Skip to main content
SpringerLink
Log in

Idiopathic Anaphylaxis

  • Chapter
  • First Online:
Book cover Anaphylaxis and Hypersensitivity Reactions

Abstract

When anaphylaxis occurs in the absence of an identifiable trigger, the anaphylactic reaction is termed idiopathic. It is a well-described type of anaphylaxis with treatment that is associated with good prognosis. Episodes may be reduced with prophylactic corticosteroids and antihistamines. There is no definitive diagnostic test for idiopathic anaphylaxis. By definition, it is a diagnosis of exclusion after eliminating other causes. Disorders that may mimic anaphylaxis should be considered for evaluation. The cause of idiopathic anaphylaxis remains uncertain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wong S, Yarnold PR, Yango C, et al. Outcome of prophylactic therapy for idiopathic anaphylaxis. Ann Intern Med. 1991; 114:133–136.

    PubMed  CAS  Google Scholar 

  2. Patterson R, Stoloff RS, Greenberger PA, Grammer LC, Harris KE. Algorithms for the diagnosis and management of idiopathic anaphylaxis. Ann Allergy 1993; 71:40–44.

    PubMed  CAS  Google Scholar 

  3. Patterson R, Clayton D, Booth B, et al. Fatal and near fatal idiopathic anaphylaxis. Allergy Proc. 1995; 16:103–108.

    Article  PubMed  CAS  Google Scholar 

  4. Krasnick J, Patterson R, Meyers G. A fatality from idiopathic anaphylaxis, Ann Allergy Asthma Immunol 1996 76: 376–379.

    Article  PubMed  CAS  Google Scholar 

  5. Bacal E, Patterson, R, Zeiss CR. Evaluation of severe (anaphylactic) reactions. Clinical Allergy 1978; 8: 295–304.

    Article  PubMed  CAS  Google Scholar 

  6. Ditto AM, Harris KE, Karsnick J, et al. Idiopathic anaphylaxis: a series of 335 cases. Ann Allergy Asthma Immunol 1996; 77:285–291.

    Article  PubMed  CAS  Google Scholar 

  7. Patterson R, Hogan M, Yarnold P, et al: Idiopathic anaphylaxis. An attempt to estimate the incidence in the United States, Arch Intern Med 1995; 155: 869–871.

    Article  PubMed  CAS  Google Scholar 

  8. Kemp SF, Lockey RF, Lieberman P, et al: Anaphylaxis, a review of 266 cases. Arch Intern Med 1995;155: 1749–1954.

    Article  PubMed  CAS  Google Scholar 

  9. Webb LM, Lieberman P. Anaphylaxis: a review of 601 cases. Ann Allergy Asthma Immunol 2006; 97: 39–43.

    Article  PubMed  Google Scholar 

  10. Yocum MW, Butterfield J, Klein J, et al. Epidemiology of anaphylaxis in Olmstead County, a population-based study. J Allergy Clin Immunol 1999; 104:452–456.

    Article  PubMed  CAS  Google Scholar 

  11. Tejedor Alonso M, Dominguez J, Sanchez-Hernandez J, Frances C, Caballer B. Idiopathic anaphylaxis: a descriptive study of 81 patients in Spain. Ann Allergy Asthma Immunol 2002; 88:313–318.

    Article  PubMed  Google Scholar 

  12. Ditto AM, Patterson R, Sider L. Allergic bronchopulmonary aspergillosis, idiopathic anaphylaxis and cystic fibrosis in a 9 year old: a case report. Pediatr Asthma Allergy Immunol 1995; 9:107–115.

    Article  Google Scholar 

  13. Dykewicz MS, Blaser M, Evans R, Patterson R. Pediatric idiopathic anaphylaxis: A report of 3 cases with recommendations for evaluation and management. Pediatr Asthma Allergy Immunol 1990; 4:217–223.

    Article  Google Scholar 

  14. Patterson R, Ditto A, Dykewicz MS, Greenberger PA, Harris KE, Kelly KJ, et al. Pediatric idiopathic anaphylaxis: additional cases and extended observations. Pediatr Asthma Allergy Immunol 1995; 9:107–115.

    Article  Google Scholar 

  15. Ditto AM, Krasnick J, Greenberger PA, et al. Pediatric idiopathic anaphylaxis: experience with 22 patients. J Allergy Clin Immunol 1997; 100:320–326.

    Article  PubMed  CAS  Google Scholar 

  16. Schwartz LB, Metcalfee DD, Miller JS, Earl H, Sullivan T. Tryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis. N Engl J Med 1987; 316:1622–1626.

