Anaphylaxis/anaphylactoid reactions

Hypersensitivity reactions Hypersensitivity reactions have occurred on rare occasions, and severe anaphylaxis/anaphylactoid reactions have occurred. Such reactions can be life-threatening or fatal. Refer to Management of Acute Hypersensitivity Reactions. 

Readministration Readministration of daclizumab after an initial course of therapy has not been studied in humans. The potential risks of such readministration, specifically those associated with immunosuppression and/or the occurrence of anaphylaxis/anaphylactoid reactions, are not known. 

Anorexia, nausea, vomiting, diarrhoea, glossitis, dysphagia, maculopapular and erythematous rashes and photosensitivity hypersensitivity reactions including urticaria, angioneurotic edema, anaphylaxis, anaphylactoid reactions. They also cause discoloration of deciduous teeth. 

Various skin reactions rarely may follow the use of any of the tetracyclines. More severe allergic responses are angioedema and anaphylaxis anaphylactoid reactions can occur even with oral administration. Other hypersensitivity reactions are burning of the eyes, cheilosis, glossitis, pruritus ani or vulvae, and vaginitis, which can persist for months after cessation of therapy. Fever, eosinophilia, and asthma also have been observed. Cross-sensitization among the various tetracyclines is common. 

Ring J, Behrendt H Anaphylaxis and anaphylactoid reactions - classification and pathophysiology. CUn Rev Allergy Immunol 1999 17 387-399. 

Adverse effects of colloids are generally extensions of their pharmacologic activity (e.g., fluid overload, dilutional coagulopathy). Albumin and dex-tran may be associated with anaphylactoid reactions or anaphylaxis. Bleeding may occur in certain patients receiving hetastarch and dextran. 

Hypersensitivity reactions - Isolated cases of serious hypersensitivity (anaphylaxis and anaphylactoid) reactions (including shock) have been reported in patients receiving micafungin. If these reactions occur, discontinue micafungin infusion and administer appropriate treatment. 

Anaphylactoid reaction There has been 1 report of an anaphylactoid reaction occurring in a patient receiving zalcitabine and zidovudine. In addition, there have been several reports of urticaria without other signs of anaphylaxis. 

Type I hypersensitivity reactions (immediate hypersensitivity or anaphylaxis) are immunologic responses to a foreign antigen to which a patient has been previously sensitized. Anaphylactoid reactions are not immunoogically mediated however, symptoms and treatment are similar. 

There are known cases (albeit not many) of anaphylactic/anaphylactoid reactions to benzoates and parabens, although no systematic anaphylaxis has been observed after orally ingested parabens. Moreover, asthmatic reactions caused by benzoates and parabens have been reported (Fahrenholz and Smith 2008). 

BETA-BLOCKERS X-RAY CONTRAST SOLUTIONS Beta-blockers are associated with T risk of anaphylactoid reactions to iodinated X-ray contrast materials Uncertain, but postulated that beta-receptors have a role in suppressing the release of mediators of anaphylaxis Consider using low-osmolality contrast media and pretreating with antihistamines and corticosteroids. Stopping beta-blockers a few days before the X-ray is associated with a risk of withdrawal t BP and tachycardia a risk-benefit assessment must therefore be made... 

Anaphylactic reactions result from the interaction of antigens with specific IgE antibodies, which have been formed by previous exposure to the antigen. Anaphylactoid reactions are clinically indistinguishable from anaphylaxis but do not result from prior exposure to a triggering agent and do not involve IgE. Intravenous anaesthetics and muscle relaxants can cause anaphylactic or anaphylactoid reactions and, rarely, they are fatal. Muscle relaxants are responsible for 70% of anaphylactic reactions during anaesthesia and suxamethonium accormts for almost half of these. 

Dejarnatt AC, Grant JA. Basic mechanisms of anaphylaxis and anaphylactoid reactions. Immunol Allergy Clin North Am 1992 12 33-46. 

Several reports have highlighted the importance of gelatin allergy in young children, with some deaths due to anaphylaxis. Elsewhere, anaphylactoid reactions have been reported to gelatin-containing injectables (SEDA-20, 310). 

Among the anaphylactic reactions to NSAIDs that result in different types of reaction (urticaria, angioedema, asthma, or hypotension), there have been very few reports of anaphylactic shock. However, anaphylaxis has been described in patients taking celecoxib (135,136) or rofecoxib (137). Rofecoxib caused anaphylaxis in a patient who had had a similar reaction to diclofenac, suggesting that COX-2 inhibitors may be not safe in all individuals who have adverse reactions to non-selective COX inhibitors. It also suggests that different mechanisms may be involved in patients with asthma and in those with anaphylactoid reactions to NSAIDs. 

This patient had all the features of anaphylactoid reactions, which include pulmonary and laryngeal edema and a massive rise in serum tryptase. The half-Ufe of tryptase is about 2 hours. Moderately raised post-mortem tryptase activity in the absence of anaphylaxis has been described. Therefore, only very high serum tryptase activity, as seen in this case, should be regarded as specific for fatal anaphylactoid reactions. 

Anaphylaxis and anaphylactoid reactions have been reported (SEDA-17, 112). 

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