Essentials of Diagnosis Anaphylaxis is a systemic reaction with cutaneous symptoms, associated with dyspnea, visceral edema, and hypotension. Urticaria is characterized by large, irregularly shaped, pruritic, erythematous wheals. Angioedema is painless, deep, subcutaneous swelling, often involving periorbital, circumoral, and facial regions. These disorders may be diagnosed clinically, especially in the context of allergen exposure; detection of specific IgE or elevated serum tryptase can confirm the diagnosis. General Considerations Certain allergens—especially drugs, insect venoms, and foods—may induce an IgE antibody response, causing a generalized release of mediators from mast cells and resulting in systemic anaphylaxis. This potentially fatal condition affects both nonatopic and atopic persons. Isolated urticaria and angioedema are more common cutaneous forms of anaphylaxis with a better prognosis. Food allergies cause an estimated 150 fatalities per year in the United States...
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