Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • acute onset
  • urticaria
  • angioedema
  • flushing
  • dyspnea
  • wheezing
  • rhinitis

Other diagnostic factors

  • allergen ingestion
  • insect stings or bites
  • pruritus
  • inspiratory stridor and hoarse voice
  • bilateral conjunctivitis
  • nausea and vomiting
  • abdominal cramping or pain
  • agitation/anxiety
  • confusion/disorientation
  • tachycardia
  • dizziness
  • syncope
  • sense of impending doom (angor animi)
  • recent exercise
  • hot or cold exposure
  • hypotension
  • bradycardia
  • cardiac arrest
  • diarrhea
  • visual disturbances
  • tremor
  • seizures

Risk factors

  • adult age: food-, insect venom-, and medication-related
  • <30 years old: food-associated, exercise-induced
  • female sex
  • atopy/asthma
  • hx of anaphylaxis
  • exposure to a common sensitizer (e.g., latex)

Diagnostic investigations

Investigations to consider

  • in vitro IgE testing
  • skin test
  • challenge test
Full details

Emerging tests

  • basophil activation test
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Instructor

Department of Allergy and Immunology

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

DAA is an author of a number of references cited in this monograph.

Assistant Professor of Anesthesiology

Department of Anesthesiology

Montefiore Medical Center

Albert Einstein College of Medicine

New York

NY

Disclosures

MHA is an author of a reference cited in this monograph.

Dr Doerthe Adriana Andreae and Dr Michael Henning Andreae would like to gratefully acknowledge Dr Andrea Vereda, a previous contributor to this monograph. AV declares that she is currently employed by Almirall SA, which manufactures Kestin (ebastine, a second-generation antihistaminic). AV wrote the main content of this topic before taking up this appointment.

Peer reviewers VIEW ALL

Associate Professor

Family Medicine and Community Health

University of Massachusetts Medical School

Worcester

MA

Disclosures

FJD declares that he has no competing interests.

Assistant Professor of Pediatrics

Mount Sinai School of Medicine

New York

NY

Disclosures

WS declares that he has no competing interests.

Visiting Consultant in Allergy

Addenbrooke’s Hospital NHS Trust

Cambridge

UK

Disclosures

LY declares that he has no competing interests.

Consultant Immunologist

Department of Immunology

Epsom & St Helier University Hospitals NHS Trust

Carshalton

Surrey

UK

Disclosures

GH declares that he has no competing interests.

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