| • | angioedema frequently occurs with acute urticaria |
pathogenesis (IgE vs. non-immunologic):
| • | IgE mediated – type I hypersensitivity: urticaria = transient (<12 hours) |
| • | children – milk, eggs, peanuts, soy, wheat |
| • | adults – fish, shellfish, peanuts, tree nuts |
|
| • | latex (avocado, banana, and chestnuts cross react) – |
| • | direct mast cell degranulators = opiates, alcohol |
| • | arachidonic acid pathway inhibitors = ASA, NSAIDS |
| • | radiocontrast dyes – mechanism unknown |
| • | spoiled fish from Scombroidae family of fish (e.g. tuna) |
| • | if not kept cold enough, their flesh develops “scombrotoxins” due to the bacterial breakdown of histidine into histamine etc… |
| • | clinical: acute (hours) – flushing, urticaria, angioedema |
| • | treatment: anti-histamines |
|
Treatment:
| • | pearl: adrenalin 1mg/ml (1:1000) 0.5 ml SQ (works quickly, they feel better after a few minutes, but they will get tachycardic and feel jumpy for a bit) |
|