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Cardiology3138 papers

Idiopathic anaphylaxis

Last edited: 4/23/2026

Overview

Idiopathic anaphylaxis refers to severe, potentially life-threatening allergic reactions without an identifiable trigger, characterized by rapid onset and multisystem involvement 1 11.

Diagnosis

Key Diagnostic Criteria: Rapid onset of symptoms involving at least one of the following: airway compromise, hypotension, or gastrointestinal symptoms 1 17.

Recommended Tests: Serum tryptase levels (elevated within 1-2 hours post-reaction may support diagnosis) 28 5 55.

Grading: Utilize diagnostic criteria from practice parameters for certainty 11.

Management

First-Line Treatments:

- Epinephrine: Intramuscular (IM) 0.3-0.5 mg for adults, titrated as needed 17 68.

Adjunctive Treatments:

- Oxygen: Supportive oxygenation 17. - Fluids: Intravenous fluids for hypotension 17. - Antihistamines: H1 and H2 blockers for symptom control 17. - Glucocorticoids: Oral or intravenous for prolonged symptom management 17.

Special Populations

Pediatrics: Tailored dosing of epinephrine (0.01 mg/kg IM for children) and vigilant monitoring 12 50.

Elderly: Increased vigilance for atypical presentations and comorbidities affecting management 18.

Comorbidities: Consider underlying conditions like systemic mastocytosis affecting response and treatment 5 55.

Key Recommendations

Prompt Administration of Epinephrine: Essential first-line treatment for suspected anaphylaxis (Evidence: Strong 1 17).

Supplemental Oxygen and Intravenous Fluids: Provide for patients with hypoxia or hypotension (Evidence: Moderate 17).

Monitor Tryptase Levels: Elevated levels post-reaction can support the diagnosis of anaphylaxis (Evidence: Moderate 28 5).

Referral to Allergy Specialist: Post-anaphylaxis evaluation and long-term management planning (Evidence: Expert opinion 80).

Education and Action Plan: Emphasize patient education and development of personalized anaphylaxis action plans (Evidence: Moderate 1 18).

References

Showing 100 most recent of 239 indexed papers.

