80% of fatal reactions do not present with skin symptoms

[my3guys]

REALITY:
• Approximately 20% of anaphylaxis
cases do not present with hives or other
cutaneous manifestations
• 80% of fatal, food-induced anaphylaxis
cases were not associated with
cutaneous signs or symptoms

Here is the link to the entire presentation:
https://www.foodallergy.org/sites/default/files/migrated-files/file/anaphylaxis-webinar-slides.pdf

I don't recall ever seeing the above statistic until recently, and I think it's really important to emphasize. I think it applied to a reaction that DS had...I added the statistic there too, but I think it deserves it's own thread to make sure people see it.

[spacecanada]

I've heard those numbers before (recently), and they frighten me as well, since I've only had hives from ingestion a few times.  My worst reactions presented without hives or cutaneous swelling -- and I've noticed first-hand that some doctors have a tough time accepting it as an allergic reaction without skin symptoms. 

[rebekahc]

I'm wondering which is the cause and which is the effect.  I suspect it could be that treatment is often delayed or not given when cutaneous symptoms are absent. That was our experience in the ER with DS (albeit 18 years ago) - his vocal chords were swollen, he was gasping for air and snot was pouring from his nose and mouth like a faucet, but the doctor refused to treat it as an allergic reaction since "he doesn't have hives." 😡 Doctors may be more up-to-date now, but I can't tell you the number of times I've seen/heard lay persons looking for hives as a determination of allergic reaction.

[spacecanada]

the doctor refused to treat it as an allergic reaction since "he doesn't have hives." 😡

Happened to me in 2015.  The paramedics that brought me in were still there when I was discharged and told me to call 911 again if I had ANY more symptoms, even itchy lips.  They were just as upset as I was.

[my3guys]

I would agree that treatment may be delayed without skin symptoms.

We also got a hard time from an ER doctor in 2016. There were no hives but plenty else going on. The paramedic backed us up and said his throats tissue was swollen and had 2 epi pens.