Idiopathic anaphylaxis: hereditary angioedema in the differential diagnosis

Anaphylaxis is potentially fatal immediate-type reaction due to the release of bioactive mediators from mast cells and basophils. Anaphylaxis typically occurs through an IgE-dependent immunologic mechanism, most commonly triggered by foods, stinging insect venoms, or medications. Medications, physical factors (e.g exercise, cold) can also trigger anaphylaxis through an IgE-independent immunologic mechanism and through direct mast cell stimulation. Idiopathic anaphylaxis is a diagnosis of exclusion that should be made only after other causes of anaphylaxis and other differential diagnoses have been considered. Patients with idiopathic anaphylaxis may also experience anaphylaxis from recognized causes such as exercise, medication, or food. Hereditary angioedema is one of the differential diagnosis of the idiopathic anaphylaxis. This report describes the assessment of the one case of idiopathic anaphylaxis accompanied with exercise and drug induced anaphylaxis in which a diagnosis of hereditary angioedema was made erroneously.