Such reactions may appear as edema or inflammation at the injection site or cause a variety of manifestations elsewhere, such as redness of the skin, itching, conjunctivitis, rhinitis, swelling of the face (angioedema), the upper or (and) lower lip, cheeks, vocal cords, pharynx accompanied by difficulty of breathing or swallowing, urticaria, severe dyspnea, which may progress to anaphylactic shock.

In the Russian original, the word "which" is in the plural (indicated by a plural ending), which makes it clear that it is "manifestations" that may progress to the shock.

However, in English it might seem like it points at "dyspnea" only, isn't it?

Is there a way in English to get around this ambiguity? "... , and these manifestations may progress to anaphylactic shock"? That's a bit unwieldy. To move "which may progress" directly to "elsewhere"?

  • 2
    I believe the antecedent is swelling, and that the parenthetic we talked about earlier should have included dyspnea. – Tᴚoɯɐuo Jun 18 '16 at 13:07
  • @TRomano - thank you. It's interesting. Maybe it's better just to exile "which may progress to anaphylactic shock" into a separate sentence. "These manifestations may progress..." – CowperKettle Jun 18 '16 at 13:08
  • But in such a messy list, we have to bring in extra-linguistic information to make that determination. – Tᴚoɯɐuo Jun 18 '16 at 13:12
  • 1
    Actually, reactions would be a good candidate noun. The symptoms (manifestations) don't progress to shock, the allergic reaction does. – Tᴚoɯɐuo Jun 18 '16 at 13:13
  • "These reactions may progress to..". Nice, thank you! – CowperKettle Jun 18 '16 at 13:14

Since each of these manifestations "may progress to anaphylactic shock", then I believe it is possible to write

[...] urticaria, severe dyspnea, all of which may progress to anaphylactic shock.

Although "all of which" does not directly refer to the word manifestations it should be clearer that each example can lead to anaphylactic shock. You can also consider "each of which" instead of "all of which".

Yes, the first time I read it, I thought it only referred to "dyspnea", not all of the examples.

If you want to refer to the word manifestations directly, then I would recommend simply starting a new sentence after the last example "dyspnea". Some possible sentences include

  1. [...] urticaria, and severe dyspnea. Manifestations may progress to anaphylactic shock.
  2. [...] urticaria, and severe dyspnea. These/Such manifestations may progress to anaphylactic shock.

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