Management of angioedema without urticaria in the emergency department

Annals of Medicine

Volumn 46, Issue 8, 2014, Pages 607-618

  Pedrosa, Maria ^a   Prieto García, Alicia ^b   Sala Cunill, Anna ^c   Caballero, T ^a,d   Baeza, M L ^b   Cabanas R ^a   Campos, A ^e   Cimbollek, S ^f   Gomez Traseira C ^a   Gonzalez Quevedo T ^f   Guilarte, M ^c   Jurado Palomo, J ^g   Lobera, T ^h   Lopez Serrano M C ^a   Marcos, C ⁱ   Pinero Saavedra M ^f   Prior, N ^a   Saenz De San Pedro B ^j   Ferrer, M ^k   Barcelo J M ^l   Daschner, A ^m   Echechipia M ⁿ   Garces M ^o   Iriarte, P ^p   Jauregui I ^q   Lazaro M ^r   Quinones M ^s   Veleiro, B ^t   Villareal, O ^u   more..

^a HOSPITAL UNIVERSITARIO LA PAZ IDIPAZ   (Spain)

^b HOSPITAL GENERAL UNIVERSITARIO GREGORIO MARAÑÓN   (Spain)

^c HOSPITAL UNIVERSITARI VALL D HEBRON   (Spain)

^d HOSPITAL UNIVERSITARIO LA PAZ   (Spain)

^e HOSPITAL UNIVERSITARIO LA FE   (Spain)

^f HOSPITAL UNIVERSITARIO VIRGEN DEL ROCÍO   (Spain)

^g HOSPITAL NUESTRA SEÑORA DEL PRADO   (Spain)

^h HOSPITAL SAN PEDRO   (Spain)

ⁱ UNIVERSITY HOSPITAL COMPLEX OF VIGO   (Spain)

^j Hosp Univ Ciudad de Jaén   (Spain)

^k UNIVERSITY CLINIC OF NAVARRA   (Spain)

^l Department of Orthopaedic Surgery   (Spain)

^m HOSPITAL UNIVERSITARIO DE LA PRINCESA   (Spain)

ⁿ Instituto de Investigación Sanitaria de Navarra   (Spain)

^o HOSPITAL CLÍNICO UNIVERSITARIO LOZANO BLESA   (Spain)

^p Universidad de La Coruña   (Spain)

^q HOSPITAL DE BASURTO   (Spain)

^r Clinica Alergoasma   (Spain)

^s HOSPITAL MONTE NARANCO   (Spain)

^t HOSPITAL JUAN CANALEJO   (Spain)

^u HOSPITAL TXAGORRITXU   (Spain)

more..

Author keywords

ACEi induced angioedema; Angioedema; Bradykinin; C1 inhibitor deficiency; Histamine

Indexed keywords

ADRENALIN; ANTIHISTAMINIC AGENT; BRADYKININ; CETIRIZINE; COMPLEMENT COMPONENT C1S INHIBITOR; CORTICOSTEROID; DEXCHLORPHENIRAMINE; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIPHENHYDRAMINE; EBASTINE; ECALLANTIDE; FEXOFENADINE; GLUCOCORTICOID; HISTAMINE; HYDROCORTISONE; ICATIBANT; LORATADINE; METHYLPREDNISOLONE; PEPTIDE; RUPATADINE; STEROID; TRANEXAMIC ACID;

ACUTE ABDOMEN; ALLERGIC REACTION; ANAPHYLAXIS; ANGIONEUROTIC EDEMA; ATOPY; CLINICAL FEATURE; CLINICAL TRIAL; DIAGNOSTIC PROCEDURE; DIFFERENTIAL DIAGNOSIS; DISEASE CLASSIFICATION; DISEASE SEVERITY; DIZZINESS; EMERGENCY PHYSICIAN; EMERGENCY WARD; FAMILY HISTORY; HEADACHE; HEART VENTRICLE ARRHYTHMIA; HUMAN; HYPERSENSITIVITY; HYPERTENSION; INJECTION SITE EDEMA; INJECTION SITE ERYTHEMA; INJECTION SITE PAIN; INJECTION SITE PRURITUS; INJECTION SITE REACTION; INTENSIVE CARE UNIT; ISCHEMIA; LUNG EDEMA; MEDICAL INFORMATION; OUTPATIENT DEPARTMENT; PALLOR; PATHOPHYSIOLOGY; RECOMMENDED DRUG DOSE; REPEATED DRUG DOSE; REVIEW; TREATMENT RESPONSE; TREMOR; UPPER RESPIRATORY TRACT; UPPER RESPIRATORY TRACT OBSTRUCTION; URTICARIA; AIRWAY OBSTRUCTION; ANAMNESIS; ANGIOEDEMA; EMERGENCY HEALTH SERVICE; METABOLISM;