1 McKenzie B, Marshall SD, Sanci L, Poonian J, Nair R, J Selman C et al.. Organ failure type in fatal and near-fatal anaphylaxis: a systematic review. BMJ open 2026. link 2 Hu G, Li J, Fu L, Chen H, Huang Y. Delayed-type anaphylactic shock to mannitol: a case report and review of the literature. Journal of medical case reports 2026. link 3 Jones D, McKergow EM, Field CJ, Mar SH. Neurocognitive symptoms with functional decline following severe anaphylaxis to rocuronium at anaesthesia induction: Kounis-like syndrome. Anaesthesia and intensive care 2026. link 4 Van Luong PT, Demoly P, Tanno LK. Recurrences of anaphylaxis: trends and risk factors. Current opinion in allergy and clinical immunology 2025. link 5 Broi UD, Simonit F, Perogio M, Visentini D, Reccardini F, Tse R et al.. Fatal anaphylactic shock due to hymenoptera venom in a farmer suffering from indolent systemic mastocytosis. The comparative diagnostic relevance of perimortem serum tryptase levels. International journal of legal medicine 2025. link 6 Liguori V, Anatriello A, Cantone A, Nicoletti MM, Argenziano G, Scavone C et al.. The Use of Botulinum Toxin Type A and the Occurrence of Anaphylaxis: A Descriptive Analysis of Data from the European Spontaneous Reporting System. Aesthetic plastic surgery 2025. link 7 Kim TH, Park J, Jo H, Oh J, Lee K, Oh J et al.. Identification of the Top 15 Drugs Associated With Anaphylaxis: A Pharmacovigilance Study. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2025. link 8 Belmont AP, Novotny S, Mukherjee EM, Park D, Wong KH, Martin-Pozo MD et al.. Anaphylaxis to Penicillin: Harvesting Insights From the Food and Drug Administration's Adverse Event Reporting System. The journal of allergy and clinical immunology. In practice 2025. link 9 Christ P, Dubrall D, Dölle-Bierke S, Francuzik W, Schmid M, Sachs B et al.. Severe drug-associated anaphylaxis: a complementary descriptive analyses of registry cases and spontaneous reports. European journal of clinical pharmacology 2025. link 10 Cho J, Oh J, Park J, Jo H, Kim TH, Kim H et al.. Global Burden of Drug-Induced Anaphylaxis Associated With 33 Classes of Antibiotics (1968-2024): A Pharmacovigilance Analysis. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2025. link 11 Golden DBK, Wang J, Waserman S, Akin C, Campbell RL, Ellis AK et al.. Anaphylaxis: A 2023 practice parameter update. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2024. link 12 Athanasopoulou SG, Leeds S, Auerbach M. Variation in the Guidelines for the Acute Management of Anaphylaxis in Pediatric Patients: An International Narrative Review. Pediatric emergency care 2024. link 13 Lee K, Lee H, Kwon R, Shin YH, Yeo SG, Lee YJ et al.. Global burden of vaccine-associated anaphylaxis and their related vaccines, 1967-2023: A comprehensive analysis of the international pharmacovigilance database. Allergy 2024. link 14 Matern LH, Gardner R, Rudolph JW, Nadelberg RL, Buléon C, Minehart RD. Clinical triggers and vital signs influencing crisis acknowledgment and calls for help by anesthesiologists: A simulation-based observational study. Journal of clinical anesthesia 2023. link 15 Sugizaki C, Sato S, Yanagida N, Ebisawa M. Analysis of drug-induced anaphylaxis cases using the Japanese Adverse Drug Event Report (JADER) database - secondary publication. Allergology international : official journal of the Japanese Society of Allergology 2023. link 16 Le HY, Tien ND, Son PN, Viet Hoa LT, Phuong LL, Hai PD. Extracorporeal membrane oxygenation support in refractory anaphylactic shock after bee stings: A case report. Perfusion 2023. link 17 McHugh K, Repanshek Z. Anaphylaxis: Emergency Department Treatment. Emergency medicine clinics of North America 2022. link 18 Yee D, Skrynski A, Dass K. 25-year-old woman • abdominal pain • urticarial rash • recent influenza immunization • Dx?. The Journal of family practice 2021. link 19 Long B, Gottlieb M. Emergency medicine updates: Anaphylaxis. The American journal of emergency medicine 2021. link 20 Dribin TE, Michelson KA, Vyles