Review Topical Sections

Anaphylaxis: recognition, treatment, and outcomes

  • Received: 14 December 2021 Revised: 10 March 2022 Accepted: 11 March 2022 Published: 18 March 2022
  • Anaphylaxis is defined as an acute, life-threatening, systemic allergic reaction associated with a broad array of clinical manifestations. Anaphylaxis typically is a type 1 (IgE mediated) hypersensitivity reaction though other mechanism may also be involved. Patients most commonly present with cutaneous symptoms followed by respiratory and gastrointestinal symptoms. Prompt recognition and treatment can be life saving. Epinephrine is the drug of choice for treatment of anaphylaxis. It is imperative that patients and their caregivers are educated on the use of epinephrine autoinjectors and provided with an emergency action plan for managing anaphylaxis.

    Citation: Divya Seth, Deepak Kamat. Anaphylaxis: recognition, treatment, and outcomes[J]. AIMS Medical Science, 2022, 9(1): 65-80. doi: 10.3934/medsci.2022007

    Related Papers:

  • Anaphylaxis is defined as an acute, life-threatening, systemic allergic reaction associated with a broad array of clinical manifestations. Anaphylaxis typically is a type 1 (IgE mediated) hypersensitivity reaction though other mechanism may also be involved. Patients most commonly present with cutaneous symptoms followed by respiratory and gastrointestinal symptoms. Prompt recognition and treatment can be life saving. Epinephrine is the drug of choice for treatment of anaphylaxis. It is imperative that patients and their caregivers are educated on the use of epinephrine autoinjectors and provided with an emergency action plan for managing anaphylaxis.


    Abbreviations

    AAAAI

    American Academy of Allergy, Asthma, and Immunology

    ACE

    Angiotensin converting enzyme

    AIE

    Auto-injectable epinephrine

    BP

    Blood pressure

    CGRP

    Calcitonin gene-related peptide

    CT

    Computerized tomography

    EEG

    Electroencephalogram

    EIA

    Exercise induced anaphylaxis

    EKG

    Electrocardiogram

    ER

    Emergency room

    HAE

    Hereditary angioedema

    HCP

    Health care professional

    Ig

    Immunoglobulin

    MCT

    Mast cell tryptase

    NSAIDs

    Non-steroidal anti-inflammatory drugs

    PAF

    Platelet Activating Factor

    RCM

    Radio-contrast media

    TNF

    Tumor necrosis factor

    US

    United States

    USP

    United States Pharmacopeia

    UV

    Ultra-violet

    VCD

    Vocal Cord Dysfunction

    WAO

    World Allergy Organization

    加载中


    Conflict of interest



    The authors declare no relevant conflict of interest.

