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Improving diagnostic accuracy of anaphylaxis in the acute care setting.

Authors
  • Bjornsson, Hjalti M
  • Graffeo, Charles S
Type
Published Article
Journal
The western journal of emergency medicine
Publication Date
Dec 01, 2010
Volume
11
Issue
5
Pages
456–461
Identifiers
PMID: 21293765
Source
Medline
License
Unknown

Abstract

The identification and appropriate management of those at highest risk for life-threatening anaphylaxis remains a clinical enigma. The most widely used criteria for such patients were developed in a symposium convened by National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network. In this paper we review the current literature on the diagnosis of acute allergic reactions as well as atypical presentations that clinicians should recognize. Review of case series reveals significant variability in definition and approach to this common and potentially life-threatening condition. Series on fatal cases of anaphylaxis indicate that mucocutaneous signs and symptoms occur less frequently than in milder cases. Of biomarkers studied to aid in the work-up of possible anaphylaxis, drawing blood during the initial six hours of an acute reaction for analysis of serum tryptase has been recommended in atypical cases. This can provide valuable information when a definitive diagnosis cannot be made by history and physical exam.

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