Corticosteroid-dependent idiopathic anaphylaxis: a report of five cases.

Idiopathic anaphylaxis (IA) is a life-threatening disease that is being increasingly recognized. In patients with frequent episodes of anaphylaxis, prednisone controls the events and then either induces remission or suppresses the manifestations of the disease until a spontaneous remission occurs. We report five patients with IA who have recurrent episodes whenever prednisone is tapered below a threshold dose, ranging from 15 to 65 mg every other day. These patients demonstrate the concept of a threshold dose of prednisone that may exist in a subset of patients with IA, and they provide further evidence of the previously reported efficacy of corticosteroids in the treatment of IA. We use the term corticosteroid-dependent IA to refer to the serious problem of chronic IA requiring maintenance prednisone therapy.