Anaphylaxis definition

In principal, data on the epidemiology of anaphylaxis will help to identify causes, risk factors and circumstances of the reaction. It will support the medical commimity to develop measures for the protection of affected patients. A true incidence of anaphylaxis has not been established, reasons are diverse study designs and the fact that there has been no universal consensus as to the definition of anaphylaxis [ 1 ]. 

The data on the epidemiology of anaphylaxis are widely varying estimates on the frequency of this condition. The findings are based on diverse study designs and are often not comparable. A clear conclusion from the data published so far is difficult. One major reason is that there is no universal consensus regarding the definition of anaphylaxis. The International Classification Codes (ICD) recording anaphylaxis are imprecise and do not properly reflect the epidemiological needs. 

Sampson HA, Munoz-Furlong A, Campbell RL, et 38 al Second symposium on the definition and management of anaphylaxis summary report-Second National Institute of Allergy and Infectious Disease/ 39 Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006 117 391-397. 

The latest consensus on the definition and management [1] of anaphylaxis agrees on the lack of imiversally accepted diagnostic criteria and reliable laboratory biomarkers to confirm the clinical impression. Sometimes it is not feasible to obtain the samples within the optimum time frame. Moreover, in spite of a correct collection of samples, histamine and/or tryptase are within normal levels. Hence, new markers should be explored and further research into the role of selected mediators is urgently needed. Recently however, studies from animal models have shown promising results. In this chapter we will seek to review our current knowledge on confirmed or putative markers for the in vitro diagnosis of anaphylaxis. 

An accurate molecular definition of cephalosporin allergy is not currently available. Relevant determinants of cephalosporin-induced anaphylaxis may not reside in the bicyclic core, but rather in the side chain (164,165). 

A 21-year-old woman had a severe anaphylactic-like reaction with laryngospasm and undetectable blood pressure within 10 minutes after interferon beta-la injection (63). It is still uncertain that anaphylaxis was definitely attributable to interferon, because rechallenge and skin tests were not performed in this patient, who had tolerated the treatment for the 6 previous months. 

Anaphylactic shock is rare, but has been reported with co-trimoxazole (20). However, it is possible that this reaction was due to the sulfonamide compound (21). The case histories of 13 patients (12 women, one man, aged 22-68 years) with anaphylactic reactions to trimethoprim alone that were reported to a national drug safety unit have been analysed (20). Nine were classified as probable anaphylaxis. The casual relation between exposure to trimethoprim and anaphylaxis was classified as definite in three reports, possible in four, and probable in six. In one patient, IgE antibodies against trimethoprim were demonstrated. 

Protein colloids contain larger molecules and have a longer intravascular residence time than crystalloids, but eventual fluid loss to the extravascular space does occur. Protein colloids, such as albumin and PPF, are prepared from pooled human blood and, therefore, carry with them a risk of transmission of viral infection or induction of anaphylaxis. The PPF is a 5% mixture (5 g of protein in 100 ml of 0.9% NaCI solution) of proteins that is osmotically equivalent to human plasma. The composition of the protein mixture is 83 to 90% albumin. Albumin typically is administered as either a 5 or 25% solution. By definition, albumin preparations must be composed of a protein mixture that is more than 90% albumin. Generally, PPF is favored over albumin for fluid resuscitation, because albumin appears to cause more interstitial edema. 

Protamide LMFAB. See Lauramide DEA Protamide LNO. See Linoleamide DEA Protamide MEAA. See Acetamide MEA Protamide MRCA. See Myristamide DEA Protamide SA. See Stearamide DEA Protamide X-45-B. SeeCocamide DEA Protamine sulfate CAS 9009-65-8 53597-25-4 Synonyms Salmine sulfate Definition Mixt. of simple proteins obtained from the sperm or testes of certain species of fish has property of neutralizing heparin Toxicoiogy LD50 (IP, rat) 120 mg/kg, (IV, rat) 75 mg/kg, (subcut., mouse) 200 mg/kg poison by IP, IV, subcut. routes human systemic effects (anaphylaxis, blood pressure decrease, decreased urine vol.) TSCA listed Hazardous Decomp. Prods. Heated to decomp., emits very toxic fumes of NOx and SOx Uses Pharmaceuticals (parenterals, injectables)... 

The term anaphylactoid reaction was first used by Biedl and Kraus [67] to describe the shock syndrome produced in dogs after the primary injection of certain peptidic materials. Later, non-protein colloids were found to produce a similar response in normal guinea-pigs [86, 264-269]. The anaphylactoid reaction, therefore, represents an unusual and hypersensitive vascular response to the first injection of a foreign substance. The symptoms of the response resemble those of anaphylaxis, but a specific antigen-antibody reaction does not appear to be implicated [701]. Using this definition, the acute serous inflammation produced in rats by the primary injection of egg-white has also been classified as an anaphylactoid reaction [402-404,561]. 

Lieberman P. Definition and criteria for the diagnoses of anaphylaxis. In Castells MC, editor. Anaphylaxis and hypersensitivity reactions. New York, NY Humana ... 

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