Lack of clear definition for anaphylaxis puts millions at risk

Mar 8 2005

A new report released today in The Journal of Allergy & Clinical Immunology sets the stage to clearly define a life-threatening medical condition that scientists characterized more than a century ago.

Millions of Americans are at risk for anaphylaxis, a severe systemic reaction often caused by food, medications, insect sting and latex. Without a clear definition of "anaphylaxis," patients will continue to be improperly diagnosed, inconsistently treated, and left uninformed about what they can do if they suffer another severe reaction. This report was the result of a multi-disciplinary "Symposium on the Definition and Management of Anaphylaxis" co-sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy & Anaphylaxis Network (FAAN), which brought together anaphylaxis experts to discuss a definition, treatment strategies and research objectives.

Anaphylaxis can become fatal within minutes, which is why it is so critical to properly diagnose and treat those at risk. But, according to the report, anaphylaxis is under diagnosed due to the lack of a widely accepted standard "working" definition.

There is a constellation of signs and symptoms in anaphylaxis that has led to inconsistencies in how anaphylaxis is defined in published studies, according to the study's lead author Hugh Sampson, M.D., Professor of Pediatrics and head of the Jaffe Food Allergy Institute at Mount Sinai Medical Center.

"The current lack of agreement on what constitutes anaphylaxis has resulted in misdiagnosis, inconsistent treatment and lack of education of affected patients. It has hampered research efforts," said Anne Munoz- Furlong, Founder & CEO of FAAN and co-author of the report. Anaphylaxis is under-recognized, under-treated in both the pre-hospital setting and emergency departments. In a review of 19,122 emergency room visits, 17 cases of anaphylaxis were identified but only four had been appropriately diagnosed and coded.

"Lack of patient education has left patients unprepared for future reactions, and has resulted in a number of fatalities. With the prevalence of allergies on the rise, and the potential vaccination of large numbers of individuals for bioterrorism purposes, the need to clearly define anaphylaxis becomes increasingly critical to a growing segment of the population," said Munoz-Furlong.

The experts all agreed that epinephrine is the universally agreed upon medication for the first aid treatment of anaphylaxis. The World Health Organization classifies it as an essential drug.

The report sets forth recommendations on diagnostic guidelines that take into account the variability of signs and symptoms by viewing anaphylaxis as a continuum with markers for diagnosing its degree of severity.

"We have put together leading medical and scientific experts to finally establish a universal definition for anaphylaxis," added Ms. Munoz-Furlong. "Our goal is to insure that everyone at risk for anaphylaxis is properly diagnosed, educated and prepared."