Bernard H. Booth

Fatal and near fatal idiopathic anaphylaxis

OBJECTIVE To document that idiopathic anaphylaxis may have a fatal or near fatal outcome. DESIGN Review of selected cases seen personally by authors during the past 16 years. SETTING University faculty practice and private practices. PATIENTS All cases of idiopathic anaphylaxis seen by the authors are not presented, but 10 cases were selected to demonstrate two fatalities and eight cases of near fatalities. RESULTS Two fatal cases had expired before emergency service therapy. Eight near fatal cases responded to acute therapy and subsequently were controlled. Remission of idiopathic anaphylaxis was then induced. Idiopathic anaphylaxis may be fatal or potentially fatal and must be treated to prevent a fatal outcome. CONCLUSIONS The documentation of fatalities and near fatalities should help patients and their physicians accept intense management of idiopathic anaphylaxis that will result in control and induction of a remission in idiopathic anaphylaxis.

An anaphylactic reaction to parathyroid hormone

Abstract An immediate-type, generalized reaction consistent with anaphylaxis occurred after intravenous administration of bovine PTH to a patient with suspected hyperparathyroidism. Cutaneous testing with purified PTH preparations and other bovine proteins demonstrated reactivity only against the PTH preparations. IgE antibodies against the PTH preparations were detected in vitro by radioimmunoassay and are presumed to be responsible for the anaphylactic reaction.