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anaphylactoid reaction
Clinically similar to anaphylaxis, but due to non-immunologic (i.e. not IgE-mediated) mast cell degranulation.
Etiology:
1) complement-mediated mast cell degranulation
2) reactions to radiographic dyes (contrast agents)
3) reactions to aspirin
4) pharmaceutical agents with direct effect on mast cells resulting in degranulation
- polymixin, opiates, tubocurarine, thiamine, pentamidine, hydralazine, daunorubicin
Clinical manifestations:
- anaphylactoid reaction due to aspirin or NSAIDs
- triad of rhinosinusitis, nasal polyps, asthma
Special laboratory:
- skin testing not available [2]
Management:
- see anaphylaxis
- for reactions to radiographic contrast agents
a) low osmolarity contrast agents
b) pretreatment with
- prednisone
- histamine-H1-receptor antagonist
Related
adverse drug reaction (ADR)
anaphylaxis
General
sign/symptom
References
- H. Quinny Cheng, USSF Fresno lecture, Oct 21, 1998
- Medical Knowledge Self Assessment Program (MKSAP) 11, 14,
American College of Physicians, Philadelphia 1998, 2006