D, Neuman MI, Brousseau DC, Mistry RD et al.. PEMCRC anaphylaxis study protocol: a multicentre cohort study to derive and validate clinical decision models for the emergency department management of children with anaphylaxis. BMJ open 2021. link 21 Gouel-Cheron A, Neukirch C, Kantor E, Malinovsky JM, Tacquard C, Montravers P et al.. Clinical reasoning in anaphylactic shock: addressing the challenges faced by anaesthesiologists in real time: A clinical review and management algorithms. European journal of anaesthesiology 2021. link 22 Gangemi S, Allegra A, Di Gioacchino M. Management of patients at risk of anaphylaxis after COVID 19 vaccination. Journal of biological regulators and homeostatic agents 2021. link 23 Tanno LK, Castells M, Caminati M, Senna G, Demoly P. Anaphylaxis and Coronavirus Disease 2019 vaccine: a danger relationship?. Current opinion in allergy and clinical immunology 2021. link 24 Yu RJ, Krantz MS, Phillips EJ, Stone CA. Emerging Causes of Drug-Induced Anaphylaxis: A Review of Anaphylaxis-Associated Reports in the FDA Adverse Event Reporting System (FAERS). The journal of allergy and clinical immunology. In practice 2021. link 25 Chiang D, Ade JM, Liu XW, Bellolio F, Lohse CM, Sandefur BJ et al.. Assessment of ED triage of anaphylaxis patients based on the Emergency Severity Index. The American journal of emergency medicine 2021. link 26 Peláez-Pérez JM, Sánchez Casado M, Álvarez-Twose I, Kounis NG. Amoxicillin-clavulanic acid-induced type II Kounis syndrome during general anaesthesia complicated with hypoxic-ischaemic encephalopathy. Revista espanola de anestesiologia y reanimacion 2021. link 27 Orihara M, Takazawa T, Nagumo K, Sakamoto S, Horiuchi T, Saito S. Interpreting the results of early skin tests after perioperative anaphylaxis requires special attention: a case report and review of literature. Journal of anesthesia 2020. link 28 Platzgummer S, Bizzaro N, Bilò MB, Pravettoni V, Cecchi L, Sargentini V et al.. Recommendations for the Use of Tryptase in the Diagnosis of Anaphylaxis and Clonal Mastcell Disorders. European annals of allergy and clinical immunology 2020. link 29 Giovannini M, Castagnoli R, Mori F, Arasi S, Barni S, Saretta F et al.. Hymenoptera venom allergy among children in Italy: time for pediatricians to take action. Allergologia et immunopathologia 2020. link 30 Hall V, Wong M, Munsif M, Stevenson BR, Elliott K, Lucas M et al.. Antimicrobial anaphylaxis: the changing face of severe antimicrobial allergy. The Journal of antimicrobial chemotherapy 2020. link 31 Barni S, Mori F, Giovannini M, de Luca M, Novembre E. In situ simulation in the management of anaphylaxis in a pediatric emergency department. Internal and emergency medicine 2019. link 32 Watts MM, Marie Ditto A. Anaphylaxis. Allergy and asthma proceedings 2019. link 33 Toy D, Braga MS, Greenhawt M, Shaker M. An update on allergic emergencies. Current opinion in pediatrics 2019. link 34 Fustiñana AL, Rino PB, Kohn-Loncarica GA. Detection and management of Anaphylaxis in children. Revista chilena de pediatria 2019. link 35 Kolawole H, Guttormsen AB, Hepner DL, Kroigaard M, Marshall S. Use of simulation to improve management of perioperative anaphylaxis: a narrative review. British journal of anaesthesia 2019. link 36 Le M, Gabrielli S, Clarke A, Eisman H, Morris J, Gravel J et al.. Emergency Management of Anaphylaxis Due to an Unknown Trigger: An 8-Year Follow-Up Study in Canada. The journal of allergy and clinical immunology. In practice 2019. link 37 Nguyen KD, Nguyen HA, Vu DH, Le TT, Nguyen HA, Dang BV et al.. Drug-Induced Anaphylaxis in a Vietnamese Pharmacovigilance Database: Trends and Specific Signals from a Disproportionality Analysis. Drug safety 2019. link 38 Aun MV, Kalil J, Giavina-Bianchi P. Adults and children with anaphylaxis in the emergency room: why it is not recognized?. Current opinion in allergy and clinical immunology 2018. link 39 Lindor RA, McMahon EM, Wood JP, Sadosty AT, Boie ET, Campbell RL. Anaphylaxis-related Malpractice Lawsuits. The western journal of emergency medicine 2018. link 40 Kishimoto N, Mukai N, Honda Y, Hirata Y, Tanaka M, Momota Y. Simulation training for medical emergencies in the dental setting using an inexpensive software application. European journal of dental education : official journal of the Association for Dental Education in Europe 2018. link 41 Greenhawt M, Wallace D, Sublett JW, Maughan E, Tanner A, Kelley KJ et al.. Current trends in food allergy-induced anaphylaxis management at school. