Diagnostic Challenges in Anaphylaxis

Jay A Lieberman; Theresa A Bingemann; Julie Wang

doi:10.1016/j.jaip.2019.11.003

Diagnostic Challenges in Anaphylaxis

J Allergy Clin Immunol Pract. 2020 Apr;8(4):1177-1184. doi: 10.1016/j.jaip.2019.11.003.

Authors

Jay A Lieberman¹, Theresa A Bingemann², Julie Wang³

Affiliations

¹ Department of Pediatrics, Division of Allergy & Immunology, University of Tennessee Health Science Center, LeBonheur Children's Hospital, Memphis, Tenn. Electronic address: jlieber1@uthsc.edu.
² Rochester Regional Health and Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY.
³ Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY.

PMID: 32276686
DOI: 10.1016/j.jaip.2019.11.003

Abstract

Anaphylaxis is a severe and potentially life-threatening allergic reaction. Since its discovery over 100 years ago, research has led to great strides in describing pathophysiologic mechanisms of anaphylaxis; however, there is still imprecision regarding its definition and a lack of reliable, confirmatory testing. In this paper, we review definitions of anaphylaxis, highlighting studies examining the utility of the current clinical consensus definition. In addition, we evaluate current difficulties and limitations for both providers in acute care settings managing episodes and allergists evaluating patients after an episode has resolved. Finally, we provide an algorithm for outpatient evaluation of patients with a history of possible anaphylaxis.

Keywords: Alpha-gal; Anaphylaxis; Definition; Diagnosis; Food; Histamine; Medication; Tryptase; Venom.

Publication types

Review

MeSH terms

Algorithms
Anaphylaxis* / diagnosis
Consensus
Humans
Outpatients