Anaphylaxis classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Anaphylaxis}} | {{Anaphylaxis}} | ||
{{CMG}}, {{AE}} [[User:Dushka|Dushka Riaz, MD]] | |||
==Overview== | |||
[[Anaphylaxis]] may be classified into 2 subtypes/groups: [[Immunologic-IgE mediated]] and [[Immunologic-non-IgE mediated]]. <ref name="pmid28800865">{{cite journal| author=LoVerde D, Iweala OI, Eginli A, Krishnaswamy G| title=Anaphylaxis. | journal=Chest | year= 2018 | volume= 153 | issue= 2 | pages= 528-543 | pmid=28800865 | doi=10.1016/j.chest.2017.07.033 | pmc=6026262 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28800865 }} </ref> | |||
The diagnostic criteria must have one of the three of the following: <ref name="pmid16461139">{{cite journal| author=Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A | display-authors=etal| title=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. | journal=J Allergy Clin Immunol | year= 2006 | volume= 117 | issue= 2 | pages= 391-7 | pmid=16461139 | doi=10.1016/j.jaci.2005.12.1303 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16461139 }} </ref> | |||
*1. Acute onset of disruption of the [[skin]] or mucosal tissue with either reduced [[blood pressure]] or decreased [[perfusion]] and/or [[respiratory compromise]]. | |||
*2. Exposure to a likely [[allergen]] followed with two of the following: involvement of [[mucosal]] tissue, [[respiratory compromise]], [[gastrointestinal]] disturbances, or reduced [[blood pressure]] | |||
*3. [[Hypotension|Reduced blood pressure]] after exposure to a known [[allergen]] | |||
==Classification== | |||
[[Anaphylaxis]] may be classified into two groups: <ref name="pmid28800865">{{cite journal| author=LoVerde D, Iweala OI, Eginli A, Krishnaswamy G| title=Anaphylaxis. | journal=Chest | year= 2018 | volume= 153 | issue= 2 | pages= 528-543 | pmid=28800865 | doi=10.1016/j.chest.2017.07.033 | pmc=6026262 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28800865 }} </ref> | |||
*Immunologic-[[Immunoglobulin E|IgE]]: whose causes include food [[Allergen|allergens]], medications, [[Latex allergy|latex]], [[Airborne transmission|airborne]] allergens | |||
*Immunologic-[[non-IgE]]: whose causes include [[IVIG]], [[NSAIDS]] and [[aspirin]] | |||
There are also three pattern classifications: | |||
*Uniphasic which resolves in an hour | |||
*[[Biphasic]] which includes recurrence even without repeated [[Exposure to insecticides|exposure]] <ref name="pmid27253484">{{cite journal| author=Lee S, Sadosty AT, Campbell RL| title=Update on biphasic anaphylaxis. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 4 | pages= 346-51 | pmid=27253484 | doi=10.1097/ACI.0000000000000279 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27253484 }} </ref> | |||
*Protracted which can lasts for days <ref name="pmid19585862">{{cite journal| author=Zisa G, Riccobono F, Calamari AM, D'Antonio CD, Galimberti M| title=A case of protracted hypotension as unique symptom of a biphasic anaphylaxis to amoxicillin. | journal=Eur Ann Allergy Clin Immunol | year= 2009 | volume= 41 | issue= 2 | pages= 60-1 | pmid=19585862 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19585862 }} </ref> | |||
[[Anaphylaxis]] can also be categorized according to the cause: <ref name="pmid28302183">{{cite journal| author=Tanno LK, Chalmers RJ, Calderon MA, Aymé S, Demoly P, on behalf the Joint Allergy Academies| title=Reaching multidisciplinary consensus on classification of anaphylaxis for the eleventh revision of the World Health Organization's (WHO) International Classification of Diseases (ICD-11). | journal=Orphanet J Rare Dis | year= 2017 | volume= 12 | issue= 1 | pages= 53 | pmid=28302183 | doi=10.1186/s13023-017-0607-3 | pmc=5356259 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28302183 }} </ref> | |||
*[[Anaphylaxis]] caused by food [[Allergen|allergens]] | |||
*[[Anaphylaxis]] caused by drug allergens | |||
*[[Anaphylaxis]] caused by [[Insect Bites|insect]] [[venom]] | |||
*[[Anaphylaxis]] caused by physical factors | |||
*[[Anaphylaxis]] caused by inhaled [[Allergen|allergens]] | |||
*[[Anaphylaxis]] caused by [[allergen]] contact | |||
*[[Anaphylaxis]] caused by [[mast cell]] disorders | |||
==References== | |||
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[[Category: (name of the system)]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[CME Category::Cardiology]] | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
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[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Immunology]] | [[Category:Immunology]] | ||
Latest revision as of 23:25, 8 April 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Dushka Riaz, MD
Overview
Anaphylaxis may be classified into 2 subtypes/groups: Immunologic-IgE mediated and Immunologic-non-IgE mediated. [1]
The diagnostic criteria must have one of the three of the following: [2]
- 1. Acute onset of disruption of the skin or mucosal tissue with either reduced blood pressure or decreased perfusion and/or respiratory compromise.
- 2. Exposure to a likely allergen followed with two of the following: involvement of mucosal tissue, respiratory compromise, gastrointestinal disturbances, or reduced blood pressure
- 3. Reduced blood pressure after exposure to a known allergen
Classification
Anaphylaxis may be classified into two groups: [1]
- Immunologic-IgE: whose causes include food allergens, medications, latex, airborne allergens
- Immunologic-non-IgE: whose causes include IVIG, NSAIDS and aspirin
There are also three pattern classifications:
- Uniphasic which resolves in an hour
- Biphasic which includes recurrence even without repeated exposure [3]
- Protracted which can lasts for days [4]
Anaphylaxis can also be categorized according to the cause: [5]
- Anaphylaxis caused by food allergens
- Anaphylaxis caused by drug allergens
- Anaphylaxis caused by insect venom
- Anaphylaxis caused by physical factors
- Anaphylaxis caused by inhaled allergens
- Anaphylaxis caused by allergen contact
- Anaphylaxis caused by mast cell disorders
References
- ↑ 1.0 1.1 LoVerde D, Iweala OI, Eginli A, Krishnaswamy G (2018). "Anaphylaxis". Chest. 153 (2): 528–543. doi:10.1016/j.chest.2017.07.033. PMC 6026262. PMID 28800865.
- ↑ Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A; et al. (2006). "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. 117 (2): 391–7. doi:10.1016/j.jaci.2005.12.1303. PMID 16461139.
- ↑ Lee S, Sadosty AT, Campbell RL (2016). "Update on biphasic anaphylaxis". Curr Opin Allergy Clin Immunol. 16 (4): 346–51. doi:10.1097/ACI.0000000000000279. PMID 27253484.
- ↑ Zisa G, Riccobono F, Calamari AM, D'Antonio CD, Galimberti M (2009). "A case of protracted hypotension as unique symptom of a biphasic anaphylaxis to amoxicillin". Eur Ann Allergy Clin Immunol. 41 (2): 60–1. PMID 19585862.
- ↑ Tanno LK, Chalmers RJ, Calderon MA, Aymé S, Demoly P, on behalf the Joint Allergy Academies (2017). "Reaching multidisciplinary consensus on classification of anaphylaxis for the eleventh revision of the World Health Organization's (WHO) International Classification of Diseases (ICD-11)". Orphanet J Rare Dis. 12 (1): 53. doi:10.1186/s13023-017-0607-3. PMC 5356259. PMID 28302183.