• Anaphylaxis is a systemic reaction that could be mediated by immunologic as well as non-immunologic mechanisms.

  • Anaphylaxis can present with mild symptoms, such as facial swelling and abdominal cramping, to severe symptoms with life-threatening complications, such as respiratory distress and hemodynamic compromise.

  • Diagnosis is clinical and laboratory evaluation is rarely required.

  • Patient may be referred to allergist to identify the inciting or triggering agents and for immunotherapy.

  • Mainstay of treatment is epinephrine 0.01 mg/kg/dose of the 1 mg/mL concentration with maximum dose of 0.3 mg in the prepubertal child and 0.5 mg in the adolescent given intramuscularly, and should be repeated every 5 to 15 minutes as needed.

  • H1-receptor antagonist may be used to treat cutaneous manifestations.

  • Steroids may be useful in patients with lower airway obstruction, asthma, rebound anaphylaxis, or severe anaphylaxis.

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