Highlights in nonhymenoptera anaphylaxis.
OBJECTIVE
The purpose of this review is to summarize new interesting findings in both research and clinical practice of nonhymenoptera anaphylaxis with particular emphasis on food and drug allergy.


RESULTS
Recent findings include some aspects of crossreactivity among betalactams, nonsteroidal anti-inflammatory drugs with special attention to an immunogenic metabolite of diclofenac and the mode of diclofenac-induced basophil degranulation. Also, new insights into the sometimes atypical anaphylaxis-like reactions after administration of monoclonal antibodies and the immunologic response to these molecules will be discussed, as well as the role of low-dose pholcodine exposure on the development of sensitization to neuromuscular blocking agents. In food-related anaphylaxis, a significant increase of incidents has been observed over the last few years, especially among children of less than 5 years of age. Unfortunately, the severity of subsequent reactions cannot be predicted from the reaction history. Tree nuts and peanuts are the most important elicitors of fatal food-induced anaphylaxis.


CONCLUSIONS
In food-related anaphylaxis, prospectively evaluated marker allergens that are indicative of a potential anaphylactic reaction are still lacking. The drug groups covered in this review are of special interest either due to their prominent role as allergens or due to new findings.
Scherer
Kathrin
K
Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Ballmer-Weber
Barbara K
BK
Bircher
Andreas J
AJ
D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D000707:Anaphylaxis / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D001491:Basophils / Q000276:immunology* / Q000378:metabolism; D015550:Cell Degranulation; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000276:immunology* / Q000503:physiopathology; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D009754:Nuts / Q000009:adverse effects; D047090:beta-Lactams / Q000009:adverse effects
D000485:Allergens; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D009466:Neuromuscular Blocking Agents; D047090:beta-Lactams