Bethel J. Anaphylaxis: diagnosis and treatment. Nursing Standard. 2013; 27:(41)

Bohlke K., Davis R. L., DeStefano F., Marcy S. M., Braun M. M., Thompson R. S. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. Journal of Allergy and Clinical Immunology. 2004; 113:(3)536-542

Bryant H. Anaphylaxis: recognition, treatment and education. emergency nurse. 2007; 15:(2)

Campbell R. L., Hagan J. B., Manivannan V., Decker W. W., Kanthala A. R., Bellolio M. F., Li J. T. Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients. Journal of Allergy and Clinical Immunology. 2012; 129:(3)748-752

Da Broi U., Moreschi C. Post-mortem diagnosis of anaphylaxis: a difficult task in forensic medicine. Forensic science international. 2011; 204:(1–3)1-5

Dhami S., Panesar S. S., Roberts G., Muraro A., Worm M., Bilò M. B., Fernandez-Rivas M. Management of anaphylaxis: a systematic review. Allergy. 2014; 69:(2)168-175

Dinakar C. Anaphylaxis in children: current understanding and key issues in diagnosis and treatment. Current allergy and asthma reports. 2012; 12:(6)641-649

Drupad H. S., Nagabushan H. Level of knowledge about anaphylaxis and its management among health care providers. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2015; 19:(7)

Gallagher M., Worth A., Cunningham-Burley S., Sheikh A. Epinephrine auto-injector use in adolescents at risk of anaphylaxis: a qualitative study in Scotland, UK. Clinical and Experimental Allergy. 2011; 41:(6)869-877

Gallagher M., Worth A., Cunningham-Burley S., Sheikh A. Strategies for living with the risk of anaphylaxis in adolescence: qualitative study of young people and their parents. Primary care respiratory journal. 2012; 21:(4)392-397

Gibbison B., Sheikh A., McShane P., Haddow C., Soar J. Anaphylaxis admissions to UK critical care units between 2005 and 2009. Anaesthesia. 2012; 67:(8)833-839

Ginde AA, Liu MC, Camargo CA Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med. 2009; 169:626-32

Grabenhenrich L. B., Dölle S., Moneret-Vautrin A., Köhli A., Lange L., Spindler T., Scherer K. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. Journal of allergy and clinical immunology. 2016; 137:(4)1128-1137

Hanna H. J., Emmanuel J., Naim S., Umasunthar T., Boyle R. J. Community healthcare professionals overestimate the risk of fatal anaphylaxis for food allergic children. Clinical and Experimental Allergy. 2016; 46:(12)1588-1595

Hochstadter E., Clarke A., De Schryver S., LaVieille S., Alizadehfar R., Joseph L., Ben-Shoshan M. Increasing visits for anaphylaxis and the benefits of early epinephrine administration: a 4-year study at a pediatric emergency department in Montreal, Canada. Journal of Allergy and Clinical Immunology. 2016; 137:(6)1888-1890

Hompes S., Köhli A., Nemat K., Scherer K., Lange L., Rueff F., Beyer K. Provoking allergens and treatment of anaphylaxis in children and adolescents – data from the anaphylaxis registry of German-speaking countries. Pediatric allergy and immunology. 2011; 22:(6)568-574

Ibrahim I., Chew B. L., Zaw W. W., Van Bever H. P. Knowledge of anaphylaxis among Emergency Department staff. Asia Pacific Allergy. 2014; 4:(3)164-171

Järvinen K. M., Sicherer S. H., Sampson H. A., Nowak-Wegrzyn A. Use of multiple doses of epinephrine in food-induced anaphylaxis in children. Journal of Allergy and Clinical Immunology. 2008; 122:(1)133-138

Kastner M, Harada L, Waserman S Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy. 2010; 65:436-444

Kapoor S, Roberts G, Bynoe Y, Gaughan M, Habibi P, Lack G Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions. Allergy. 2004; 59:185-191

Koplin J. J., Martin P. E., Allen K. J. An update on epidemiology of anaphylaxis in children and adults. Current opinion in allergy and clinical immunology. 2011; 11:(5)492-496

Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, Bernstein JA, Burks AW, Feldweg AM, Fink JN, Greenberger PA, Golden DB, James JM, Kemp SF, Ledford DK, Lieberman P, Sheffer AL, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, Lang D, Nicklas RA, Oppenheimer J, Portnoy JM, Randolph C, Schuller DE, Spector SL, Tilles S, Wallace D The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010; 126:477-80