AIRWAY OBSTRUCTION; ANAPHYLAXIS; ANGIOEDEMA; BRADYKININ; EMERGENCY SERVICE, HOSPITAL; HISTAMINE; HUMANS; MEDICAL HISTORY TAKING;

EID: 84919400439     PISSN: 07853890     EISSN: 13652060     Source Type: Journal    
DOI: 10.3109/07853890.2014.949300     Document Type: Review

References (96)

1. Winters M. Clinical practice guideline: initial evaluation and management of patients presenting with acute urticaria or angioedema. American Academy of Emergency Medicine web site. 2006. Available at: http://www.aem.org/em-resources/position-statements/2006/clinicalpractice-guidelines (accessed 6 February 2013).
2. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol. 2005; 53: 373-88.
3. Bas M, Adams V, Suvorava T, Niehues T, Hoffmann TK, Kojda G. Nonallergic angioedema: role of bradykinin. Allergy. 2007; 62: 842-56.
4. Weldon D. Differential diagnosis of angioedema. I mmunol Allergy Clin North Am. 2006; 26: 603-13.
5. Bernstein JA, Moellman J. Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema. Int J Emerg Med. 2012; 5: 39.
6. Stevenson D D. Aspirin and NSAID sensitivity. I mmunol Allergy Clin North Am. 2004; 24: 491-505.
7. Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, Bork K, et al. Classification, diagnosis and approach to treatment in angioedema: Consensus report from the Hereditary Angioedema International Working Group. Allergy. 2014; 69: 602-16.
8. Stone KD, Prussin C, Metcalfe DD. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol. 2010; 125(2 Suppl 2): S73-80.
9. Commins SP, Borish L, Steinke JW. Immunologic messenger molecules: cytokines, interferons, and chemokines. J Allergy Clin Immunol. 2010; 125(2 Suppl 2): S53-72.
10. Schwartz L, Metcalfe D, Miller J, Earl H, Sullivan T. Tryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis. N Engl J Med. 1987; 316: 1622-6.
11. Durham SR. Allergic inflammation: cellular aspects. Allergy. 1999; 54(Suppl 5): 18-20.
12. Grigoriadou S, Longhurst HJ. An approach to the patient with angiooedema. Clin Exp Immunol. 2009; 155: 367-77.
13. Theoharides TC, Kempuraj D, Tagen M, Conti P, Kalogeromitros D. Differential release of mast cell mediators and the pathogenesis of inflammation. Immunol Rev. 2007; 217: 65-78.
14. Cicardi M, Bergamaschini L, Zingale LC, Gioffré D, Agostoni A. Idiopathic nonhistaminergic angioedema. Am J Med. 1999; 106: 650-4.
15. Björkqvist J, Sala-Cunill A, Renné T. Hereditary angioedema: a bradykinin-mediated swelling disorder. Thromb Haemost. 2013; 109: 368-74.
16. Kaplan AP, Ghebrehiwet B. The plasma bradykinin-forming pathways and its interrelationships with complement. Mol Immunol. 2010; 47: 2161-9.
17. Blanch A, Roche O, López-Granados E, Fontán G, López-Trascasa M. Detection of C1 inhibitor (SERPING1/C1NH) mutations in exon 8 in patients with hereditary angioedema: evidence for 10 novel mutations. Hum Mutation. 2002; 20: 405-6.
18. Davis AE. The pathophysiology of hereditary angioedema. Clin Immunol. 2005; 114: 3-9.
19. Nussberger J, Cugno M, Cicardi M. Bradykinin-mediated angioedema. N Engl J Med. 2002; 347: 621-2.
20. Castelli R, Deliliers D, Zingale LC, Pogliani E, Cicardi M. Lymphoproliferative disease and acquired C1 inhibitor deficiency. Haematologica. 2007; 92: 716-18.
21. Barilla-LaBarca M, Gioffre D, Zanichelli A, Cicardi M, Atkinson JP. Acquired C1 esterase inhibitor deficiency in two patients presenting with a lupus-like syndrome and anticardiolipin antibodies. Arthritis Rheum. 2002; 47: 223-6.
