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November 26, 1982

Anaphylaxis and Related Allergic Emergencies Including Reactions due to Insect Stings

JAMA. 1982;248(20):2632-2636. doi:10.1001/jama.1982.03330200056014

ALLERGIC emergencies refer to acute reactions mediated by immunologic mechanisms of such severity as to require immediate treatment. These immunologic reactions involve antigen-antibody interactions that result in the release of chemical mediators, and resultant signs and symptoms. The main thrust of this section will deal with systemic anaphylaxis and acute laryngeal edema. A discussion of status asthmaticus is handled separately in this volume (see chapter 1). Likewise, anaphylactoid reactions or pseudoallergies, such as reactions to radiographic contrast media or aspirin and nonsteroidal anti-inflammatory agents will not be covered here, since an immunologic basis has not been demonstrated; nevertheless, the same general principles of treatment apply, since an airway must always be maintained and hypotension and shock must be treated in a similar manner as the treatment of an anaphylactic reaction. Although it was once thought that allergic persons might be more susceptible to such reactions, strong evidence for such a