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2018. link 42 Kase Tanno L, Ansotegui I, Demoly P. Globalization and anaphylaxis. Current opinion in allergy and clinical immunology 2018. link 43 Zhao Y, Lu H, Thai S, Li X, Hui J, Tang H et al.. Development and validation of an algorithm to identify drug-induced anaphylaxis in the Beijing Pharmacovigilance Database. International journal of clinical pharmacy 2018. link 44 Graudins LV, Trubiano JA, Zubrinich CM, Elliott AS, Aung AK. Medication-related anaphylaxis treated in hospital: Agents implicated, patient outcomes, and management lessons. Pharmacoepidemiology and drug safety 2018. link 45 Zhao Y, Sun S, Li X, Ma X, Tang H, Sun L et al.. Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database. International journal of clinical pharmacy 2018. link 46 Bouzillé G, Osmont MN, Triquet L, Grabar N, Rochefort-Morel C, Chazard E et al.. Drug safety and big clinical data: Detection of drug-induced anaphylactic shock events. Journal of evaluation in clinical practice 2018. link 47 Mukai K, Kuda Y, Shibamoto T, Tanida M, Kurata Y, Yokoyama H. Renal response to anaphylaxis in anesthetized rats and isolated perfused rat kidneys: roles of nitric oxide. The journal of physiological sciences : JPS 2018. link 48 LoVerde D, Iweala OI, Eginli A, Krishnaswamy G. Anaphylaxis. Chest 2018. link 49 Kuda Y, Shibamoto T, Zhang T, Yang W, Tanida M, Kurata Y. Gastric vascular and motor responses to anaphylactic hypotension in anesthetized rats, in comparison to those with hemorrhagic or vasodilator-induced hypotension. The journal of physiological sciences : JPS 2018. link 50 Johnston EB, King C, Sloane PA, Cox JW, Youngblood AQ, Lynn Zinkan J et al.. Pediatric anaphylaxis in the operating room for anesthesia residents: a simulation study. Paediatric anaesthesia 2017. link 51 Stave GM, Lee EH, Darcey DJ. Laboratory Animal Bite Anaphylaxis: A National Survey: Part 1: Case Series and Review of the Literature. Journal of occupational and environmental medicine 2017. link 52 Stave GM, Lee EH, Darcey DJ. Laboratory Animal Bite Anaphylaxis: A National Survey: Part 2: Treatment Protocols. Journal of occupational and environmental medicine 2017. link 53 Mong JS, Ooi CK. Transient Coagulopathy Due to Wasp Sting: A Case Report. The Journal of emergency medicine 2017. link 54 Lee WJ, Kim DH, Woo SH, Seol SH, Choi SP. Targeted temperature management after cardiac arrest with anaphylaxis. The American journal of emergency medicine 2017. link 55 Sargant N, Erlewyn-Lajeunesse M, Benger J. Does anaphylaxis masquerade as asthma in children?. Emergency medicine journal : EMJ 2015. link 56 Bennett JR. Anaphylaxis attributed to exercise: considerations for sports medicine specialists. The Physician and sportsmedicine 2015. link 57 Berrío Valencia MI. Perioperative anaphylaxis. Brazilian journal of anesthesiology (Elsevier) 2015. link 58 Campbell RL, Park MA, Kueber MA, Lee S, Hagan JB. Outcomes of allergy/immunology follow-up after an emergency department evaluation for anaphylaxis. The journal of allergy and clinical immunology. In practice 2015. link 59 Gómez Galán C, Ferré Ybarz L, Peña Peloche MA, Sansosti Viltes A, de la Borbolla Morán JM, Torredemer Palau A et al.. Intention to prescribe self-injectable epinephrine: Are there differences depending on who assesses the patient post-reaction?. Allergologia et immunopathologia 2015. link 60 Gaspar Â, Santos N, Piedade S, Santa-Marta C, Pires G, Sampaio G et al.. One-year survey of paediatric anaphylaxis in an allergy department. European annals