Name: Anaphylm (dibutepinephrine) in Type I allergic reactions including anaphylaxis: Clinical presentation - signs and symptoms
Published: 2026-09-21T21:39:21-04:00

Multisystem involvement and reactions without skin signs

“Anaphylaxis usually occurs with multisystem involvement but can present with isolated cardiovascular or respiratory compromise. Skin/mucosa signs may be absent in up to 20% of presentations.” (opens the source at this quote in a new tab)

“Skin signs are absent in 10–20% of anaphylaxis reactions, and this may result in delays in the recognition of anaphylaxis.” (opens the source at this quote in a new tab)

“In a prospective, multicenter ED-based study (412 reactions), 31% of reactions had predominantly wheezing without any other major organ system features, while 14% were purely cardiovascular.” (opens the source at this quote in a new tab)

Cutaneous and mucosal symptoms

“Cutaneous symptoms (angioedema, flush, generalized erythema, generalized itching, generalized urticaria) were found in 294 patients (76.96%)” (opens the source at this quote in a new tab)

Finding	Adult anaphylaxis emergency department visits (n = 1,422)
Any mucocutaneous symptom	“1392 (97.9%)”
Flushing	“613 (43.1%)”
Pruritus	“675 (47.5%)”
Diffuse urticaria	“570 (40.1%)”
Throat tightness	“780 (54.9%)”
Angioedema	“824 (57.9%)”

Respiratory symptoms

“Respiratory symptoms (apnoea, dyspnoea, stridor) were found in 258 patients (67.54%)” (opens the source at this quote in a new tab)

Finding	Adult anaphylaxis emergency department visits (n = 1,422)
Any respiratory symptom	“1196 (84.1%)”
Cough	“251 (17.7%)”
Voice change	“339 (23.8%)”
Dyspnea	“987 (69.4%)”
Wheezing	“375 (26.4%)”
Hypoxemia	“87 (6.1%)”

Cardiovascular symptoms

“Cardiovascular symptoms (loss of consciousness, drop in blood pressure, collapse, cardiac arrest, dizziness, tachycardia, disorientation) were found in 279 patients (73.04%)” (opens the source at this quote in a new tab)

Finding	Adult anaphylaxis emergency department visits (n = 1,422)
Any cardiovascular symptom	“764 (53.7%)”
Hypotension	“185 (13.0%)”
Presyncope	“517 (36.4%)”
Syncope	“117 (8.2%)”
Incontinence	“34 (2.4%)”

Gastrointestinal symptoms

“Gastrointestinal symptoms (abdominal pain, diarrhoea, nausea, vomiting, incontinence) were found in 111 patients (29%)” (opens the source at this quote in a new tab)

Finding	Adult anaphylaxis emergency department visits (n = 1,422)
Any gastrointestinal symptom	“644 (45.3%)”
Emesis	“206 (14.5%)”
Nausea	“510 (35.9%)”
Abdominal cramp	“229 (16.1%)”
Diarrhea	“109 (7.7%)”

Neurological symptoms

“Nausea, vomiting, diarrhea, scrotal edema, uterine cramps, vaginal bleeding, urinary incontinence, dizziness, seizures, confusion, and syncope may also be seen” (opens the source at this quote in a new tab)

Category	Quoted findings
Neurological symptoms	“confusion, drowsy, headache”
Neurological signs	“unexplained change in mental status, lethargy, somnolence, seizure”
Neurological findings in infants	“hypotonia, persistent and unexplained irritability, inconsolability, crying, or decreased activity”
Findings not assigned to one organ system	“lower back pain in women due to uterine cramping, sense of impending doom, metallic taste, anxiety”

Signs and symptoms specific to infants and young children

“Infants with anaphylaxis may have distinct signs such as a hoarse cry (laryngeal involvement), repetitive lip licking (mucosal involvement), or abrupt non-specific behavioral changes (e.g., irritability, persistent crying).” (opens the source at this quote in a new tab)

Onset and progression of reactions

“Reactions occur along a severity spectrum including life-threatening anaphylaxis, which is characterized by airway, breathing, and/or cardiovascular (ABC) compromise. Anaphylaxis is dynamic; reactions may initially appear mild and then become severe.” (opens the source at this quote in a new tab)