SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

August 9, 2007

Idiopathic anaphylaxis

Summary
Background – Idiopathic anaphylaxis (IA) is a subject of considerable discussion and some debate.

Findings – IA was reviewed by Greenberger of Northwestern Univ in Chicago, IL. He described IA as prednisone-responsive anaphylaxis without detected etiology, occurring at any time of day. IA may be frequent (at least 6 episodes per year) or infrequent. IA is generally manifest as: 1) IA generalized – urticaria or angioedema with associated severe respiratory distress, syncope or hypotension, and occasionally G-I symptoms or 2) IA angioedema – massive swelling of tongue/oropharynx sometimes with peripheral angioedema without any systemic symptomatology.

Reference
Immunol Allergy Clin North Am 2007;27:273-93

Editor's Comments
IA is a debated entity with some observers having the opinion that IA is a “diagnosis of exclusion.” Others, led by the author and his colleagues in Northwestern Univ feel that IA is a distinct entity, generally not well controlled by antihistamines but often controlled by long-term, low dosage prednisone. Serum tryptase levels have been reported to be elevated in a few patients with IA in whom these findings were described.

 

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