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2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis

Simons, F. Estelle R.; Ardusso, Ledit R.F.; Bilò, M. Beatrice; Dimov, Vesselin; Ebisawa, Motohiro; El-Gamal, Yehia M.; Ledford, Dennis K.; Lockey, Richard F.; Ring, Johannes; Sanchez-Borges, Mario; Senna, Gian Enrico; Sheikh, Aziz; Thong, Bernard Y.; Worm, Margittafor the World Allergy Organization

Current Opinion in Allergy and Clinical Immunology: August 2012 - Volume 12 - Issue 4 - p 389–399
doi: 10.1097/ACI.0b013e328355b7e4
ANAPHYLAXIS AND INSECT ALLERGY: Edited by Theodore Freeman and Ralf G. Heine

Purpose of review The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis published in early 2011 provide a global perspective on patient risk factors, triggers, clinical diagnosis, treatment, and prevention of anaphylaxis. In this 2012 Update, subsequently published, clinically relevant research in these areas is reviewed.

Recent findings Patient risk factors and co-factors that amplify anaphylaxis have been documented in prospective studies. The global perspective on the triggers of anaphylaxis has expanded. The clinical criteria for the diagnosis of anaphylaxis that are promulgated in the Guidelines have been validated. Some aspects of anaphylaxis treatment have been prospectively studied. Novel investigations of self-injectable epinephrine for treatment of anaphylaxis recurrences in the community have been performed. Progress has been made with regard to measurement of specific IgE to allergen components (component-resolved testing) that might help to distinguish clinical risk of future anaphylactic episodes to an allergen from asymptomatic sensitization to the allergen. New strategies for immune modulation to prevent food-induced anaphylaxis and new insights into subcutaneous immunotherapy to prevent venom-induced anaphylaxis have been described.

Summary Research highlighted in this Update strengthens the evidence-based recommendations for assessment, management, and prevention of anaphylaxis made in the WAO Anaphylaxis Guidelines.

aDepartment of Pediatrics & Child Health and Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, Canada

bCátedra Neumonología, Alergia e Inmunología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina

cDepartment of Allergy, Immunology and Respiratory Diseases, University Hospital, Ancona, Italy

dSection of Allergy, Asthma and Immunology, Department of Pediatrics and Medicine, University of Chicago, Chicago, Illinois, USA

eDepartment of Allergy, National Hospital Organization, Sagamihara National Hospital, Clinical Research Center for Allergy & Rheumatology, Kanagawa, Japan

fPediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt

gUniversity of South Florida Morsani College of Medicine, Tampa, Florida, USA

hDepartment of Dermatology and Allergy, Tech. Universitat Muenchen, Munich, Germany

iCentro Medico Docente La Trinidad, Caracas, Clinica El Avila, Caracas, Venezuela

jThe Allergy Unit, Verona General Hospital, Verona, Italy

kCenter for Population Health Sciences, The University of Edinburgh, Edinburgh, UK

lDepartment of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, Singapore

mAllergie-Centrum-Charité, Klinik fur Dermatologie und Allergologie, Charité, Universitatsmedizin, Berlin, Germany

Correspondence to Professor F. Estelle R. Simons, Room FE125, 820 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1R9. Tel: +1 204 787 2537; fax: +1 204 787 5040; e-mail:

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.