Pediatric emergency medicine trisk 1670 1670
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multisystem reaction involving the respiratory, cardiovascular, dermatologic, and
gastrointestinal systems.
Anaphylactic reactions classically involve an IgE-mediated response that
occurs after reexposure to an antigen to which the patient has been sensitized. The
term anaphylactoid reaction is sometimes used to refer to a clinically similar
non–IgE-mediated reaction that doesn’t require prior antigen exposure. Although
the mortality rate for children <18 years is low (estimated at 0.1 per million
population), emergency department (ED) visits for anaphylaxis have increased
dramatically over the past decade especially among children.
Potential routes of allergen exposure include parenteral, oral, and inhalational.
Foods (eggs, milk, peanuts, tree nuts) are the most common inciting allergens
among children in the United States; other common triggers include hymenoptera
stings, drugs, immunotherapy, radiocontrast media, and blood products ( Table
85.1 ). Unfortunately, the causative agent is unknown in a significant proportion
of cases.
