Food allergy, dermatologic diseases, and anaphylaxisSecond symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium
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
References (47)
- et al.
Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization
J Allergy Clin Immunol
(2004) - et al.
Underreporting of anaphylaxis in a community emergency room
J Allergy Clin Immunol
(1995) - et al.
Emergency department anaphylaxis: a review of 142 patients in a single year
J Allergy Clin Immunol
(2001) - et al.
Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions
J Emerg Med
(2005) Clinical features and severity grading of anaphylaxis
J Allergy Clin Immunol
(2004)- et al.
Epinephrine absorption in children with a history of anaphylaxis
J Allergy Clin Immunol
(1998) - et al.
Epinephrine absorption in adults: intramuscular versus subcutaneous injection
J Allergy Clin Immunol
(2001) - et al.
Changes in BP induced by passive leg raising predict response to fluid loading in critically ill patients
Chest
(2002) Fatal posture in anaphylactic shock
J Allergy Clin Immunol
(2003)- et al.
Histamine and tryptase levels in patients with acute allergic reactions: an emergency department-based study
J Allergy Clin Immunol
(2000)
Biphasic anaphylactic reactions
Ann Allergy Asthma Immunol
Biphasic systemic-anaphylaxis—an inpatient and outpatient study
J Allergy Clin Immunol
Fatalities due to anaphylactic reactions to foods
J Allergy Clin Immunol
Quandaries in prescribing an emergency action plan and self-injectable epinephrine for first-aid management of anaphylaxis in the community
J Allergy Clin Immunol
Multicenter study of emergency department visits for food allergies
J Allergy Clin Immunol
Multicenter study of emergency department visits for insect sting allergies
J Allergy Clin Immunol
Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes
J Allergy Clin Immunol
A murine model of peanut anaphylaxis: T- and B-cell responses to a major peanut allergen mimic human responses
J Allergy Clin Immunol
The atopic dog as a model of peanut and tree nut food allergy
J Allergy Clin Immunol
A neonatal swine model for peanut allergy
J Allergy Clin Immunol
Epidemiology of anaphylaxis in Olmsted County: a population-based study
J Allergy Clin Immunol
Anaphylactic shock occurring outside hospitals
Allergy
Symposium on the definition and management of anaphylaxis: summary report
J Allergy Clin Immunol
Cited by (1803)
Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study
2024, Journal of Clinical AnesthesiaMilk-induced anaphylaxis among children presenting to Canadian emergency departments
2024, Annals of Allergy, Asthma and ImmunologyReal-World Sensitization and Tolerance Pattern to Seafood in Fish-Allergic Individuals
2024, Journal of Allergy and Clinical Immunology: In PracticeAnaphylaxis: A 2023 practice parameter update
2024, Annals of Allergy, Asthma and Immunology