, H1 and H2 antagonists, corticosteroids and, occasionally, bronchodilators. Post-treatment observation of these patients is necessary, and they should remain within ready access of emergency care for the following 48 hours.




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eLetters:

Read all eLetters

0.1 ml of 1/1000 epinephrine is 100 micrograms or 0.1 milligram
Axel Ellrodt
CMAJ, 25 Aug 2003 [Full text]
post - acute treatment of anaphylaxis
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