Food allergy, dermatologic diseases, and anaphylaxis
Second symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium

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There is no universal agreement on the definition of anaphylaxis or the criteria for diagnosis. In July 2005, the National Institute of Allergy and Infectious Disease and Food Allergy and Anaphylaxis Network convened a second meeting on anaphylaxis, which included representatives from 16 different organizations or government bodies, including representatives from North America, Europe, and Australia, to continue working toward a universally accepted definition of anaphylaxis, establish clinical criteria that would accurately identify cases of anaphylaxis with high precision, further review the evidence on the most appropriate management of anaphylaxis, and outline the research needs in this area.

Section snippets

Definition of anaphylaxis and criteria for diagnosis

Anaphylaxis is a severe, potentially fatal, systemic allergic reaction that occurs suddenly after contact with an allergy-causing substance. Participants at the symposium agreed that a brief, broad definition of anaphylaxis that reflected its course and potential severity would be most useful to both the medical and lay community and recommended the following: “Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.”

To identify individuals experiencing such a

Management of anaphylaxis

As with the treatment of any critically ill patient, the treatment of anaphylaxis begins with a rapid assessment and maintenance of airway, breathing, and circulation. When a patient fulfills any of the 3 criteria of anaphylaxis outlined above, the patient should receive epinephrine immediately because epinephrine is the treatment of choice in anaphylaxis. There undoubtedly will be patients who present with symptoms not yet fulfilling the criteria of anaphylaxis yet in whom it would be

Research needs

The investigation of anaphylaxis has been impeded by the lack of universally accepted diagnostic criteria and the absence of reliable laboratory biomarkers to confirm the clinical impression. This in turn has thwarted efforts to ascertain the incidence and outcome of anaphylaxis in various populations, to determine the most effective forms of therapy, to identify patients at risk for life-threatening anaphylaxis, and to elucidate the basic immunologic and pathogenic mechanisms responsible for

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