Update on idiopathic anaphylaxis

Idiopathic anaphylaxis (AI) refers to anaphylaxis without a recognizable cause after a comprehensive allergic workup. The diagnostic approach usually includes an accurate clinical history aimed at excluding both the most and the less frequent causes of anaphylaxis and all pathologies that may resemble anaphylaxis. AI is more common in adults than in children. The epidemiology of AI has been reduced in recent years, probably to increase knowledge and discover new clinical entities, such as the alpha-gal anaphylaxis. Anaphylaxis results from the massive activation of the mast cells (MCs). Thus, it is also necessary to exclude MC disorders, such as mastocytosis and mast cell activation syndrome, and alpha-tryptasemia, which may manifest with IA symptoms.

Automated summary

Idiopathic anaphylaxis refers to anaphylaxis without a known cause despite comprehensive allergic workup. The diagnostic approach involves ruling out common and uncommon allergens and other conditions that may mimic anaphylaxis. Idiopathic anaphylaxis is more prevalent in adults and the epidemiology has decreased in recent years due to increased knowledge and the discovery of new clinical entities. Activation of mast cells plays a pivotal role in anaphylaxis, therefore, disorders such as mastocytosis, mast cell activation syndrome, and alpha-tryptasemia should also be excluded as they may present with similar symptoms.