UNDIFFERENTIATED SOMATOFORM IDIOPATHIC ANAPHYLAXIS - NONORGANIC SYMPTOMS MIMICKING IDIOPATHIC ANAPHYLAXIS

Background: Northwestern University's Division of Allergy and Immunolo gy has had experience with the diagnosis and treatment of more than 35 0 patients with idiopathic anaphylaxis (IA). In 1992 we reported a gro up of patients with IA whose presentations mimicked IA, but IA and oth er organic causes were later excluded. Psychologic factors were suspec ted as the underlying problem. These patients were classified as IA-va riant. Management of these causes was extremely difficult. There was s ignificant morbidity and high and unnecessary costs. Objective: We aim to distinguish the nature of this disease and to highlight the evalua tion and treatment of this group of patients. Methods: Their cases are reviewed and reported. Results: Common features included (1) presenti ng symptoms mimicking IA, (2) no objective findings that correlated wi th 1, (3) no response to the therapeutic regimen for IA, (4) meeting t he Diagnostic and Statistical Manual of Mental Disorders criteria for undifferentiated somatoform disorder, and (5) significant wasted healt h care expenditure. Conclusions: This group of patients were better de fined as having undifferentiated somatoform-IA. An algorithm was propo sed to expedite the diagnosis of the disease so that with early recogn ition of the disease, unwarranted repetitive consultations, tests, and inappropriate therapy can be avoided.