Anaphylaxis classification: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(12 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Anaphylaxis}}
{{Anaphylaxis}}
{{CMG}}, {{AE}} [[User:Dushka|Dushka Riaz, MD]]


{{CMG}}
==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==
==Classification==


'''Anaphylactic shock''', the most severe type of anaphylaxis, occurs when an allergic response triggers a quick release from [[mast cell]]s of large quantities of [[immunology|immunological]] mediators ([[histamine]]s, [[prostaglandin]]s, [[leukotriene]]s) leading to systemic [[vasodilation]] (associated with a sudden drop in blood pressure) and [[edema]] of [[bronchial]] [[mucosa]] (resulting in [[bronchoconstriction]] and difficulty breathing).  Anaphylactic shock can lead to death in a matter of minutes if left untreated.
[[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>


Researchers typically distinguish between "'''true anaphylaxis'''" and "'''pseudo-anaphylaxis'''."  The symptoms, treatment, and risk of death are identical, but "true" anaphylaxis is always caused directly by [[degranulation]] of [[mast cell]]s or basophils that is mediated by [[immunoglobulin]] E (IgE), and pseudo-anaphylaxis occurs due to all other causes.  The distinction is only important for researchers who are studying mechanisms of allergic reactions. Due to the word "pseudo", it may frustrate patients who feel they are being told that a life-threatening allergic reaction isn't "real".
*[[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==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]
==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[CME Category::Cardiology]]


[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Cardiology]]
[[Category:Cardiology]]
Line 19: Line 53:
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Immunology]]
[[Category:Immunology]]
{{WH}}
{{WS}}

Latest revision as of 23:25, 8 April 2021

Anaphylaxis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anaphylaxis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Anaphylaxis classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Anaphylaxis classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Anaphylaxis classification

CDC on Anaphylaxis classification

Anaphylaxis classification in the news

Blogs on Anaphylaxis classification

Directions to Hospitals Treating Anaphylaxis

Risk calculators and risk factors for Anaphylaxis classification

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]

Classification

Anaphylaxis may be classified into two groups: [1]

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]

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.

Template:WH Template:WS

References

Template:WH Template:WS CME Category::Cardiology

Retrieved from "https://www.wikidoc.org/index.php?title=Anaphylaxis_classification&oldid=1696627"