    [1] Wood RA, Camargo CA, Lieberman P, et al. (2014) Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol 133: 461-467. http://doi.org/10.1016/j.jaci.2013.08.016
    [2] Simons FE, Ebisawa M, Sanchez-Borges M, et al. (2015) 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J 8: 32. https://doi.org/10.1186/s40413-015-0080-1
    [3] Lee S, Hess EP, Lohse C, et al. (2017) Trends, characteristics, and incidence of anaphylaxis in 2001–2010: a population-based study. J Allergy Clin Immunol 139: 182-188.e2. https://doi.org/10.1016/j.jaci.2016.04.029
    [4] Clark S, Wei W, Rudders SA, et al. (2014) Risk factors for severe anaphylaxis in patients receiving anaphylaxis treatment in US emergency departments and hospitals. J Allergy Clin Immunol 134: 1125-1130. https://doi.org/10.1016/j.jaci.2014.05.018
    [5] Simons FE, Ardusso LR, Bilo MB, et al. (2011) World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol 127: 587-593.e22. https://doi.org/10.1016/j.jaci.2011.01.038
    [6] Jerschow E, Lin RY, Scaperotti MM, et al. (2014) Fatal anaphylaxis in the United States, 1999–2010: temporal patterns and demographic associations. J Allergy Clin Immunol 134: 1318-1328.e7. https://doi.org/10.1016/j.jaci.2014.08.018
    [7] Liew WK, Williamson E, Tang ML (2009) Anaphylaxis fatalities and admissions in Australia. J Allergy Clin Immunol 123: 434-442. https://doi.org/10.1016/j.jaci.2008.10.049
    [8] Tanno LK, Bierrenbach AL, Simons FER, et al. (2018) Critical view of anaphylaxis epidemiology: open questions and new perspectives. Allergy Asthma Clin Immunol 14: 12. https://doi.org/10.1186/s13223-018-0234-0
    [9] Shaker MS, Wallace DV, Golden DBK, et al. (2020) Anaphylaxis—a 2020 practice parameter update, systematic review, and grading of recommendations, assessment, development and evaluation (GRADE) analysis. JACI 145: 1082-1123.
    [10] Adkinson NF, Bochner BS, Busse WW, et al. (2009) Middleton's allergy: principles and practice. St Louis (MO): Mosby, Inc.
    [11] Strait RT, Morris SC, Yang M, et al. (2002) Pathways of anaphylaxis in the mouse. JACI 109: 658-668.
    [12] Gonzalez-Estrada A, Silvers SK, Klein A, et al. (2017) Epidemiology of anaphylaxis at a tertiary care center: a report of 730 cases. Ann Allergy Asthma Immunol 118: 80-85. https://doi.org/10.1016/j.anai.2016.10.025
    [13] World Allergy OrganizationWhite Book on Allergy: Update 2013, Executive Summary (2013). Available from: https://www.worldallergy.org (WhiteBook2-2013-v8)
    [14] Braganza SC, Acworth JP, Mckinnon DRL, et al. (2006) Paediatric emergency department anaphylaxis: different patterns from adults. Arch Dis Child 91: 159-163. https://doi.org/10.1136/adc.2004.069914
    [15] Worm M, Scherer K, Köhli-Wiesner A, et al. (2017) Food-induced anaphylaxis and cofactors—data from the anaphylaxis registry. Allergol Select 1: 21-27. https://doi.org/10.5414/ALX01401E
    [16] Bock SA, Muñoz-Furlong A, Sampson HA (2007) Further fatalities caused by anaphylactic reactions to food, 2001–2006. JACI 119: 1016-1018. https://doi.org/10.1016/j.jaci.2006.12.622
    [17] Lieberman P, Nicklas RA, Randolph C, et al. (2015) Anaphylaxis—a practice parameter update 2015. Ann Allergy Asthma Immunol 115: 341-384. http://doi.org/10.1016/j.anai.2015.07.019
    [18] Simons FE (2006) Anaphylaxis, killer allergy: long-term management in the community. J Allergy Clin Immunol 117: 367-377. https://doi.org/10.1016/j.jaci.2005.12.002
    [19] Muraro A, Roberts G, Worm M, et al. (2014) Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 69: 1026-1045. https://doi.org/10.1111/all.12437
    [20] Cardona V, Ansotegui IJ, Ebisawa M, et al. (2020) World Allergy Organization anaphylaxis guidance 2020. World Allergy Organ J 13: 100472. https://doi.org/10.1016/j.waojou.2020.100472
    [21] Dua S, Dowey J, Foley L, et al. (2018) Diagnostic value of tryptase in food allergic reactions: a prospective study of 160 adult peanut challenges. J Allergy Clin Immunol Pract 6: 1692-1698.e1. https://doi.org/10.1016/j.jaip.2018.01.006
    [22] Francis A, Fatovich DM, Arendts G, et al. (2018) Serum mast cell tryptase measurements: sensitivity and specificity for a diagnosis of anaphylaxis in emergency department patients with shock or hypoxemia. Emerg Med Australas 30: 366-374. https://doi.org/10.1111/1742-6723.12875
    [23] Brown SG, Stone SF, Fatovich DM, et al. (2013) Anaphylaxis: clinical patterns, mediator release, and severity. J Allergy Clin Immunol 132: 1141-1149.e5. https://doi.org/10.1016/j.jaci.2013.06.015
    [24] Vadas P, Gold M, Perelman B, et al. (2008) Platelet-activating factor, PAF acetyl hydrolase, and severe anaphylaxis. N Engl J Med 358: 28-35. https://doi.org/10.1056/NEJMoa070030
    [25] Sampson HA, Aceves S, Bock SA, et al. (2014) Food allergy: a practice parameter update. J Allergy Clin Immunol 134: 1016-1025.e43. https://doi.org/10.1016/j.jaci.2014.05.013
    [26] Commins SP, James H, Tran N, et al. (2010) Testing for IgE antibody to the carbohydrate galactose-a-1, 3-galactose in patients with recurrent idiopathic anaphylaxis: how many cases are we missing?. J Allergy Clin Immunol 125: AB119. https://doi.org/10.1016/j.jaci.2009.12.470
    [27] Carlisle A, Lieberman J (2021) Clinical Management of Infant Anaphylaxis. J Asthma Allergy 14: 821-827. https://doi.org/10.2147/JAA.S286692
    [28] Sheikh A, Ten Brock V, Brown SG, et al. (2007) H1 Antihistamine in the treatment of anaphylaxis: Cochrane systematic review. Allergy 62: 830-837. https://doi.org/10.1111/j.1398-9995.2007.01435.x
    [29] Simons FE (2009) Anaphylaxis: recent advances in assessment and treatment. J Allergy Clin Immunol 124: 625-636. https://doi.org/10.1016/j.jaci.2009.08.025
    [30] Choo KJ, Simons E, Sheikh A (2010) Glucocorticoids for the treatment of anaphylaxis: Cochrane systematic review. Allergy 65: 1205-1211. https://doi.org/10.1111/j.1398-9995.2010.02424.x
    [31] Lieberman P (2005) Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol 95: 217-226. https://doi.org/10.1016/S1081-1206(10)61217-3
    [32] Fleischer DM, Tamara T, Perry TT, et al. (2012) Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study. Pediatrics 130: e25-e32. https://doi.org/10.1542/peds.2011-1762
    [33] Hubbard S (2003) Nutrition and food allergies: the dietitian's role. Ann Allergy Asthma Immunol 90: 115-116. https://doi.org/10.1016/s1081-1206(10)61672-9
    [34] Golden DB, Demain J, Freeman T, et al. (2017) Stinging insect hypersensitivity: a practice parameter updates 2016. Ann Allergy Asthma Immunol 118: 28-54. https://doi.org/10.1016/j.anai.2016.10.031
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