DOI: https://doi.org/10.36347/sjams.2026.v14i10.005

Pages: 1206-1210

Background: Anaphylaxis is a rapidly evolving systemic hypersensitivity reaction that may cause life-threatening airway, breathing, or circulatory compromise. Recognition is particularly challenging in infants and young children, in whom symptoms may be nonspecific and skin findings may be absent. Objective: To provide a clinically focused synthesis of current pediatric anaphylaxis recognition, emergency treatment, observation, discharge planning, and recent therapeutic developments. Sources: This narrative review used targeted searches of PubMed/MEDLINE and official international allergy and regulatory websites for English-language guidelines, consensus reports, reviews, observational studies, and regulatory documents available through October 2026. Pediatric evidence and major international guidance were prioritized; landmark older publications were retained when they defined diagnostic criteria or established practice. This was not a systematic review, and no formal risk-of-bias assessment or meta-analysis was undertaken. Content: Diagnosis remains clinical and treatment must not await laboratory confirmation. Acute airway, respiratory, or circulatory compromise after a compatible exposure may represent anaphylaxis even without urticaria or hypotension. Intramuscular epinephrine in the mid-anterolateral thigh is first-line therapy. Persistent illness requires repeated assessment, additional intramuscular doses, circulatory support, and early escalation to monitored intravenous epinephrine infusion by experienced teams when refractory anaphylaxis is present. Antihistamines are limited to cutaneous symptoms, and routine corticosteroids are not supported for prevention of biphasic reactions. Observation and disposition should be individualized according to severity, treatment requirements, response, comorbidity, and access to emergency care. Conclusion: The most important modifiable factor in pediatric anaphylaxis care is prompt recognition followed by immediate epi