Summary The clinical course of twenty‐one patients who presented with life‐threatening symptoms, appearing to be allergic in aetiology, is described. In ten of these patients, clinical evaluation established a diagnosis, for example: drug allergy, food allergy, a curious form of hospital addiction syndrome, an underlying malignancy, systemic mast cell disease or a complement abnormality. In the remaining subjects, it was found that their condition could be stabilized with sympathomimetics, antihistamines and corticosteroids. In those in whom no aetiology could be found, there was usually a spontaneous subsidence of the frequency and severity of attacks or spontaneous remission. No fatalities occurred.

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