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Diagnostic Criteria for Anaphylaxis Print E-mail
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Written by G. Firman MD   
Tuesday, 24 October 2017 04:20


Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death; it involves multiple organ systems, including the respiratory tract, gastrointestinal tract, and skin.


Diagnostic Criteria for Anaphylaxis

Anaphylaxis is highly likely when any one of the following three criteria is fulfilled

Criterion 1

Onset of an illness within minutes to several hours after possible exposure to an allergen, with involvement of the skin, mucosal tissue, or both (e.g., generalized hives, pruritus or flushing, or swollen lips, tongue, or uvula) and at least one of the following signs or symptoms:

  • Respiratory compromise (e.g., dyspnea, wheeze or bronchospasm, stridor, reduced peak expiratory flow, or hypoxemia)
  • Reduced blood pressure or associated symptoms of end-organ dysfunction (e.g., hypotonia or collapse, syncope, or incontinence)

Criterion 2

Two or more of the following signs or symptoms that occur rapidly (within minutes to several hours) after exposure to a likely allergen:

  • Involvement of the skin or mucosal tissue (e.g., generalized hives, itching or flushing, or swollen lips, tongue, or uvula)
  • Respiratory compromise (e.g., dyspnea, wheeze or bronchospasm, stridor, reduced peak expiratory flow, or hypoxemia)
  • Reduced blood pressure or associated symptoms of hypotension (e.g., hypotonia or collapse, syncope, or incontinence)
  • Persistent gastrointestinal symptoms (e.g., crampy abdominal pain or vomiting)

Criterion 3

Reduced blood pressure within minutes to several hours after exposure to a known allergen:

  • Infants and children: low systolic blood pressure (age-specific) or >30% decrease in systolic blood pressure
  • Adults: systolic blood pressure of <90 mm Hg or >30% decrease from the person’s baseline blood pressure




References:

  1. Jones SM, Burks AW. Food Allergy. N Engl J Med. 2017 Sep 21;377(12):1168-1176. [Medline]
  2. Castells M. Diagnosis and management of anaphylaxis in precision medicine. J Allergy Clin Immunol. 2017 Aug;140(2):321-333. [Medline]
  3. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, Brown SG, Camargo CA Jr, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD Jr, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW. 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. J Allergy Clin Immunol. 2006 Feb;117(2):391-7. [Medline]


Created Oct 24, 2017.

Last Updated on Wednesday, 25 October 2017 12:03
 

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