Multiphasic anaphylaxis in the emergency and intensive care setting

Area of Science:

• Allergy and Immunology
• Clinical Medicine

Background:

• Anaphylaxis is a severe allergic reaction requiring immediate treatment.
• Biphasic or multiphasic anaphylaxis involves symptom recurrence despite initial treatment, posing clinical challenges.
• Current guidelines lack clear strategies for managing recurrent anaphylaxis, particularly multiphasic cases.

Purpose of the Study:

• To present a case of multiphasic anaphylaxis.
• To explore potential underlying conditions contributing to recurrent anaphylaxis.
• To provide insights into the clinical management of complex anaphylaxis cases.

Main Methods:

• Case report of a woman in her 60s experiencing multiphasic anaphylaxis.
• Clinical analysis of the patient's reaction to clarithromycin.
• Investigation into potential associated conditions, including systemic mastocytosis.

Main Results:

• The patient experienced recurrent anaphylaxis despite standard treatment.
• Analysis indicated a high likelihood of systemic mastocytosis.
• Formal diagnostic criteria for systemic mastocytosis were not met by the patient.

Conclusions:

• Multiphasic anaphylaxis requires careful consideration of underlying conditions.
• Systemic mastocytosis may be associated with recurrent anaphylaxis, even without meeting diagnostic criteria.
• Case reports are valuable for understanding and managing rare clinical presentations of anaphylaxis.