22. Farkas H, Szongoth M, Bély M, Varga L, Fekete B, Karádi I, et al. Angiooedema due to acquired deficiency of C1-esterase inhibitor associated with leucocytoclastic vasculitis. Acta Derm Venereol. 2001; 81: 298-300.
23. Farkas H, Csepregi A, Nemesánszky E. Acquired angioedema associated with chronic hepatitis C. J Allergy Clin Immunol. 1999; 103: 711-12.
24. Alsenz J, Bork K, Loos M. Autoantibody-mediated acquired deficiency of C1 inhibitor. N Engl J Med. 1987; 316: 1360-6.
25. Ponce IM, Caballero T, Reche M, Piteiro AB, López-Serrano MC, Fontán G, et al. Polyclonal autoantibodies against C1 inhibitor in a case of acquired angioedema. Ann Allergy Asthma Immunol. 2002; 88: 632-7.
26. Marcos C, López Lera A, Varela S, Liñares T, Alvarez-Eire M G, L opez-Trascasa M. Clinical, biochemical, and genetic characterization of type III hereditary angioedema in 13 Northwest Spanish families. Ann Allergy Asthma Immunol. 2012; 109: 195-200. e2.
27. Martin L, Raison-Peyron N, Nöthen MM, Cichon S, Drouet C. Hereditary angioedema with normal C1 inhibitor gene in a family with affected women and men is associated with the p.Th r328Lys mutation in the F12 gene. J Allergy Clin Immunol. 2007; 120: 975-7.
28. Bouillet L, Ponard D, Rousset H, Cichon S, Drouet C. A case of hereditary angio-oedema type III presenting with C1-inhibitor cleavage and a missense mutation in the F12 gene. Br J Dermatol. 2007; 156: 1063-5.
29. Bork K. Hereditary angioedema with normal C1 inhibitor activity including hereditary angioedema with coagulation factor XII gene mutations. Immunol Allergy Clin North Am. 2006; 26: 709-24.
30. Dewald G, Bork K. Missense mutations in the coagulation factor XII (Hageman factor) gene in hereditary angioedema with normal C1 inhibitor. Biochem Biophys Res Commun. 2006; 343: 1286-9.
31. Gómez-Traseira C, López-Lera A, Drouet C, López-Trascasa M, Pérez-Fernández E, Favier B, et al. Hereditary angioedema caused by the p. Th r309-Lys mutation in the F12 gene: a multifactorial disease. J Allergy Clin Immunol. 2013; 6: 986-9.
32. Cichon S, Martin L, Hennies HC, Müller F, Van Driessche K, Karpushova A, et al. Increased activity of coagulation factor XII (Hageman factor) causes hereditary angioedema type III. Am J Hum Genet. 2006; 79: 1098-104.
33. Defendi F, Charignon D, Ghannam A, Baroso R, Csopaki F, Allegret-Cadet M, et al. Enzymatic assays for the diagnosis of bradykinin-dependent angioedema. PLoS One. 2013; 8: e70140.
34. Bork K, Fischer B, Dewald G. Recurrent episodes of skin angioedema and severe attacks of abdominal pain induced by oral contraceptives or hormone replacement therapy. Am J Med. 2003; 114: 294-8.
35. Bouillet L, Longhurst H, Boccon-Gibod I, Bork K, Bucher C, Bygum A, et al. Disease expression in women with hereditary angioedema. Am J Obstet Gynecol. 2008; 199: 484.e1-4.
36. Casas JP, Chua W, Loukogeorgakis S, Vallance P, Smeeth L, Hingorani AD, et al. effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis. Lancet. 2005; 366: 2026-33.
37. Sheikh IA, Kaplan AP. Mechanism of digestion of bradykinin and lysylbradykinin (kallidin) in human serum. Role of carboxipeptidase, angiotensin converting enzyme and determination of final degradation products. Biochem Pharmacol. 1989; 38: 993-1000.
