Table 2 Essential information on anaphylaxis: summary of collaborating organizations’ principal anaphylaxis guidelines ¹

Definition of anaphylaxis

"a serious life-threatening generalized or systemic hypersensitivity reaction" and “a serious allergic reaction that is rapid in onset and might cause death"

"an acute life-threatening systemic reaction with varied mechanisms, clinical presentations, and severity that results from the sudden release of mediators from mast cells and basophils"

"a severe life-threatening generalized or systemic hypersensitivity reaction"

Epidemiology

not a major emphasis

not a major emphasis

summary of anaphylaxis epidemiology and clinical presentation: gaps in the evidence (Box 15)

Patient risk factors and co-factors relevant to anaphylaxis

describe vulnerability related to age, concomitant diseases (asthma, CVD, mastocytosis), concurrent medications (beta-blockers, ACE inhibitors); describe co-factors such as exercise, acute infection, emotional stress, premenstrual status, and ethanol or NSAID ingestion; Figure 1

describe concomitant diseases (asthma, CVD, mastocytosis), concurrent medications (beta-blockers, ACE inhibitors); mention premenstrual status as a co-factor

give examples of patient-specific factors, pre-existing conditions, medications and lifestyle factors; describe concomitant asthma in detail; Box 6

Underlying mechanisms

provide an overview of immunologic mechanisms (IgE-dependent and IgE-independent), non-immunologic (direct mast cell activation) and idiopathic anaphylaxis (no apparent trigger); Figure 2

describe immunologic mechanisms in the context of different anaphylaxis triggers; describe idiopathic anaphylaxis; Table E7

major focus on IgE-mediated anaphylaxis to food, insect venoms, and drugs; other mechanisms are mentioned

Anaphylaxis triggers (causes, elicitors, or inducers)

describe most triggers; state that the relative importance of specific triggers varies in different age groups and different global regions; Figure 2

describe many triggers in detail, with major emphasis on foods, venoms, drugs, biological agents, perioperative agents, radiocontrast media, latex, exercise, human seminal fluid, and idiopathic anaphylaxis; Table E5

overview of some triggers; describe food triggers in considerable detail; state that the importance of triggers varies with age and geography