    Article  PubMed  CAS  Google Scholar 

  17. Moro M, Tejedor MA, Esteban J et al. Severity of Anaphylaxis According to Causes and Demographic Characteristics [abstract]. J Allergy Clin Immunol 2008; 121:S24.

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Garriga MM, Friedman MM, Metcalfe DD. A survey of the number and distribution of mast cells in the skin of patients with mast cell disorders. J Allergy Clin Immunol 1988; 82: 425–432.

    Article  PubMed  CAS  Google Scholar 

  20. Keffer J, Bressler RB, Wright R, Kaliner MA, Metcalfe DD. Analysis of the wheal and flare reactions that follow the intradermal injection of histamine and morphine in adults with recurrent, unexplained anaphylaxis and systemic mastocytosis. J Allergy Clin Immunol 1989; 83: 595–601.

    Article  PubMed  CAS  Google Scholar 

  21. Greenberger PA, Smith LJ, Patteron R. Comparison of cutaneous and bronchial reactivity to leukotriene D4 in humans. J Lab Clin Med 1986; 108:70–75.

    PubMed  CAS  Google Scholar 

  22. Tejedor MA, Perez C, Sastre et al. Mast cell releasibility in idiopathic anaphylaxis subtypes [abstract]. J Allergy Clin Immunol 2000; 105: S348.

    Google Scholar 

  23. Tejedor Alonso MA. Sastre Dominguez J, Sanchez-Hernandez JJ, PerezFrances C., Hoz de la Caballer B. Clinical and functional differences among patients with idiopathic anaphylaxis. J Invest Allergol Clin Immunol 2004; 14:177–186.

    PubMed  CAS  Google Scholar 

  24. Reed J, Yedulapuram M, Lieberman P, et al. Differences in cytokine production between idiopathic anaphylaxis (IA) subjects and controls [abstract]. J Allergy Clin Immunol 2006; 117: S305.

    Article  Google Scholar 

  25. Sonin L, Patterson R. Metbisulfite challenge in patients with idiopathic anaphylaxis. J Allergy Clin Immunol 1985; 75:67–69.

    Article  PubMed  CAS  Google Scholar 

  26. Slater JE, Raphael G, Cutler GB. Recurrent anaphylaxis in menstruating women: treatment with luteinizing hormone releasing hormone – a preliminary report. Obstet Gynecol 1987; 70:542–546.

    PubMed  CAS  Google Scholar 

  27. Slater JE, Kaliner M. Effects of sex hormones on histamine release in recurrent idiopathic anaphylaxis. J Allergy Clin Immunol 1987; 80: 285–290.

    Article  PubMed  CAS  Google Scholar 

  28. Gruber BL, Baeza ML, Marchese MJ, Agnello V, Kaplan AP. Prevalence and functional role of anti-IgE autoantibodies in urticarial syndromes. J Invest Dermatol 1988; 90:213.

    Article  PubMed  CAS  Google Scholar 

  29. Grant JA, Alam R, Lett-Brown MA. Histamine-releasing factors and inhibitors: historical perspectives and possible implications in human illness. J Allergy Clin Immunol 1991; 88:683–693.

    Article  PubMed  CAS  Google Scholar 

  30. Mozelsio N, Grammer L. Quantitation of monocyte chemoattractant protein-1 in patients with idiopathic anaphylaxis [abstract]. J Allergy Clin Immunol 2001; 107:S80.

    Google Scholar 

  31. Akin C, Scott LM, Kocabas CN, Kushnir-Sukjov N, Brittain E, Noel P, Metcalfe DD. Demonstration of an aberrant mast-cell population with clonal markers in a subset of patients with “idiopathic” anaphylaxis. Blood. 2007; 110:2331–2333.

    Article  PubMed  CAS  Google Scholar 

  32. Metcalfe DD, Schwartz L. Assessing anaphylactic risk? Consider mast cell clonality. J Allergy Clin Immunol 2009; 123: 687–688.

    Article  PubMed  Google Scholar 

  33. Tanus T, Mines D, Atkins PC, Levinson AI. Serum tryptase in idiopathic anaphylaxis a case report and review of the literature. Ann Emerg Med 1994; 24: 104–107.

    Article  PubMed  CAS  Google Scholar 

  34. Shanmugam G, Schwartz LB, Khan DA. Prolonged elevation of serum tryptase in indiopathic anaphylaxis. J Allergy Clin Immunol 2006 117: 950–951.

