Table 2 |
|
|
Clinical criteria for diagnosing anaphylaxis8 |
|
| Anaphylaxis is highly likely when any one of the following 3 criteria are fulfilled: |
1. Acute onset of an illness (minutes to several hours) with involvement of the skin,
mucosal tissue, or both (e.g., generalized hives, pruritus or flushing, swollen lips-tongue-uvula) |
| AND AT LEAST ONE OF THE FOLLOWING |
a. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF,
hypoxemia) b. Reduced BP or associated symptoms of end-organ dysfunction (e.g., hypotonia [collapse], syncope, incontinence) |
| 2. Two or more of the following that occur rapidly after exposure to a likely allergen
for that patient (minutes to several hours): |
a. Involvement of the skin-mucosal tissue (e.g., generalized hives, itch-flush, swollen
lips-tongue-uvula) b. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia) c. Reduced BP or associated symptoms (e.g., hypotonia [collapse], syncope, incontinence) d. Persistent gastrointestinal symptoms (e.g., crampy abdominal pain, vomiting) |
| 3. Reduced BP after exposure to known allergen for that patient (minutes to several
hours): |
a. Infants and children: low systolic BP (age specific) or greater than 30% decrease
in systolic BP* b. Adults: systolic BP of less than 90 mm Hg or greater than 30% decrease from that person's baseline |
|
|
|
|
PEF = Peak expiratory flow; BP = blood pressure. *Low systolic blood pressure for children is defined as less than 70 mm Hg from 1 month to 1 year, less than (70 mm Hg 1 [2 times age]) from 1 to 10 years, and less than 90 mm Hg from 11 to 17 years. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, Jr., Bock SA, Branum A, 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, 2006:391-7. |
|
|
Cox Allergy, Asthma & Clinical Immunology 2009 5:4 doi:10.1186/1710-1492-5-4 |
|