38. Slater EE, Merrill DD, Guess HA, Roylance PJ, Cooper WD, Inman WH, et al. Clinical profile of angioedema associated with angiotensin converting-enzyme inhibition. JAMA. 1988; 260: 967-70.
39. Sánchez-Borges M, González-Aveledo LA. Angiotensin-converting enzyme inhibitors and angioedema. Allergy Asthma Immunol Res. 2010; 2: 195-8.
40. Makani H, Messerli FH, Romero J, Wever-Pinzon O, Korniyenko A, Berrios RS, et al. Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors. Am J Cardiol. 2012; 110: 383-91.
41. Caldeira D, David C, Sampaio C. Tolerability of angiotensin-receptor blockers in patients with intolerance to angiotensin-converting enzyme inhibitors: a systematic review and meta-analysis. Am J Cardiovasc Drugs. 2012; 12: 263-77.
42. Byrd JB, Shreevatsa A, Putlur P, Foretia D, McAlexander L, Sinha T, et al. Dipeptidyl peptidase IV deficiency increases susceptibility to angiotensin-converting enzyme inhibitor-induced peritracheal edema. J Allergy Clin Immunol. 2007; 120: 403-8.
43. Byrd JB, Touzin K, Sile S, Gainer JV, Yu C, Nadeau J, et al. Dipeptidyl peptidase IV in angiotensin-converting enzyme inhibitor-associated angioedema. Hypertension. 2008; 51: 141-7.
44. Brown NJ, Byiers S, Carr D, Maldonado M, Ann B. Dipeptidyl peptidase IV inhibitor use associated with increased risk of ACE inhibitorassociated angioedema. Hypertension. 2009; 54: 516-23.
45. Kaplan AP. Angioedema. World Allergy Organ J. 2008; 1: 103-13.
46. Cugno M, Nussberger J, Cicardi M, Agostoni A. Bradykinin and the pathophysiology of angioedema. Int Immunopharmacol. 2003; 3: 311-17.
47. Montinaro V, Loizzo G, Zito A, Castellano G, Gesualdo L. Successful treatment of a facial attack of angioedema with icatibant in a patient with idiopathic angioedema. Am J Emerg Med. 2013; 31: 1295.e5-6.
48. Del Corso I, Puxeddu I, Sardano E, Geraci S, Breggia M, Rocchi V, et al. Treatment of idiopathic nonhistaminergic angioedema with bradykinin B2 receptor antagonist icatibant. Ann Allergy Asthma Immunol. 2012; 108: 460-1.
49. Jenneck C, Juergens U, Buecheler M, Novak N. Pathogenesis, diagnosis, and treatment of aspirin intolerance. Ann Allergy Asthma Immunol. 2007; 99: 13-21.
50. Caballero T, Baeza M L, Cabañas R, Campos A, Cimbollek S, Gómez-Traseira C, et al. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part I. Classification, epidemiology, pathophysiology, genetics, clinical symptoms, and diagnosis. J Investig Allergol Clin Immunol. 2011; 21: 333-47.
51. Caballero T, Baeza M L, Cabañas R, Campos A, Cimbollek S, Gómez-Traseira C, et al. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part II. Treatment, follow-up, and special situations. J Investig Allergol Clin Immunol. 2011; 21: 422-3.
52. Wilkerson RG. Angioedema in the emergency department: an evidencebased review. Emerg Med Pract. 2012; 14: 1-21.
53. Agostoni A, Cicardi M. Hereditary and acquired C1-inhibitor defi-ciency: biological and clinical characteristics in 235 patients. Medicine. 1992; 71: 206-15.
54. Agostoni A, Aygören-Pürsün E, Binkley KE, Blanch A, Bork K, Bouillet L, et al. Hereditary and acquired angioedema: problems and progress: proceedings of the third C1 esterase inhibitor deficiency workshop and beyond. J Allergy Clin Immunol. 2004; 114(3 Suppl): S51-131.
55. Carreer FM. The C1 inhibitor deficiency. A review. Eur J Clin Chem Clin Biochem. 1992; 30: 793-807.
