[Severe allergic-immunologic reactions]

Besides acute bronchial asthma IgE-mediated anaphylaxis is certainly the most important allergological emergency. Anaphylaxis is most often caused by drugs, foods and insect stings. The most relevant pathogenetic factors induced by allergy mediators are hypovolemia, bronchial obstruction and cardiac failure. Emergency treatment consists in intramuscular application of adrenaline and volume substitution by intravenous infusion. All patients should be hospitalized immediately and treated on an intensive care unit. Unfortunately, the subsequent consultation with an allergist does often not take place. This important preventive measure includes supply of instruction for allergen avoidance and of emergency medications. In anaphylaxis induced by insect stings specific immunotherapy should be started.