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Review
. 2015 Feb;135(2):e547-50.
doi: 10.1542/peds.2014-2394. Epub 2015 Jan 12.

Caustic ingestions mimicking anaphylaxis: case studies and literature review

Michael G Sherenian  1 , Mark Clee  1 , Amanda C Schondelmeyer  2 , Alessandro de Alarcón  3 , Jinzhu Li  4 , Amal Assa'ad  4 , Kimberly Risma  5
Affiliations
Review

Caustic ingestions mimicking anaphylaxis: case studies and literature review

Michael G Sherenian et al. Pediatrics. 2015 Feb.

Abstract

Anaphylaxis presents in children with rapid involvement of typically 2 or more organ systems including cutaneous, gastrointestinal, and respiratory. Caustic ingestions (CI) may also present with acute involvement of cutaneous, gastrointestinal, and respiratory systems. We present 2 cases of "missed diagnosis" that illustrate how CI presenting with respiratory symptoms can be mistaken for anaphylaxis owing to these similarities. Both of these patients had delay in appropriate care for CI as a result. These cases demonstrate the importance of considering CI in children who have gastrointestinal symptoms, respiratory distress, and oropharyngeal edema.

Keywords: esophago-gastroduodenoscopy; microlaryngoscopy.

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Figures

FIGURE 1
FIGURE 1
Microlaryngoscopy and rigid bronchoscopy at the initial presentation of Patient A depicting A, the supraglottic view; B, true vocal folds; C, subglottis; and D, carina. Blood-tinged secretions were noted throughout the examination (indicated by arrows) as well as ulceration and friable mucosa (indicated by the asterisk).
FIGURE 2
FIGURE 2
Close-up images of early mucosal injury after caustic ingestion in Patient A. A, Lingual surface of the epiglottis demonstrating white eschar (indicated by arrow). B, Posterior pharyngeal wall and hypopharynx demonstrating demucosalized surfaces (indicated by asterisk) and white eschar (indicated by arrow).
See this image and copyright information in PMC

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