PMID- 31690393
OWN - NLM
STAT- MEDLINE
DCOM- 20201105
LR  - 20201105
IS  - 1539-6304 (Electronic)
IS  - 1088-5412 (Linking)
VI  - 40
IP  - 6
DP  - 2019 Nov 1
TI  - Anaphylaxis.
PG  - 453-456
LID - 10.2500/aap.2019.40.4270 [doi]
AB  - Anaphylaxis is a sudden onset, immediate reaction that implies a risk of death. 
      Think of a "rule of 2s" for anaphylaxis, which implies that reactions usually 
      begin within 2 minutes to 2 hours after injection, infusion, ingestion, contact, 
      or inhalation. Fatalities can be from asphyxiation from laryngeal or 
      oropharyngeal swelling, collapse from hypotensive shock, cardiac arrest, or acute 
      severe bronchoconstriction that causes respiratory failure and arrest. When there 
      is activation of mast cells and basophils in anaphylaxis, chemical mediators are 
      detectable. The preformed mediators from mast cells include histamine, tryptase, 
      carboxypeptidase A, and proteoglycans (heparin, chondroitin sulfates). Newly 
      synthesized mediators include prostaglandin D(2), leukotriene D(4), and platelet 
      activating factor. Crucial actions of the mediators include an abrupt increase in 
      vascular permeability, vascular smooth muscle relaxation, and bronchial smooth 
      muscle contraction. Anaphylaxis can be classified into immunologic, 
      nonimmunologic, or idiopathic based on the associated mechanism. For example, 
      immunologic causes of anaphylaxis are those mediated by immunoglobulin E (IgE) 
      antibodies acting through the FcepsilonR I (foods, insect venom, 32 beta-lactam 
      antibiotics), whereas non-IgE immunologic anaphylaxis is mediated without the 
      presence of anti-allergen IgE antibodies or via FcepsilonRI activation (radiographic 
      contrast material). Nonimmunologic anaphylaxis involves mast cell mediator 
      release such as occurs with exercise or with cold temperature exposure, or from 
      medications such as opioids or vancomycin. Idiopathic anaphylaxis involves mast 
      cell activation (acutely elevated urine histamine or serum tryptase) and 
      activated lymphocytes. Because anaphylaxis is a medical emergency, the drug of 
      choice is epinephrine, not H(1) antihistamines or H(2) receptor antagonists.
FAU - Watts, Melissa M
AU  - Watts MM
FAU - Marie Ditto, Anne
AU  - Marie Ditto A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Anaphylaxis/drug therapy/*etiology/mortality/pathology
MH  - Basophils/metabolism
MH  - Emergency Medicine/methods
MH  - Epinephrine/therapeutic use
MH  - Humans
MH  - Mast Cells/metabolism
EDAT- 2019/11/07 06:00
MHDA- 2020/11/06 06:00
CRDT- 2019/11/07 06:00
PHST- 2019/11/07 06:00 [entrez]
PHST- 2019/11/07 06:00 [pubmed]
PHST- 2020/11/06 06:00 [medline]
AID - 10.2500/aap.2019.40.4270 [doi]
PST - ppublish
SO  - Allergy Asthma Proc. 2019 Nov 1;40(6):453-456. doi: 10.2500/aap.2019.40.4270.