CHILDHOOD ANAPHYLAXIS: NEW DEVELOPMENTS IN DIAGNOSIS AND TREATMENT

CHILDHOOD_ANAPHYLAXIS_NEW_DEVELOPMENTS _IN_DIAGNOSIS_AND_TREATMENT_kapak

BIPHASIC, REFRACTORY AND PERSISTENT ANAPHYLAXIS

Şefika İlknur Kökcü Karadağ

Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric Immunology and Allergic Diseases, İstanbul, Türkiye

Kökcü Karadağ. Biphasic, Refractory and Persistent Anaphylaxis. In: Harmancı K, editor. Childhood Anaphylaxis: New Developments in Diagnosis and Treatment. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.259-266.

ABSTRACT

Anaphylaxis is a life-threatening systemic hypersensitivity reaction that may present in biphasic, Persistent, or refractory forms. Biphasic anaphylaxis is characterized by the recurrence of symptoms within 4872 hours after complete resolution, in the absence of re-exposure to the allergen. Persistent anaphylaxis involves symptoms that persist for at least 4 hours, whereas refractory anaphylaxis represents the most critical form, defined by its failure to respond to epinephrine and its requirement for intensive care intervention. Delayed administration of epinephrine, severe initial symptoms, and underlying conditions such as mastocytosis increase the risk of developing these anaphylaxis subtypes. Diagnosis relies on thorough clinical evaluation and the exclusion of differential diagnoses. This section discusses the definitions, risk factors, and management strategies for each anaphylaxis subtype in detail.

Keywords: Anaphylaxis; Biphasic reaction; Persistent anaphylaxis; Refractory anaphylaxis; Adrenaline

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