    Article  PubMed  CAS  Google Scholar 

  35. Koterba AP, Akin C. Differences in the Clinical Presentation of Anaphylaxis in Patients with indolent Systemic Mastocytosis (ISM) versus Idiopathic Anaphylaxis (IA) [abstract]. J Allergy Clin Immunol 2008; 121: S68–S69.

    Article  Google Scholar 

  36. Grammer LC, Shaughnessy MA, Harris KE, Goolsby CL. Lymphocyte subsets and activation markers in patients with acute episodes of idiopathic anaphylaxis. Ann Allergy Asthma Immunol 2000; 85:368–371.

    Article  PubMed  CAS  Google Scholar 

  37. Howell DL, Jacobs C, Metz G et al. Molecular Profiling Distinguishes Patients with Active Idiopathic Anaphylaxis from Normal Volunteers and Reveals Novel Aspects of Disease Biology [abstract]. J Allergy Clin Immunol 2009; 123:S150.

    Article  Google Scholar 

  38. Munoz MF, Lopez Cazana JM, Villas F, et al. Exercise-induced anaphylactic reaction to hazelnut. Allergy 1994; 49:314.

    Article  Google Scholar 

  39. Sheffer AL, Soter NA, McFadden ER Jr, et al. Exercise-induced anaphylaxis: a distinct form of physical allergy. J Allergy Clin Immunol 1983: 71:311.

    Article  PubMed  CAS  Google Scholar 

  40. Romano A, Di Fonso M, Giuffreda F, et al. Food-dependent exercise-induced anaphylaxis: clinical and laboratory findings in 54 subjects. Int Arch Allergy Immunol 2001; 125:264–272.

    Article  PubMed  CAS  Google Scholar 

  41. Moneret-Vautrin DA, Morisset M, Lemerdy M, et al. Food allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy). Allerg Immunol (Paris) 2002; 34:135–140.

    CAS  Google Scholar 

  42. Stricker WE, Anorve-Lopez E, Reed CE. Food skin testing in patients with idiopathic anaphylaxis. J Allergy Clin Immunol 1986; 77: 516–519.

    Article  PubMed  CAS  Google Scholar 

  43. Furlong TJ, DeSimone J, Sicherer SH. Peanut and tree nut allergic reactions in restaurants and other food establishments. J Allergy Clin Immunol 2001; 108:867–870.

    Article  PubMed  CAS  Google Scholar 

  44. DiCello MC, MycA, Baker JR Jr. Baldwin JL. Anaphylaxis after ingestion of carmine colored foods: two case reports and a review of the literature. Allergy Asthma Proc 1999; 20:377.

    Article  PubMed  CAS  Google Scholar 

  45. Greenberger PA, Flais MJ. Bee pollen-induced anaphylactic reaction in an unknowingly sensitized subject. Ann Allergy Asthma Immunol 2001; 86:239.

    Article  PubMed  CAS  Google Scholar 

  46. Blanco C, Quiralte J, Castillo R et al. Anaphylaxis after ingestion of wheat flour contaminated with mites. J Allergy Clin Immunol 1997; 99:308–313.

    Article  PubMed  CAS  Google Scholar 

  47. Sanchez-Borges M, Suarez-Chacon R, Capriles-HulettA, Caballero-Fonseca F. An update on oral anaphylaxis from mite ingestion. Ann Allergy Asthma Immunol 2005; 94:216.

    Article  PubMed  Google Scholar 

  48. Becker K, Southwick K, Readon J. Histamine poisoning associated with eating tuna burgers. JAMA 2001; 285:1327.

    Article  PubMed  CAS  Google Scholar 

  49. Gelincik A, Ozseker F, BuyukozturkS et al. Recurrent anaphylaxis due to non-ruptured hepatic hydatid cysts. Int Arch Allergy Immunol 2007; 143:296.

    Article  PubMed  Google Scholar 

  50. Cogen FC, Beezhold D. Hair glue anaphylaxis: a hidden latex allergy Ann Allergy Asthma Immunol 2002; 88:61–63.

    Article  PubMed  Google Scholar 

  51. Schwartz LB, Irani AM. Serum tryptase in the laboratory diagnosis of systemic mastocytosis. Hematol Oncol Clin North Am 2000; 14: 641–657.

    Article  PubMed  CAS  Google Scholar 

  52. Lieberman P. Anaphylaxis. Middleton: Allergy: Principles and Practice, 7th ed. St Louis, Mosby; 2009:1027–1049.

    Book  Google Scholar 

  53. Lieberman P, Kemp S, Oppenheimer J, et al. The diagnosis and management of anaphylaxis: an updated practice parameter. J Allergy Clin Immunol 2005; 115:S483–S523.

