title: Multiphasic anaphylaxis: report of a case with prehospital and emergency department considerations.
abstract: Anaphylaxis, a multisystem allergic reaction, represents a true medical emergency. Anaphylaxis is characterized by a combination of the following symptoms: urticaria, angioedema, distributive shock, and respiratory failure. Most often, the patient is rapidly treated with prompt resolution of the anaphylaxis in either the out-of-hospital or emergency department (ED) setting. Infrequently, recurrent or multiphasic anaphylaxis is encountered, involving a reappearance of allergic phenomena after complete resolution of the original reaction. Recurrence may involve nuisance-level issues such as urticaria; alternatively, multiphasic reactions may be characterized by cardiovascular collapse or respiratory compromise. Initially aggressive pharmacological therapy followed by prolonged observation in either the ED or the in-hospital setting is strongly recommended to monitor for potential recurrence.
authors.affiliation: Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Brady
authors.forename: S
authors.initials: S
authors.lastname: Luber
authors.forename: T P
authors.initials: TP
authors.lastname: Joyce
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D001733:Bites and Stings / Q000150:complications; D004632:Emergency Medical Services; D006801:Humans; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors