Anaphylaxis history

De Swert LF, Bullens D, Raes M. Dermaux AM Anaphylaxis in referred pediatric patients demographic and chnical features, triggers, and therapeutic approach. Eur J Pediatr 2008 167 1251-1261. Brockow K, Jofer C, Behrendt H, Ring J Anaphylaxis in patients with mastocytosis a study on history chnical features and risk factors in 120 patients. AUergy 2008 63 226-232. 

BrockowKjJoferQ BehrendtH,RingJ Anaphylaxis 70 in patients with mastocytosis a study on history, clinical features and risk factors in 120 patients. Allergy 2008 63 226-232. 71... 

If patients have experienced anaphylaxis, the identification of any possible elicitor is important to help avoid further episodes. With skin tests and specific IgE antibodies combined with history, a relevant allergy may be detected. Cellular tests monitoring basophil histamine release or basophil activation may be helpful in some patients who resist diagnosis by standard means [26,31]. 

Author Country Population age Number questioned Percent with history of anaphylaxis to venoms... 

The natural history of Hymenoptera venom anaphylaxis, that is the risk to develop anaphylaxis again when re-stung, has been analyzed in several prospective studies (table 3) [35-37], and in placebo or whole-body extract treated controls of prospective studies on venom immunotherapy [38-40]. It is higher in patients with a history of severe as compared to mild systemic anaphylactic reactions, and in honey bee than in vespid venom-allergic patients - most likely because of the smaller and less constant amoimt of venom applied by vespids [10,41]. A short interval between two stings increases the risk of anaphylaxis [25], but severe anaphylaxis may occur again even after intervals of 10-20 years or more. 

Sting provocation tests are often considered to be the gold standard, although they are less reliable in vespids than in honey bees [35-37, 41, 43]. They are commonly used to assure the efficacy of venom immunotherapy, but are generally considered as unethical in untreated patients with a history of venom anaphylaxis. 

Reisman RE Natural history of insect sting allergy relationship of severity of symptoms of initial sting anaphylaxis to re-sting reactions. J Allergy Clin InununoJ 1992 90 335-339. 

The diagnostic work-up in patients with a history of LA anaphylaxis uses the classical steps [29] ... 

Published clinical scenarios outline the available options in making these decisions [36], It is impossible to predict the outcome of a future anaphylaxis episode with certainty based on the history of a previous episode [37]. Therefore, when in doubt, erring on the side of caution is generally advised prescribe one or more epinephrine autoinjectors, and advise the person at risk or the caregiver of a child at risk to inject epinephrine promptly in an anaphylaxis episode [36]. 

Epinephrine absorption in children with a history of anaphylaxis. J Allergy Chn Immunol 1998 101 33- 33 37. 

Past history of anaphylaxis Incidence of symptom by extremely small amount... 

A thorough drug allergy history should be taken to discern true allergy (anaphylaxis) from adverse event (stomach upset). 

Verify the patient s allergy history and the type of reaction experienced. Attempt to discern between true allergy and adverse event. (3-Lactam-allergic patients may receive clindamycin, vancomycin, or other antimicrobials. Crossreactivity between penicillin allergy and cephalosporins is low but cephalosporins should be avoided in patients with a history of anaphylaxis to penicillins. 

Cephalosporins Cross-al le rge trici ty Contraindicated in patients with history of anaphylaxis to penicillins Disulfiram-1 ike reaction with ethanol... 

Cephalosporins should not be used in an individual with a history of anaphylaxis, angioedema, or urticaria with penicillins or... 

Patients with a history of allergies, especially to penicillin, are at increased risk for developing a severe hypersensitivity reaction, marked by severe pruritus, angio-edema, bronchospasm, and anaphylaxis. 

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