56. Farkas H, Harmat G, Fáy A, Fekete B, Karádi I, Visy B, et al. Erythema marginatum preceding an acute oedematous attack of hereditary angioneurotic oedema. Acta Derm Venereol. 2001; 81: 376-7.
57. Bentsianov BL, Parhiscar A, Azer M, Har-El G. The role of fiberoptic nasopharyngoscopy in the management of the acute airway in angioneurotic edema. Laryngoscope. 2000; 110: 2016-19.
58. Ishoo E, Shah UK, Grillone GA, Stram JR, Fuleihan NS. Predicting airway risk in angioedema: staging system based on presentation. Otolaryngol Head Neck Surg. 1999; 121: 263-8.
59. Nzeako U C. Diagnosis and management of angioedema with abdominal involvement: a gastroenterology perspective. World J Gastroenterol. 2010; 16: 4913.
60. Cohen N, Sharon A, Golik A, Zaidenstein R, Modai D. Hereditary angioneurotic edema with severe hypovolemic shock. J Clin Gastroenterol. 1993; 16: 237-9.
61. Bork K. [Hypovolemic shock caused by ascites in hereditary angioedema]. Med Klin (Munich). 1998; 93: 554.
62. Sabroe R, Black A. Angiotensin-converting enzyme (ACE) inhibitors and angio-oedema. Br J Dermatol. 1997; 136: 153-8.
63. Tosi M. Molecular genetics of C1 inhibitor. Immunobiology. 1998; 199: 358-65.
64. Pappalardo E, Cicardi M, Duponchel C, Carugati A, Choquet S, Agostoni A, et al. Frequent de novo mutations and exon deletions in the C1inhibitor gene of patients with angioedema. J Allergy Clin Immunol. 2000; 106: 1147-54.
65. Pedrosa M, Caballero T, Gómez-Traseira C, Olveira A, López-Serrano MC, López-Serrano C. Usefulness of abdominal ultrasonography in the follow-up of patients with hereditary C1-inhibitor deficiency. Ann Allergy Asthma Immunol. 2009; 102: 483-6.
66. Sadeghi N, Van Daele D, Hainaux B, Engelholm L, Michel O. Hereditary angio-edema involving the gastrointestinal tract: CT findings. Eur Radiol. 2001; 11: 99-101.
67. Schwartz LB, Yunginger JW, Miller J, Bokhari R, Dull D. Time course of appearance and disappearance of human mast cell tryptase in the circulation after anaphylaxis. J Clin Invest. 1989; 83: 1551-5.
68. Papadopoulou-Alataki E. Upper airway considerations in hereditary angioedema. Curr Opin Allergy Clin Immunol. 2010; 10: 20-5.
69. Frigas E, Park MA. Acute urticaria and angioedema: diagnostic and treatment considerations. Am J Clin Dermatol. 2009; 10: 239-50.
70. Simons FER, Ardusso LRF, Bilò MB, Dimov V, Ebisawa M, El-Gamal YM, et al. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol. 2012; 12: 389-99.
71. Sánchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. 2012; 5: 125-47.
72. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009; 64: 1427-43.
73. Choo K, Simons FE, Sheikh A. Glucocorticoids for the treatment of anaphylaxis. Cochrane Database Syst Rev. 2012; 4: CD007596.
74. Rowe B, Spooner C, Ducharme F, Bretzlaff J, Bota G. Early emergency department treatment of acute asthma with systemic corticosteroids (Review). Cochrane Database Syst Rev. 2001;(1): CD002178.
75. Simons FER. Anaphylaxis: recent advances in assessment and treatment. J Allergy Clin Immunol. 2009; 124: 625-36.
76. Simons FER, Ardusso LRF, Bilò MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. 2011; 127: 587-93. e1-22.
77. Cicardi M, Bork K, Caballero T, Craig T, Li HH, Longhurst H, et al. Evidence-based recommendations for the therapeutic management of angioedema owing to hereditary C1 inhibitor deficiency: consensus report of an International Working Group. Allergy. 2012; 67: 147-57.
