By Johannes Ring
Anaphylaxis is the main dramatic and in all probability life-threatening manifestation of an immediate-type hypersensitive reaction response. even if recognized for over a hundred years, it nonetheless poses many unresolved questions, and its useful administration and acute therapy are usually extra empiric in nature than evidence-based. during this booklet, a multidisciplinary team of specialists overview the state-of-the-art within the pathophysiology, epidemiology, analysis and scientific symptomatology of anaphylaxis. Its etiology with reference to assorted elicitors similar to insect venoms, radiocontrast media, analgesics, basic and native anesthetics is tested intimately. eventually, therapy modalities for anaphylaxis are mentioned either for acute reactions and as basic administration ideas for sufferers in danger. supplying thorough and updated insurance of this often underestimated challenge, this publication is of curiosity not just to allergologists and immunologists, but additionally to all physicians and affected sufferers.
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Extra info for Anaphylaxis (Chemical Immunology and Allergy, Vol. 95)
Triggering of mast cells and basophils leads to release of various vasoactive mediators, among which histamine was the first recognized in 1908 (fig. 3, 4) . 4 Ring · Behrendt · de Weck Table 1. Pathophysiology of anaphylactic reactions Immunoglobulin E-mediated (type I) IgG or IgM immune complex reaction Non-immune hypersensitivity via direct mediator release or direct activation of plasma-protein systems Fig. 3. Mast cell in different stages of secretion (from Heidrun Behrendt). Fig. 4. Microcirculatory stasis in the rabbit omentum during anaphylactic shock (from ).
Ergebnisse einer multizentrischen Studie. Berlin, Springer, 1986. Ring · Behrendt · de Weck 21 Lockey RF, Benedict LM, Turkeltaub TB, Bukantz SC: Fatalities from immunotherapy and skin testing. J Allergy Clin Immunol 1987;79:666–677. 22 Lorenz W, Doenicke A, Dittmann I, Hug P, Schwarz B: Anaphylaktoide Reaktionen nach Applikation von Blutersatzmitteln beim Menschen. Verhinderung dieser Nebenwirkung von Haemacccel durch Praemedikation mit H1- und H2-Antagonisten. Anaesthesist 1977;26:644. 23 Magendie F: Lectures on the blood and on the changes it undergoes during disease.
Epidemiology of Anaphylaxis 4 Smit DV, Cameron PA, Rainer TH: Anaphylaxis presentation in a emergency department in Hong Kong: incidence and predictors of biphasic reactions. J Emerg Med 2005;28:381–388. 5 Kiratiseavee S, Ranesg S: Evaluation of pediatric patients admitted with adverse food reactions to an inner-city pediatric ED. J Allergy Clin Immunol 2007;119:S114. 19 6 Mulla ZD, Simon MR: Hospitalizations for anaphylaxis in Florida: epidemiologic analysis of a population-based dataset. J Allergy Clin Immunol 2007; 119:S32.
Anaphylaxis (Chemical Immunology and Allergy, Vol. 95) by Johannes Ring