The incidence of anaphylaxis has been on the rise in recent years. Drugs and foods are main triggers, and individuals in different regions and age groups have different characteristics. Its pathogenesis includes immune (IgE-mediated and non-IgE-mediated) factors, non-immune factors and idiopathic ones. The clinical manifestations are symptoms and signs of the skin and mucosa, and respiratory, circulatory, digestive, and nervous systems. There is still a lack of laboratory test indices with high sensitivity and specificity to diagnose anaphylaxis. Adrenaline intramuscular injection is the first-line treatment for anaphylaxis, but its usage during emergencies is unsatisfactory. Glucocorticoids are most frequently used in anaphylaxis, but there is controversy over whether they are beneficial. Currently, high-quality clinical cohort studies are needed to provide solid evidence for the epidemiology, diagnosis and treatment of anaphylaxis. This article reviews the research progress on anaphylaxis, aiming to enhance the understanding of anaphylaxis among medical staff.

This article reported a case of type 1 diabetes caused by a programmed death-1 ( PD-1) inhibitor. The patient was a 52-year-old man with metastatic renal cell carcinoma who received the combined therapy of PD-1 inhibitor Nivolumab and vascular endothelial growth factor ( VEGF) inhibitor Bevacizumab. He presented with thirst, polydipsia, polyuria, repeated vomiting, and fatigue 9 weeks after initiation of the therapy and developed into diabetic ketoacidosis (DKA) about 2 weeks later, with blood glucose 50.9 mmol/L, HbA1C8.4％, serum fasted and glucose-loaded C peptide<0.01 ng/ml, arginine test negative, and autoantibodies negative. The patient was diagnosed as type 1 diabetes caused by the PD-1 inhibitor and was given intensive glucose lowering treatment with insulin, water and electrolyte disorders were also corrected. His symptoms improved but he had to continue insulin treatment. It is recommended to check baseline glucose level prior to the initiation of treatment with PD-1 inhibitor, and should carefully monitor the clinical symptoms and glucose levels during the treatment. Timely detection, correct diagnosis and treatment are important to ensure patients' safety and to improve their prognosis.