Early anaphylactic phase

With less severe symptoms in the early anaphylactic phase (EAR), after 6-10 h, the late anaphylactic phase (LAR) occurs, which is triggered by mast cells releasing chemokines, cytokines, and leukotriens—massive chemoattractants for neutrophils and eosinophils. 

DDBJ—see EMBL DLS—dynamic light scattering DM—donkey s milk DNA—deoxyribonucleic acid DNCB—2,4-dinitrochlorobenzene DSC—differential scanning calorimetry DTH—delayed cellular hypersensitivity DXMS—deuterium exchange mass spectrometry EAACI—European Academy of Allergology and Clinical Immunology EAR—early anaphylactic phase ECFA—eosinophil chemotactic factors of anaphylaxis ECP—eosinophil cationic protein EDN—eosinophil-derived neurotoxin eHF—extensively hydrolyzed formula ELISA—enzyme-linked immunosorbent assay... 

Early recognition of anaphylactic shock and the immediate use of epinephrine and other supportive measures (see Chap. 8) may be life-saving. The critical time is usually the first 30-60 min after this initial phase, symptoms often subside completely, even in the absence of continuing therapy. However, patients with severe reactions may require treatment and medical observation for at least 24 h delayed fatality can occur due to severe hypotension or hypoxemia leading to infarction of parenchymatous organs such as the brain, heart, kidney, or liver. Symptoms of urticaria or serum sickness may occur in the aftermath of anaphylactic reactions and last for several days. 

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