Anaphylactic and anaphylactoid reactions. A review

Area of Science:

• Immunology
• Pharmacology
• Emergency Medicine

Background:

• Anaphylaxis is a severe, life-threatening, immunologically mediated reaction.
• Anaphylactoid reactions mimic anaphylaxis clinically but lack immunological mediation.
• Both reaction types involve vasoactive mediators like histamine, leukotrienes, kinins, and prostaglandins.

Purpose of the Study:

• To review the pathophysiology, incidence, and drug-induced causes of anaphylactic/anaphylactoid reactions.
• To propose therapeutic strategies for managing these reactions, particularly in the context of spinal condition treatments.

Main Methods:

• Literature review of anaphylactic and anaphylactoid reactions.
• Analysis of the role of vasoactive mediators in reaction development.
• Evaluation of therapeutic interventions, focusing on volume replacement.

Main Results:

• Symptoms onset can range from 15 minutes to 2.5 hours post-exposure.
• Pathophysiology involves vasodilation leading to fluid loss and reduced plasma volume.
• Volume replacement is identified as a primary therapeutic approach.

Conclusions:

• Understanding the pathophysiology of anaphylaxis and anaphylactoid reactions is key to effective management.
• Prompt recognition and intervention, including volume resuscitation, are critical for patient outcomes.
• This review provides insights for physicians managing patients at risk for these reactions, especially those undergoing spinal treatments.