78. Maurer M, Aberer W, Bouillet L, Caballero T, Fabien V, Kanny G, et al. Hereditary angioedema attacks resolve faster and are shorter after early icatibant treatment. PLoS One. 2013; 8: e53773.
79. Cicardi M, Banerji A, Bracho F, Malbrán A, Rosenkranz B, Riedl M, et al. Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedema. N Engl J Med. 2010; 363: 532-41.
80. European Public Assessment Report (EMEA 925383/2011) for Firazyr (Icatibant). 2011. Available at: http://www.ema.europa.eu/ema (accessed 18 August 2013).
81. Cicardi M, Levy R, McNeil D, Li HH, Sheffer AL, Campion M, et al. Ecallantide for treatment of acute attacks of hereditary angioedema. N Engl J Med. 2010; 363: 523-31.
82. Lumry WR, Bernstein JA, Li HH, MacGinnitie AJ, Riedl M, Soteres DF, et al. Efficacy and safety of ecallantide in treatment of recurrent attacks of hereditary angioedema: open-label continuation study. Allergy Asthma Proc. 2013; 34: 155-61.
83. Caballero T, López-Serrano MC. A naphylactic reaction and antibodies to DX-88 (kallikrein inhibitor) in a patient with hereditary angioedema. J Allergy Clin Immunol. 2006; 117: 476-7.
84. Sheffer AL, Austen KF, Rosen FS. Tranexamic acid therapy in hereditary angioneurotic edema. N Engl J Med. 1972; 287: 452-4.
85. Prematta M, Gibbs JG, Pratt EL, Stoughton TR, Craig TJ. Fresh frozen plasma for the treatment of hereditary angioedema. Ann allergy Asthma Immunol. 2007; 98: 383-8.
86. Castelli R, Zanichelli A, Cicardi M, Cugno M. Acquired C1-inhibitor deficiency and lymphoproliferative disorders: a tight relationship. Crit Rev Oncol Hematol. 2013; 87: 323-32.
87. Bork K. Diagnosis and treatment of hereditary angioedema with normal C1 inhibitor. Allergy Asthma Clin Immunol. 2010; 6: 15.
88. Flattery MP, Sica DA. Angiotensin-converting enzyme inhibitor-related angioedema: recognition and treatment. Prog Cardiovasc Nurs. 2007; 22: 47-51.
89. Bas M, Greve J, Stelter K, Bier H, Stark T, Hoffmann TK, et al. Therapeutic efficacy of icatibant in angioedema induced by angiotensinconverting enzyme inhibitors: a case series. Ann Emerg Med. 2010; 56: 278-82.
90. Bas M, Kojda G, Stelter K. [Angiotensin-converting enzyme inhibitor induced angioedema: new therapy options]. Anaesthesist. 2011; 60: 1141-5.
91. Doña I, Blanca-López N, Cornejo-García JA, Torres MJ, Laguna JJ, Fernández J, et al. Characteristics of subjects experiencing hypersensitivity to non-steroidal anti-inflammatory drugs: patterns of response. Clin Exp Allergy. 2011; 41: 86-95.
92. Working Group of Resucitation Council (UK). Resuscitation Council (UK) Emergency treatment of anaphylactic reactions. Guidelines for healthcare providers. 2013; (286360).
93. Cardona Dahl V. [Guideline for the management of anaphylaxis]. Med Clin (Barc). 2011; 136: 349-55.
94. Unsworth DJ. Following up patients after treatment for anaphylaxis. Practitioner. 2012; 256: 21-4, 3.
95. Campbell RL, Luke A, Weaver AL, St Sauver JL, Bergstralh EJ, Li JT, et al. Prescriptions for self-injectable epinephrine and follow-up referral in emergency department patients presenting with anaphylaxis. Ann Allergy Asthma Immunol. 2008; 101: 631-6.
96. Sheikh A, Simons F, Barbour V, Worth A. Adrenaline auto-injectors for the treatment of anaphylaxis with and without cardiovascular collapse in the community. Cochrane Database Syst Rev. 2012; (8): CD008935.