Anaphylaxis is not Always Synonymous of Allergy – A Recurrent Presentation
Ana Moura Figueiredo1*, Mariana M. Anjos1, Patrícia Marques1, Julieta Morais1
1Pediatrics Service, Centro Hospitalar do Me dio Tejo, Torres Novas, Portugal.
*Corresponding Author: Ana Moura Figueiredo, Pediatrics Service, Centro Hospitalar do Me dio Tejo, Torres Novas, Portugal.
https://doi.org/10.58624/SVOAPD.2025.04.001
Received: January 06, 2025
Published: January 27, 2025
Citation: Figueiredo AM, Anjos MM, Marques P, Morais J. Anaphylaxis is not Always Synonymous of Allergy – A Recurrent Presentation. SVOA Paediatrics 2025, 4:1, 01-04. doi: 10.58624/SVOAPD.2025.04.001
Abstract
This case report presents a 9-year-old previously healthy female who experienced recurrent episodes of anaphylaxis without identifiable triggers. Her initial episode included sudden nighttime awakening, abdominal pain, vomiting, diarrhea, bilateral plantar itching, followed by a generalized pruritic rash, facial erythema, and labial edema. After treatment with intramuscular adrenaline, antihistamines, and corticosteroids, the symptoms resolved rapidly. However, over the next six weeks, she experienced four additional anaphylactic crises with similar gastrointestinal and cutaneous symptoms, and one episode with respiratory involvement. Laboratory investigations revealed elevated tryptase levels during crises, suggesting mast cell activation. Extensive allergological and etiological testing, including screening for clonal mast cell disorders, was negative. A diagnosis of Mast Cell Activation Syndrome (MCAS) was considered, supported by her response to mast cell stabilizers, sodium cromoglicate, and ketotifen. This report highlights the challenges in diagnosing MCAS, particularly in pediatric populations, where its prevalence remains unclear. The case emphasizes the importance of excluding other potential causes of anaphylaxis and the need for personalized treatment, which in this case significantly improved the patient's symptoms and quality of life. The patient continues to have a controlled emotional state, with no further episodes following initiation of preventive therapy.
Keywords: Anaphylaxis, Mast Cell Activation Syndrome, Pediatrics