of allergy and clinical immunology 2015. link 61 Tejedor-Alonso M A, Moro-Moro M, Múgica-García MV. Epidemiology of Anaphylaxis: Contributions From the Last 10 Years. Journal of investigational allergology & clinical immunology 2015. link 62 Akyıldız B, Özsoylu S, Öztürk MA, İnci A, Düzlü Ö, Yıldırım A. A fatal case caused by massive honey bee stings. The Turkish journal of pediatrics 2015. link 63 Sala-Cunill A, Björkqvist J, Senter R, Guilarte M, Cardona V, Labrador M et al.. Plasma contact system activation drives anaphylaxis in severe mast cell-mediated allergic reactions. The Journal of allergy and clinical immunology 2015. link 64 Averin K, Lorts A, Connor C. Anaphylactic shock after amiodarone infusion resulting in haemodynamic collapse requiring a temporary ventricular assist device. Cardiology in the young 2015. link 65 Weiss GM, Fandrick AD, Sidebotham D. Successful rescue of an adult with refractory anaphylactic shock and abdominal compartment syndrome with venoarterial extracorporeal membrane oxygenation and bedside laparotomy. Seminars in cardiothoracic and vascular anesthesia 2015. link 66 Chan-Dominy AC, Anders M, Millar J, Horton S, Best D, Brizard C et al.. Extracorporeal membrane modality conversions. Perfusion 2015. link 67 Scherbak D, Lazkani M, Sparacino N, Loli A. Kounis syndrome: a stinging case of ST-elevation myocardial infarction. Heart, lung & circulation 2015. link 68 Campbell RL, Bellolio MF, Knutson BD, Bellamkonda VR, Fedko MG, Nestler DM et al.. Epinephrine in anaphylaxis: higher risk of cardiovascular complications and overdose after administration of intravenous bolus epinephrine compared with intramuscular epinephrine. The journal of allergy and clinical immunology. In practice 2015. link 69 Bhatt HV, Frost EA. Hypotension on induction: anaphylaxis or cardiac failure?. Middle East journal of anaesthesiology 2014. link 70 Zilberstein J, McCurdy MT, Winters ME. Anaphylaxis. The Journal of emergency medicine 2014. link 71 Nowak RM, Macias CG. Anaphylaxis on the other front line: perspectives from the emergency department. The American journal of medicine 2014. link 72 Leatherman BD. Anaphylaxis in the allergy practice. International forum of allergy & rhinology 2014. link 73 Banerji A, Rudders S, Clark S, Wei W, Long AA, Camargo CA. Retrospective study of drug-induced anaphylaxis treated in the emergency department or hospital: patient characteristics, management, and 1-year follow-up. The journal of allergy and clinical immunology. In practice 2014. link 74 Candar M, Gunes H, Boz BV, Kandis H, Kutlucan L, Saritas A. Asystole after the first dose of lansoprazole. The American journal of emergency medicine 2014. link 75 Joshi D, Alsentzer E, Edwards K, Norton A, Williams SE. An algorithm developed using the Brighton Collaboration case definitions is more efficient for determining diagnostic certainty. Vaccine 2014. link 76 Raisch DW, Garg V, Arabyat R, Shen X, Edwards BJ, Miller FH et al.. Anaphylaxis associated with gadolinium-based contrast agents: data from the Food and Drug Administration's Adverse Event Reporting System and review of case reports in the literature. Expert opinion on drug safety 2014. link 77 Komericki P, Grims RH, Aberer W, Kränke B. Near-fatal anaphylaxis caused by human serum albumin in fibrinogen and erythrocyte concentrates. Anaesthesia 2014. link 78 Koklu E, Taskale T, Koklu S, Ariguloglu EA. Anaphylactic shock due to vitamin K in a newborn and review of literature. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 2014. link 79 Hocagil H, Karakilic E, Hocagil C, Senlikci H, Buyukcam F. Underdiagnosis of anaphylaxis in the emergency department: misdiagnosed or miscoded?. Hong Kong medical journal = Xianggang yi xue za zhi 2013. link 80 Nowak R, Farrar JR, Brenner BE, Lewis L, Silverman RA, Emerman C et al.. Customizing anaphylaxis guidelines for emergency medicine. The Journal of emergency medicine 2013. link 81 Grossman SL, Baumann BM, Garcia Peña BM, Linares MY, Greenberg B, Hernandez-Trujillo VP. Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey. The Journal of pediatrics 2013. link 82 Fineman S, Dowling P, O'Rourke D. Allergists' self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma, and Immunology member survey. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2013. link 83 Wallace DV. Anaphylaxis in the allergist's office: preparing your office and staff for medical emergencies. Allergy and asthma proceedings 2013. link 84 Desjardins M, Clarke A, Alizadehfar R, Grenier D, Eisman H, Carr S et al.. Canadian allergists' and nonallergists' perception of epinephrine use and vaccination of persons with egg allergy. The journal of allergy and clinical immunology. In practice 2013. link 85 Ribeiro-Vaz I, Marques J, Demoly P, Polónia J, Gomes ER. Drug-induced anaphylaxis: a decade review of reporting to the Portuguese Pharmacovigilance Authority. European journal of clinical pharmacology 2013. link 86 Botsis T, Woo EJ, Ball R. Application of information retrieval approaches to case classification in the vaccine adverse event reporting system. Drug safety 2013. link 87 Havaldar PV, Patil SS, Phadnis C. Anaphylaxis due to Red fire ant bite. Indian pediatrics 2012. link 88 Simons E, Sicherer SH, Simons FE. Timing the transfer of responsibilities for anaphylaxis recognition and use of an epinephrine auto-injector from adults to children and teenagers: pediatric allergists' perspective. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2012. link 89 Steele R, Camacho-Halili M, Rosenthal B, Davis-Lorton M, Aquino M, Fonacier L. Anaphylaxis in the community setting: determining risk factors for admission. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2012. link 90 Souvignet J, Declerck G, Trombert B, Rodrigues JM, Jaulent MC, Bousquet C. Evaluation of automated term groupings for detecting anaphylactic shock signals for drugs. AMIA ... Annual Symposium proceedings. AMIA Symposium 2012. link 91 Erlewyn-Lajeunesse M, Hunt LP, Heath PT, Finn A. Anaphylaxis as an adverse event following immunisation in the UK and Ireland. Archives of disease in childhood 2012. link 92 Rankins KB, McGovern R, Winston ES, Al-Dulaimy K, Pope JH. Abdominal anaphylaxis presenting as trauma: a recipe for delayed diagnosis. The Journal of emergency medicine 2012. link 93 Saritas A, Erbas M, Gonen I, Candar M, Ozturk O, Kandis H et al.. Asystole after the first dose of ceftriaxone. The American journal of emergency medicine 2012. link 94 Androutsos G, Karamanou M, Stamboulis E, Liappas I, Lykouras E, Papadimitriou GN. The Nobel Prize laureate - father of anaphylaxis Charles-Robert Richet (1850-1935) and his anticancerous serum. Journal of B.U.ON. : official journal of the Balkan Union of Oncology 2011. link 95 Arga M, Bakirtas A, Catal F, Derinoz O, Harmanci K, Razi CH et al.. Training of trainers on epinephrine autoinjector use. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology 2011. link 96 Botsis T, Nguyen MD, Woo EJ, Markatou M, Ball R. Text mining for the Vaccine Adverse Event Reporting System: medical text classification using informative feature selection. Journal of the American Medical Informatics Association : JAMIA 2011. link 97 Botsis T, Ball R. Network analysis of possible anaphylaxis cases reported to the US vaccine adverse event reporting system after H1N1 influenza vaccine. Studies in health technology and informatics 2011. link 98 Kamikado C, Shibamoto T, Zhang W, Kuda Y, Ohmukai C, Kurata Y. Portacaval shunting attenuates portal hypertension and systemic hypotension in rat anaphylactic shock. The journal of physiological sciences : JPS 2011. link 99 Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI et al.. The diagnosis and management of anaphylaxis practice parameter: 2010 update. The Journal of allergy and clinical immunology 2010. link 100 Gold MS, Gidudu J, Erlewyn-Lajeunesse M, Law B. Can the Brighton Collaboration case definitions be used to improve the quality of Adverse Event Following Immunization (AEFI) reporting? Anaphylaxis as a case study. Vaccine 2010. link

