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

From: International consensus on (ICON) anaphylaxis

  WAO Guidelines AAAAI/ACAAI Guidelines EAACI Guidelines
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
  1. 1For details, see ICON: Anaphylaxis text pages 3-5 and references 2, 3 and 4, including the tables, figures, and boxes that are mentioned above in this Table.
  2. ACE, angiotensin-converting enzyme; CVD, cardiovascular disease; NSAID, non-steroidal anti-inflammatory drug.