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Table 6 Essential information on anaphylaxis: summary of unmet needs

From: International consensus on (ICON) anaphylaxis

 

High-resource countries1

Limited-resource countries2

Definition of anaphylaxis, eg. serious, life-threatening generalized allergic or hypersensitivity reaction

need ↑ awareness of a current anaphylaxis definition for clinical use

need ↑ awareness of a current anaphylaxis definition for clinical use

Epidemiology

need integration of the clinical criteria for diagnosis of anaphylaxis with ICD-9 and ICD-10 codes; need more reliable prevalence estimates in healthcare settings and in the general population; and need more reliable prevalence estimates of mortality rates from different triggers in different patient populations

need concurrent epidemiologic studies of anaphylaxis using similar methods in different countries in order to obtain reliable prevalence estimates in the general population

Patient risk factors and co-factors relevant to anaphylaxis

need ↑ awareness of patient risk factors for severe or fatal anaphylaxis, eg. asthma, CVD and MCAD; and need ↑ awareness of the role of co-factors such as exercise, ethanol, NSAIDs, emotional stress, acute infection, perimenstrual status

need baseline information about the prevalence of asthma, CVD, and MCAD so their relationship with anaphylaxis can be ascertained; need ↑ awareness of potential patient risk factors and co-factors; insights might be obtained from studies of fatal episodes3

Underlying mechanisms

need greater understanding of IgE-dependent, IgE-independent, and non-immunologic mechanisms (direct mast cell activation)

need greater understanding of IgE-dependent, IgE-independent, and non-immunologic mechanisms

Triggers (causes, elicitors, or inducers)

need improved standardization of allergens, a standardized mechanism for reporting novel triggers, and continued efforts to standardize protocols for skin tests and challenge tests

need more comprehensive information about newly-discovered allergen triggers, allergens in some geographic areas, and certain groups of allergens, eg. reptile venoms and helminths

  1. 1Within high-resource countries, limited-resource areas can be found in inner cities, some rural areas, many public venues, and situations such as anaphylaxis on airplanes.
  2. 2In this Table, “limited-resource countries” include mid- and low-resource countries.
  3. 3In some limited-resource countries, fewer than 5% of deaths are certified with regard to cause.
  4. CVD, cardiovascular disease; ICD, International Classification of Disease; MCAD; mast cell activation disorders; NSAIDs, non-steroidal anti-inflammatory drugs.
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World Allergy Organization Journal

ISSN: 1939-4551

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