Anaphylaxis and anaphylactoid reactions

The clinical syndrome of anaphylaxis and anaphylactoid reactions is quite variable, making diagnosis difficult at times. Early recognition by patient or physician is imperative to appropriate management. Recurrences may be life-threatening if the initial diagnosis is incorrect, as patients do not avoid the offending allergen. Release of inflammatory mediators from mast cells and basophils are responsible for the symptoms and signs in both anaphylactic and anaphylactoid reactions. They differ only in the initial cause of the activation of the mast cell or basophil. Management, regardless of the cause, involves rapid treatment. Intravenous fluids and adrenalin (preferably intravenous if appropriate) usually produce a response in more than 90% of patients. Prevention strategies including pharmacological prophylaxis should not be undervalued, because recurrences can easily be avoided. Follow-up with an allergist/immunologist is essential.