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Masqueraders of Anaphylaxis

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Anaphylaxis

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Abstract

Anaphylaxis often includes cutaneous, respiratory, gastrointestinal, and cardiovascular manifestations. It often occurs after ingestion or injection of an exogenous substance. There are many conditions which can mimic the symptoms and situational setting of anaphylaxis and thereby be mistaken for anaphylaxis. The main masqueraders of anaphylaxis are urticaria/angioedema, flushing syndromes, asthma, vocal cord dysfunction, aspiration, other forms of transient loss of consciousness including vasovagal syncope, seizures and strokes, other forms of shock, gastrointestinal and postprandial syndromes, and non-organic causes.

To further complicate the diagnosis, there are conditions on the differential diagnosis of anaphylaxis, such as cold urticaria and cholinergic urticaria, which can sometimes progress to anaphylaxis. And, due to hypotension, anaphylaxis can lead to some of the very same conditions with which it can be confused, such as seizures, cardiogenic shock, and transient loss of consciousness. A careful history, physical exam and directed testing can help diagnose the masqueraders of anaphylaxis.

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Authors and Affiliations

  1. Division of Immunology and Allergy, Hospital for Sick Children, Toronto, ON, Canada

    Julia E. M. Upton

  2. Department of Paediatrics, University of Toronto, Toronto, ON, Canada

    Julia E. M. Upton

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  1. Queen’s University, Kingston, ON, Canada

    Anne K. Ellis

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Upton, J.E.M. (2020). Masqueraders of Anaphylaxis. In: Ellis, A. (eds) Anaphylaxis. Springer, Cham. https://doi.org/10.1007/978-3-030-43205-8_7

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