Pediatric emergency medicine trisk 1671 1671
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TABLE 85.1
COMMON CAUSES OF ANAPHYLAXIS
Insect venom
Hymenoptera
Fire ants
Drugs
Antibiotics—penicillin, cephalosporins, sulfonamides
Anesthesia-related drugs—lidocaine, neuromuscular blocking agents
Aspirin
Radiocontrast media
Foods
Peanuts
Cashews
Other tree nuts
Milk
Seafood—shellfish
Grains
Fruit
Blood products
Immunotherapy
Allergen extracts
Other
Latex
Idiopathic
Potential conditions and risk factors for severe and fatal anaphylaxis include
systemic mastocytosis, asthma, and specific allergens (e.g., peanuts, tree nuts).
Clinicians should recognize that prior anaphylactic symptomatology doesn’t
predict reaction severity upon allergen reexposure.
During immune-mediated anaphylaxis, IgE binding to high-affinity receptors
on mast cells and basophils triggers the release of systemic mediators causing
bronchospasm, increased vascular permeability, and impaired systemic and
pulmonary vascular smooth muscle tone. Biochemical mediators include
histamine, prostaglandin D2, leukotrienes, anaphylatoxins (C3, C4a, C5a),
