#3-52E. The Great Mimic: Distinguishing VCD/ILO from Anaphylaxis (JACI In Practice, 2026)

Did you know that a significant proportion of adults referred for anaphylaxis may actually be suffering from a functional airway disorder? In this episode, we examine a 2026 study titled "Vocal Cord Dysfunction / Inducible Laryngeal Obstruction (VCD/ILO) as a mimic of anaphylaxis," which highlights a critical diagnostic challenge in allergy practice. Analyzing data from 133 patients, the authors reveal that VCD/ILO is a frequent mimic characterized by prominent upper airway symptoms like throat tightness and stridor, yet it is distinctively marked by the absence of urticaria and cardiovascular collapse—key features of true anaphylaxis. This clinical distinction is paramount for accurate diagnosis. However, as we review these findings, we must remain cognizant of the study's limitations, specifically its retrospective, single-center design and potential selection bias regarding which patients underwent the gold-standard laryngoscopy. For clinicians, mastering this differentiation is essential to prevent the unnecessary administration of adrenaline and to ensure patients receive appropriate speech pathology management rather than avoiding non-existent allergens.

Citation: Satouris P, et al. Vocal Cord Dysfunction / Inducible Laryngeal Obstruction (VCD/ILO) as a mimic of anaphylaxis: A retrospective cohort study. The Journal of Allergy and Clinical Immunology: In Practice. 2026. DOI: https://doi.org/10.1016/j.jaip.2026.02.006

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.