Idiopathic Anaphylaxis: Case Report

Abstract

Anaphylaxis is a rapidly progressive and fatal type I hypersensitivity reaction. Food, venom and drugs are the most frequent triggers of anaphylaxis. Idiopathic anaphylaxis is identified when other causes are excluded, and there is no specific trigger. A four-year-old boy presented to the hospital six times in the last 16 months with complaints of eyes and lips angioedema, urticaria and dyspnoea; some reactions were considered to be triggered by a stimulus (e.g., walnut, Turkish pizza or peach), whereas some were considered to have started spontaneously. Although he got bronchiolitis at the eighth month, there was no other history of illness. His brother is allergic to grass pollens. Physical examination revealed no pathologic findings on admission. Laboratory tests showed eosinophil count of 735/mm3, total IgE of 407 IU/mL, meadow pollen-specific IgE of 66, dust mix-specific IgE of 7 and tomato-specific IgE of 0.6 kU/L. Serum C4 and tryptase levels were normal. Various H1/H2 antihistamines, montelukast and adrenalin autoinjector were prescribed for the reactions. He was diagnosed with idiopathic anaphylaxis according to detailed anamnesis and laboratory results, although he was considered to have food-induced anaphylaxis at the beginning.