Anaphylaxis, Pediatric

Benjamin T. Prince and Rachel G. Robison Reviewed 06/2017



  • Anaphylaxis is a serious, life-threatening, systemic allergic reaction that is rapid in onset, and is a result of mast cell and basophil activation and degranulation.

  • Skin and mucosal...


Anaphylaxis is a clinical diagnosis that is considered highly likely when any one of the following three criteria is met: 
  • Acute onset of illness (minutes to hours) with involvement of skin, ...



First Line

  • IM epinephrine 1:1,000 (1 mg/mL) solution

    • 0.01 mg/kg, maximum of 0.3 mg (child) or 0.5 mg (adult), repeated q5–15min as needed (most respond to 1 or 2 doses)

    • Many deaths fr...

Ongoing Care

Follow-up Recommendations

Most patients who are diagnosed with anaphylaxis will benefit from a referral to an allergist/immunologist for further evaluation, recommendations, and management...

Additional Reading

  • Greenberger  PA, Rotskoff  BD, Lifschultz  B. Fatal anaphylaxis: postmortem findings and associated comorbid diseases. Ann Allergy Asthma Immunol.  2007;98(3):252–257. [View Ab...



  • 995.0 Other anaphylactic reaction

  • 995.60 Anaphylactic reaction due to unspecified food

  • 989.5 Toxic effect of venom


  • T78.2XXA Anaphylactic shock, unspecified, initial encounter

  • T78.00XA Anap...


  • Q: Can a patient have an anaphylactic reaction on first exposure to an allergen?

  • A: In IgE-mediated anaphylaxis, a patient must have been previously exposed to the offending allergen for sensitizat...

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