Immunotherapy is maintained at 100 micrograms per antigen for 60 months. Specific IgE and IgG titers can then help predict continued need for therapy. To document safety of a particular agent provocative skin testing can be performed. Fatalities usually occur in victims with prior knowledge i.e., past anaphylaxis. Usually it is a meal away from home, with alcohol, denial, reliance on p.o. antihistamines and no Epi-Pen.
Reactions are secondary to anaphylatoxin production.
Pretreatment with antihistamines 50mg IM l hr. Reaction is not related to iodine. Atopics allergic to shellfish have a slightly increased risk. Low osmolality contrast media has decreased reactions with increased patient comfort. Modulators of Arachidonic acid metabolism.