Liberman D. B., Teach S. J. Management of anaphylaxis in children. Pediatric emergency care. 2008; 24:(12)861-866

Mullins R. J., Camargo C. A. Latitude, sunlight, vitamin D, and childhood food allergy/anaphylaxis. Current allergy and asthma reports. 2012; 12:(1)64-71

Muraro A., Agache I., Clark A., Sheikh A., Roberts G., Akdis C. A., Mazon A. EAACI food allergy and anaphylaxis guidelines: managing patients with food allergy in the community. Allergy. 2014; 69:(8)1046-1057

National Institute of Care and Excellence. Anaphylaxis: assessment and referral after emergency treatment. 2011. (accessed 05/05/2020)

Osborne NJ, Koplin JJ, Martin PE Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011; 127:(3)668-76

Resuscitation Council UK. Emergency treatment of anaphylactic reactions: Guidelines for healthcare providers. 2020. (Last accessed 05/05/2020)

Sampson HA, Munoz-Furlong A, Bock SA, Schmitt C, Bass R, Chowdhury BA, Decker WW, Furlong TJ, Galli SJ, Golden DB, Gruchalla RS, Harlor AD, Hepner DL, Howarth M, Kaplan AP, Levy JH, Lewis LM, Lieberman PL, Metcalfe DD, Murphy R, Pollart SM, Pumphrey RS, Rosenwasser LJ, Simons FE, Wood JP, Camargo CA Symposium on the definition and management of anaphylaxis: summary report. J Allergy Clin Immunol. 2005; 115:584-91

Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, Brown SG, Camargo CA, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW 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; 117:391-7

Schoessler S., White M. V. Recognition and treatment of anaphylaxis in the school setting: the essential role of the school nurse. The journal of school nursing. 2013; 29:(6)407-415

Shen Y, Li L, Grant J, Zhao Z, Zhang X, Zhou L, Fowler D Anaphylactic deaths in Maryland (US) and Shanghai: a review of forensic autopsy cases from 2004 to 2006. Forensic Sci Int. 2009; 186:1-5

Sheikh A, Shehata YA, Brown SG, Simons FE Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock. Cochrane Database Syst Rev. 2008;

Silva R., Gomes E., Cunha L., Falcão H. Anaphylaxis in children: a nine years' retrospective study (2001–2009). Allergologia et immunopathologia. 2012; 40:(1)31-36

Simons F.E, Ardusso L.R, Bilo M.B, El-Gamal Y.M, Ledford D.K, Ring J World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. 2011; 127:(e1-22)587-593

Taback S. P., Simons F. E. R. Anaphylaxis and vitamin D: A role for the sunshine hormone?. Journal of allergy and clinical immunology. 2007; 120:(1)

Tse Y., Rylance G. Emergency management of anaphylaxis in children and young people: new guidance from the Resuscitation Council (UK). Archives of Disease in Childhood-Education and Practice. 2009; 94:(4)97-101

Uram R. What every pediatrician must know about anaphylaxis and anaphylactoid reactions. Pediatric annals. 2000; 29:(12)737-742

Wood R.A, Camargo C.A, Lieberman P, Sampson H.A, Schwartz L.B, Zitt M Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol. 2014; 133:461-467

Anaphylaxis: Triggers and symptoms

02 June 2020
7 min read
Volume 1 · Issue 3


Anaphylaxis is a severe allergic reaction, which is potentially life-threatening. It is therefore important that health professionals have a good understanding of its triggers, presentation and management. This first article of a two-part series, focuses on the common triggers and symptoms of anaphylaxis, and explores some of the literature around assessment and diagnosis.

Anaphylaxis is a severe allergic reaction that can be potentially life-threatening, particularly in children and adolescents (Sampson et al, 2005; Sampson et al, 2006; Hompes et al, 2011; Simons et al, 2011; Grabenhenrich et al, 2016). It can present in virtually any setting and is very unpredictable (Sheikh et al, 2008; Dinakar, 2012; Grabenhenrich et al, 2016). In fact, the more rapidly anaphylaxis develops in a patient, the more likely the reaction is to be severe and life-threatening (Lieberman et al, 2010). It has also been reported that 60% of individuals who had anaphylaxis were not equipped with the correct medication needed to treat it (Wood et al, 2014). There is therefore a need to have a deeper understanding of anaphylaxis and how to correctly assess and diagnose it (Dinakar, 2012; Grabenhenrich et al, 2016). This article, the first of a two-part series, explores common anaphylaxis triggers and looks at some of the literature on the importance of early assessment and appropriate diagnosis in children and young people.

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