Histopathology findings in anaphylaxis shock

Abstract

Known by more than two centuries as cells described by Paul Erlich, mast cells still remain the most actively involved cells in allergy pathogeny, including its most severe manifestation, anaphylaxis shock. Brutal mast cells degranulation, due to contact with an allergen, is followed by the release of preformed or newly synthesized factors which would be associated to an entire spectrum of clinical manifestations that may eventually be lethal. Within this context, we present the case of a man who died by anaphylaxis shock after exposure to a great number of bee bites. Standard microscopy and anti-tryptase immunohistochemistry, revealed in necroptic specimens, edema, vascular congestion, extensive hemorrhages, and an increased number of perivascular mast cells within the inflammatory reaction in lesional skin, tongue base, epiglottis, larynx, extended more than subepithelial location up to periglandular and perimuscular locations. The histopathological picture provides a better understanding of clinical symptoms that lead to death in such cases.