Original source

[1]
Organ failure type in fatal and near-fatal anaphylaxis: a systematic review. — McKenzie B, Marshall SD, Sanci L, Poonian J, Nair R, J Selman C et al. BMJ open (2026)
[2]
Delayed-type anaphylactic shock to mannitol: a case report and review of the literature. — Hu G, Li J, Fu L, Chen H, Huang Y Journal of medical case reports (2026)
[3]
Neurocognitive symptoms with functional decline following severe anaphylaxis to rocuronium at anaesthesia induction: Kounis-like syndrome. — Jones D, McKergow EM, Field CJ, Mar SH Anaesthesia and intensive care (2026)
[4]
Recurrences of anaphylaxis: trends and risk factors. — Van Luong PT, Demoly P, Tanno LK Current opinion in allergy and clinical immunology (2025)
[5]
Fatal anaphylactic shock due to hymenoptera venom in a farmer suffering from indolent systemic mastocytosis. The comparative diagnostic relevance of perimortem serum tryptase levels. — Broi UD, Simonit F, Perogio M, Visentini D, Reccardini F, Tse R et al. International journal of legal medicine (2025)
[6]
The Use of Botulinum Toxin Type A and the Occurrence of Anaphylaxis: A Descriptive Analysis of Data from the European Spontaneous Reporting System. — Liguori V, Anatriello A, Cantone A, Nicoletti MM, Argenziano G, Scavone C et al. Aesthetic plastic surgery (2025)
[7]
Identification of the Top 15 Drugs Associated With Anaphylaxis: A Pharmacovigilance Study. — Kim TH, Park J, Jo H, Oh J, Lee K, Oh J et al. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (2025)
[8]
Anaphylaxis to Penicillin: Harvesting Insights From the Food and Drug Administration's Adverse Event Reporting System. — Belmont AP, Novotny S, Mukherjee EM, Park D, Wong KH, Martin-Pozo MD et al. The journal of allergy and clinical immunology. In practice (2025)
[9]
Severe drug-associated anaphylaxis: a complementary descriptive analyses of registry cases and spontaneous reports. — Christ P, Dubrall D, Dölle-Bierke S, Francuzik W, Schmid M, Sachs B et al. European journal of clinical pharmacology (2025)
[10]
Global Burden of Drug-Induced Anaphylaxis Associated With 33 Classes of Antibiotics (1968-2024): A Pharmacovigilance Analysis. — Cho J, Oh J, Park J, Jo H, Kim TH, Kim H et al. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (2025)
[11]
Anaphylaxis: A 2023 practice parameter update. — Golden DBK, Wang J, Waserman S, Akin C, Campbell RL, Ellis AK et al. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (2024)
[12]
Variation in the Guidelines for the Acute Management of Anaphylaxis in Pediatric Patients: An International Narrative Review. — Athanasopoulou SG, Leeds S, Auerbach M Pediatric emergency care (2024)
[13]
Global burden of vaccine-associated anaphylaxis and their related vaccines, 1967-2023: A comprehensive analysis of the international pharmacovigilance database. — Lee K, Lee H, Kwon R, Shin YH, Yeo SG, Lee YJ et al. Allergy (2024)
[14]
Clinical triggers and vital signs influencing crisis acknowledgment and calls for help by anesthesiologists: A simulation-based observational study. — Matern LH, Gardner R, Rudolph JW, Nadelberg RL, Buléon C, Minehart RD Journal of clinical anesthesia (2023)
[15]
Analysis of drug-induced anaphylaxis cases using the Japanese Adverse Drug Event Report (JADER) database - secondary publication. — Sugizaki C, Sato S, Yanagida N, Ebisawa M Allergology international : official journal of the Japanese Society of Allergology (2023)
