Dribin Timothy E, Muraro Antonella, Camargo Carlos A, Turner Paul J, Wang Julie, Roberts Graham, Anagnostou Aikaterini, Halken Susanne, Liebermann Jay, Worm Margitta, Zuberbier Torsten, Sampson Hugh A
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Department of Woman and Child Health, Food Allergy Centre, Padua University Hospital, Padua, Italy.
J Allergy Clin Immunol. 2025 Jan 27. doi: 10.1016/j.jaci.2025.01.021.
The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.
We sought to develop a consensus anaphylaxis definition, overview, and clinical support tool.
A 12-member writing group developed draft outputs modified with input from a 46-member international expert panel, 31 medical stakeholder organizations, and 15 patient advocacy organizations. The expert panel participated in a modified Delphi process to seek consensus for the outputs using a ≥80% consensus threshold.
The first sentence of the definition reads, "Anaphylaxis is a serious allergic (hypersensitivity) reaction that can progress rapidly and may cause death." The definition also describes organ systems that may be involved and signs of life-threatening reactions. The overview includes details of anaphylaxis recognition and management. The clinical support tool incorporates new clinical criteria to help determine the likelihood that patients are having anaphylaxis, intramuscular epinephrine indications and dosing, and common findings from the anaphylaxis organ systems. In addition, 93.5% (43/46), 97.8% (45/46), and 93.5% (43/46) of experts agreed with the definition, overview, and clinical support tool, respectively.
The anaphylaxis overview is a novel educational tool conveying key elements of anaphylaxis recognition and management. We propose that the definition and clinical support tool should replace previous definitions and clinical criteria. The clinical support tool should facilitate improved anaphylaxis recognition and management across different clinical settings and standardize research outcomes.
2006年美国国立过敏与传染病研究所/食物过敏与过敏反应网络的过敏反应标准在临床护理和研究中被广泛使用。2020年，世界过敏组织发布了修订后的标准，但尚未得到统一采用。不同的标准导致护理和研究结果不一致。
我们试图制定一个关于过敏反应的共识定义、概述和临床支持工具。
一个由12名成员组成的写作小组制定了初稿，并根据来自一个由46名成员组成的国际专家小组、31个医学利益相关者组织和15个患者权益倡导组织的意见进行了修改。专家小组参与了一个改进的德尔菲过程，以≥80%的共识阈值就这些产出寻求共识。
定义的第一句是：“过敏反应是一种严重的过敏（超敏）反应，可迅速进展并可能导致死亡。”该定义还描述了可能涉及的器官系统以及危及生命反应的体征。概述包括过敏反应识别和管理的详细信息。临床支持工具纳入了新的临床标准，以帮助确定患者发生过敏反应的可能性、肌肉注射肾上腺素的适应症和剂量，以及过敏反应器官系统的常见表现。此外，分别有93.5%（43/46）、97.8%（45/46）和93.5%（43/46）的专家同意该定义、概述和临床支持工具。
过敏反应概述是一种传达过敏反应识别和管理关键要素的新型教育工具。我们建议该定义和临床支持工具应取代以前的定义和临床标准。临床支持工具应有助于在不同临床环境中改善过敏反应的识别和管理，并使研究结果标准化。
