Anaphylaxis

Clinical criteria for diagnosing anaphylaxis[6]Sampson HA, Muñoz-Furlong A, Campbell RL, et al. 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. http://www.jacionline.org/article/S0091-6749%2805%2902723-5/fulltext http://www.ncbi.nlm.nih.gov/pubmed/16461139?tool=bestpractice.com

Anaphylaxis is highly likely when any 1 of the following 3 criteria are fulfilled:

1. Acute onset of an illness (minutes to hours)

   • Involvement of skin, mucosal tissue, or both (i.e., generalized hives, pruritus or flushing, swollen lips-tongue-uvula) and at least 1 of the following: respiratory compromise (i.e., dyspnea, wheeze-bronchospasm, stridor, reduced peak expiratory flow [PEF], hypoxemia) or reduced BP or associated symptoms of end-organ dysfunction (i.e., hypotonia/collapse, syncope, incontinence)

2. Occurrence of 2 or more of the following symptoms or signs after exposure to a likely allergen (minutes or hours)

   • Involvement of skin, mucosal tissue, or both (i.e., generalized hives, pruritus or flushing, swollen lips-tongue-uvula)

   • Respiratory compromise (i.e., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)

   • Reduced BP or associated symptoms of end-organ dysfunction (i.e., hypotonia/collapse, syncope, incontinence)

   • Persistent gastrointestinal symptoms (i.e., crampy abdominal pain, vomiting)

3. Reduced BP after exposure to a known allergen (minutes to several hours)

   • Systolic BP of <90 mmHg or >30% decrease from baseline.