    Article  Google Scholar 

  54. Saltoun CA. Urticaria, Angioedema and Hereditary Angioedema. In: Grammer LC, Greenberger PA, eds. Allergic Diseases, Diagnosis and Management, 7th ed. Lippincott Williams & Wilkins, Philadephia, PA; 2009:539–553.

    Google Scholar 

  55. Erem C, Kocak M, Onder Ersoz H et al. Epinephrine-secreting cystic pheochromocytoma presenting with an incidental adrenal mass: a case report and a review of the literature. Endocrine 2005; 28: 225–230.

    Article  PubMed  CAS  Google Scholar 

  56. Ueda T, Oka N, Matsumoto A et al. Pheochromocytoma presenting as recurrent hypotension and syncope. Intern Med 2005; 44:222–227.

    Article  PubMed  Google Scholar 

  57. Bahrainwala AH, Simon MR. Wheezing and vocal cord dysfunction mimicking asthma. Curr Opin Pulm Med 2001; 7:8–13.

    Article  PubMed  CAS  Google Scholar 

  58. Patterson R, Schatz M, Harton M. Munchausen’s stridor: non-organic laryngeal obstruction. Clin Allergy 1974; 4:307–310.

    Article  PubMed  CAS  Google Scholar 

  59. McGrath K. Anaphylaxis. In: Grammer LC and Greenberger PA, eds. Allergic Diseases, Diagnosis and Management, 7th ed. Lippincott Williams & Wilkins, Philadelphia, PA; 2009:197–219.

    Google Scholar 

  60. Choy AC, Patterson R, Patterson DR et al. Undifferentiated somatoform idiopathic anaphylaxis: non-organic symptoms mimicking idiopathic anaphylaxis. J Allergy Clin Immunol 1995; 96:893–900.

    Article  PubMed  CAS  Google Scholar 

  61. Greenberger PA, Patterson R. The prevention of immediate generalized reaction to radiocontrast media in high-risk patients. J Allergy Clin Immunol 1991; 87: 867–872.

    Article  PubMed  CAS  Google Scholar 

  62. Patterson R, Fitzsimons EJ, Choy AC, Harris KE. Malignant and corticosteroid-dependent idiopathic anaphylaxis: successful responses to ketotifen. Ann Allergy Asthma Immunol 1997; 79:138.

    Article  PubMed  CAS  Google Scholar 

  63. Boxer MR, Greenberger PA, Patterson R. The impact of prednisone in life-threatening idiopathic anaphylaxis: reduction in acute episodes and medical costs. Ann Allergy 1989; 62:201.

    PubMed  CAS  Google Scholar 

  64. Warrier P, Casale TB. Omalizumab in idiopathic anaphylaxis. Ann Allergy Asthma Immunol. 2009 Mar;102(3):257–258.

    Article  PubMed  Google Scholar 

  65. Jones JD, Marney SR Jr, Fahrenholz JM. Idiopathic anaphylaxis successfully treated with omalizumab. Ann Allergy Asthma Immunol. 2008 Nov;101(5):550–551.

    Article  PubMed  Google Scholar 

  66. Commins SP, Satinover SM, Hosen J, Mozena J, Borish L, Lewis BD et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α(alpha)-1,3-galactose. J Allergy Clin Immunol 2009; 123:426–433.

    Article  PubMed  CAS  Google Scholar 

  67. Commins SP, James H, Tran N, Kelly RE, Liberman P, Platts-Mills T. Testing for IgE antibody to the carbohydrate galactose-α(alpha)-1,3-galactose (alpha-gal) in patients with recurrent, idiopathic anaphylaxis: how many cases are we missing? [Abstract] J Allergy Clin Immunol 2009; 125: S119.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Karen Hsu Blatman

Authors
  1. Karen Hsu Blatman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leslie C. Grammer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen Hsu Blatman .

Editor information

Editors and Affiliations

  1. Harvard Medical School, Ambulatory Center, Brigham and Women’s Hospital, Boyleston Street, Route 9 850, Chestnut Hill, 02467, Massachusetts, USA

    Mariana C. Castells

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Blatman, K.H., Grammer, L.C. (2011). Idiopathic Anaphylaxis. In: Castells, M. (eds) Anaphylaxis and Hypersensitivity Reactions. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-951-2_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-951-2_13

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-950-5

  • Online ISBN: 978-1-60327-951-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation