Advice on Idiopathic Anaphylaxis

Published: September 24, 2013

Q: I have had four severe allergic reactions (wheezing, swollen eyelids, sneezing) but there was nothing common to each experience – nothing I could figure out, anyway. Two of the times I hadn’t even eaten anything. A skin test was inconclusive. My doctor called it “idiopathic anaphylaxis.” What do you suggest I do going forward?

Dr. Waserman: Idiopathic anaphylaxis is a scary and frustrating problem. Unfortunately, it’s not at all uncommon. Despite our best efforts, a definitive explanation sometimes cannot be found for an allergic reaction.

Without access to your complete health background – your previous allergy or asthma history, whether the reactions took place recently, close together, in the context of exercise, how long they lasted – I can only make general comments.

Going forward, I recommend perseverance and preparedness. If you experience another idiopathic anaphylaxis reaction, keep a diary of anything and everything you might have been exposed to, including foods, inhalants, medications, pets and workplace exposures (such as exposure to latex in the health-care industry).

Until things have settled, I would recommend avoiding any new foods or non-essential medications.

Your situation needs to be reviewed in detail with an allergist. Be sure to discuss and create an “action plan” which, in the event of another reaction, would outline exactly what to do when you feel symptoms coming on – for example, using an epinephrine auto-injector, antihistamines or inhalers.

Dr. Susan Waserman is an allergist and Professor of Medicine in the Division of Allergy and Clinical Immunology at McMaster University in Hamilton, Ont. She is also a past president of the Canadian Society of Allergy and Clinical Immunology.

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