anaphylaxis: getting to the point (and price) of diagnosis and treatment

Ronald B MossAdamis Pharmaceuticals Corporation, San Diego, CA, USAAnaphylaxis was first described by Charles Richet and Paul Portier in 1901 as an immune reaction that is the opposite of immune protection resulting from vaccination.1 Anaphylaxis can be better categorized into both immunoglobulin E (IgE) and non-IgE pathways.2 Between 1.6% and 5.1% of the Americans are estimated to experience anaphylaxis, which can be fatal.3 The common triggers for an acute anaphylactic episode are foods, drugs, and venoms. Ultimately, a number of mediators are released that explain the clinical symptoms of flushing, pruritus, urticaria, shortness of breath, bronchospasm, hypotension, and cardiovascular collapse.2 Epinephrine injection is the evidence-based treatment for acute anaphylaxis, and delayed epinephrine administration is a risk factor for fatal anaphylaxis.3 However, like many other effective therapies in medicine, there remain barriers to treatment of anaphylaxis.