Anaphylaxis - Different Causes
IgE-dependent
Nonimmunologic triggers → direct
activation of mast cells and basophils
1. Food allergy. Rare: storage
mite-contaminated flour. Meat: alpha-gal
1. Physical factors → exercise, cold, heat
sIgE, WDEIA - omega-5 gliadin sIgE
2. Medications - opioids, NSAIDs
2. Insect stings/bites - kissing bugs,
3. Radiocontrast agents
mosquitoes, pigeon ticks, green ants,
4. Alcohol (ethanol), may augment, rarely
pharaoh ants, venoms from jellyfish,
induces
scorpions, snakes
3. Medications - antibiotics, NSAIDs
4. Biologic materials - allergen
immunotherapy, monoclonal antibodies,
chemotherapy, vaccines (gelatin)
5. Natural rubber latex
6. Food additives - spices, insect-derived IgE-independent
Idiopathic
colorants (carmine), vegetable gums
- IgG-dependent (rare) -
7. Inhalants (rare) - horse dander, cat - hidden or previously high-molecular weight
dander, grass pollen unrecognized trigger? dextran, infliximab
8. Human seminal fluid (rare trigger of
anaphylaxis in women) - systemic mastocytosis - Coagulation system
9. Occupational allergens - stinging insects, vs. mast cell activation activation - heparin
natural rubber latex syndrome contaminated with
oversulfated chondroitin
sulfate)
AllergyGoAway.com, updated: 2019