Which agents are believed to cause direct nonimmunologic release of anaphylaxis mediators from mast cells?

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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Certain agents are thought to cause direct nonimmunologic release of mediators from mast cells, a process not mediated by IgE. These include opioids, dextrans, protamine, and vancomycin. Mechanisms underlying these reactions are poorly understood but may involve specific receptors (eg, opioids) or non–receptor-mediated mast cell activation (eg, hyperosmolarity).

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