fatal anaphylactic reaction
fatal anaphylactic reactionA general term for an acute allergic reaction that results in sudden death.
Generalised flushing, urticaria, angio-oedema, vomiting, diarrhoea, rhinorrhoea, sneezing, coughing, conjunctivitis, loss of consciousness, and shock.
Iatrogenic agents, food reactions, venom (bees, wasps).
History of prior anaphylactic reactions; specific IgE antibodies to suspected antigen; elevated beta-tryptase, which is released from mast cells in anaphylactic reactions (with the caveat that beta-tryptase can be raised in non-anaphylatic fatalities and can be normal in asthmatic deaths).
Mechanism(s) of death in anaphylaxis
• Respiratory arrest—e.g., increased airways resistance with asphyxia due to pharyngeal and laryngeal oedema, lower airways obstruction due to bronchospasm or mucus plugging.
• Cardiac arrest—e.g., secondary to respiratory arrest, due to mediators of anaphylaxis on the heart, or shock with profound vasodilation and angio-oedema, leading to loss of intravascular fluid.
• Both, leading to cardiopulmonary arrest.