DocWire News Editors

DocwireNews

&ldquo;Anaphylaxis&mdash;we know it, we see it, and we even cause it, so we have to be the ones to prevent and treat it,&rdquo; Anne Ellis, MD, MSc, FRCPC, told an audience of allergists at the ACAAI annual meeting. Allergists have the tools to manage it effectively, so they must be the experts.Ellis, of Queens University in Ontario, Canada, is the winner of the ACAAI Bernard Berman Memorial Lecture. In it, she reviewed the pathophysiology of anaphylaxis, subcategorized as non-immunologic or immunologic, the latter of which can be subcategorized into IgE mediated and non-Ig mediated. In anaphylaxis, there is a release of histamine and other mediators (PAF, leukotrienes, and prostaglandins), which results in smooth muscle spasm, vascular permeability, vasodilation, myocardial depression, and activation of vagal effector pathways. She stressed the role of PAF as an important mediator and encouraged her colleagues not to focus only on histamine.Ellis&rsquo; research has elucidated variants in the clinical course of anaphylaxis. Most cases begin within minutes of exposure to an antigen. However, some cases can be late onset, up to one hour after exposure; biphasic, including a second related episode; or protracted. In her studies, the longer it took to control a case of anaphylaxis, the more likely a biphasic episode was.&ldquo;Get things better fast,&rdquo; she said, as early intervention will help prevent biphasic anaphylaxis. When considering whether to release a patient home, Ellis said that healthcare practitioners should consider these findings.Some allergists have argued that biphasic reactions do not occur, she noted. However, that is due to biphasic reactions that do not occur during food challenges, as clinicians are ready for reactions and treat immediately. Biphasic reactions are happening in the field, she said, and research is exploring why they happen.While reviewing administration guidelines, Ellis offered tips and areas for caution. Most clinicians should be using intramuscular epinephrine, with intravenous administration reserved for emergency physicians and anesthesiologists. Epinephrine can be repeated every three to five minutes if symptoms are still present. Ellis said there is &ldquo;no downside&rdquo; to continuing to dose them. In addition, she cautioned against sitting patients up, rather keeping them in a recumbent position with the legs elevated. Administration should be accompanied by oxygen and a lot of IV fluids.&ldquo;Early treatment is good, but primary and secondary prevention are better,&rdquo; she concluded.

Jordana Jampel

Positive Preliminary Results From Phase 1 Trial of Dopaminergic Neuron Graft for Parkinson’s Disease

Dementia

Bradley Warady, MD

Joel M. Topf, MD, FACP

2025 Hume Award Winner Is Dedicated to Children’s Care

NKF Spring Clinical Meetings 2025

Distant Brain Metastases in Cutaneous Melanoma May Be Mitigated With Multiple Pathway Inhibitors

Melanoma

Latest News

Memorial Lecture: Allergists Should be the Experts in Anaphylaxis

ACAAI 2018

“Anaphylaxis—we know it, we see it, and we even cause it, so we have to be the ones to prevent and treat it,” Anne Ellis, MD, MSc, FRCPC, told an audience of allergists ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe