Last reviewed: May 2019
Last updated: March  2019

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
  • history 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

Assistant Professor

Pediatric Allergy and Immunology

Penn State Health Milton S. Hershey Medical Center

Hershey

PA

Disclosures

DAA is author of an UpToDate article on food allergy and a number of references cited in this topic.

Associate Professor

Department of Anesthesiology

Penn State Health Milton S. Hershey Medical Center

Hershey

PA

Disclosures

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

Dr Doerthe Adriana Andreae and Dr Michael Henning Andreae would like to gratefully acknowledge Dr Andrea Vereda, a previous contributor to this topic.

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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