Refractory anaphylaxis: a new entity for severe anaphylaxis
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Anaphylaxis reactions lie on a spectrum of severity, ranging from relatively mild lower respiratory involvement (depending on the definition of anaphylaxis used) to more severe reactions which are refractory to initial treatment with epinephrine and may rarely cause death. A variety of grading scales exist to characterize severe reactions, but there is a lack of consensus about the optimal approach to define severity. More recently, a new entity called refractory anaphylaxis (RA) has emerged in the literature, characterized by the persistence of anaphylaxis despite initial epinephrine treatment. However, slightly different definitions have been proposed to date. In this Rostrum, we review these definitions as well as data relating to epidemiology, elicitors, risk factors and management of RA. We propose a need to align the different definitions for RA, to improve epidemiological surveillance, advance our understanding of the pathophysiology of RA, and optimize management strategies to reduce morbidity and mortality.
Date Issued
2023-07
Date Acceptance
2023-04-18
Citation
Journal of Allergy and Clinical Immunology: In Practice, 2023, 11 (7), pp.2043-2048
ISSN
2213-2198
Publisher
Elsevier
Start Page
2043
End Page
2048
Journal / Book Title
Journal of Allergy and Clinical Immunology: In Practice
Volume
11
Issue
7
Copyright Statement
© 2023 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/37172716
PII: S2213-2198(23)00481-6
Subjects
Anaphylaxis
Autoinjector
Emergency management
Epinephrine
Food allergy
Intensive care
Refractory
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2023-05-10