[16]
Extracorporeal membrane oxygenation support in refractory anaphylactic shock after bee stings: A case report. — Le HY, Tien ND, Son PN, Viet Hoa LT, Phuong LL, Hai PD Perfusion (2023)
[17]
Anaphylaxis: Emergency Department Treatment. — McHugh K, Repanshek Z Emergency medicine clinics of North America (2022)
[18]
25-year-old woman • abdominal pain • urticarial rash • recent influenza immunization • Dx? — Yee D, Skrynski A, Dass K The Journal of family practice (2021)
[19]
Emergency medicine updates: Anaphylaxis. — Long B, Gottlieb M The American journal of emergency medicine (2021)
[20]
PEMCRC anaphylaxis study protocol: a multicentre cohort study to derive and validate clinical decision models for the emergency department management of children with anaphylaxis. — Dribin TE, Michelson KA, Vyles D, Neuman MI, Brousseau DC, Mistry RD et al. BMJ open (2021)
[21]
Clinical reasoning in anaphylactic shock: addressing the challenges faced by anaesthesiologists in real time: A clinical review and management algorithms. — Gouel-Cheron A, Neukirch C, Kantor E, Malinovsky JM, Tacquard C, Montravers P et al. European journal of anaesthesiology (2021)
[22]
Management of patients at risk of anaphylaxis after COVID 19 vaccination. — Gangemi S, Allegra A, Di Gioacchino M Journal of biological regulators and homeostatic agents (2021)
[23]
Anaphylaxis and Coronavirus Disease 2019 vaccine: a danger relationship? — Tanno LK, Castells M, Caminati M, Senna G, Demoly P Current opinion in allergy and clinical immunology (2021)
[24]
Emerging Causes of Drug-Induced Anaphylaxis: A Review of Anaphylaxis-Associated Reports in the FDA Adverse Event Reporting System (FAERS). — Yu RJ, Krantz MS, Phillips EJ, Stone CA The journal of allergy and clinical immunology. In practice (2021)
[25]
Assessment of ED triage of anaphylaxis patients based on the Emergency Severity Index. — Chiang D, Ade JM, Liu XW, Bellolio F, Lohse CM, Sandefur BJ et al. The American journal of emergency medicine (2021)
[26]
Amoxicillin-clavulanic acid-induced type II Kounis syndrome during general anaesthesia complicated with hypoxic-ischaemic encephalopathy. — Peláez-Pérez JM, Sánchez Casado M, Álvarez-Twose I, Kounis NG Revista espanola de anestesiologia y reanimacion (2021)
[27]
Interpreting the results of early skin tests after perioperative anaphylaxis requires special attention: a case report and review of literature. — Orihara M, Takazawa T, Nagumo K, Sakamoto S, Horiuchi T, Saito S Journal of anesthesia (2020)
[28]
Recommendations for the Use of Tryptase in the Diagnosis of Anaphylaxis and Clonal Mastcell Disorders. — Platzgummer S, Bizzaro N, Bilò MB, Pravettoni V, Cecchi L, Sargentini V et al. European annals of allergy and clinical immunology (2020)
[29]
Hymenoptera venom allergy among children in Italy: time for pediatricians to take action. — Giovannini M, Castagnoli R, Mori F, Arasi S, Barni S, Saretta F et al. Allergologia et immunopathologia (2020)
[30]
Antimicrobial anaphylaxis: the changing face of severe antimicrobial allergy. — Hall V, Wong M, Munsif M, Stevenson BR, Elliott K, Lucas M et al. The Journal of antimicrobial chemotherapy (2020)
[31]
In situ simulation in the management of anaphylaxis in a pediatric emergency department. — Barni S, Mori F, Giovannini M, de Luca M, Novembre E Internal and emergency medicine (2019)
[32]
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