SPECIAL COMMENTARIESAnaphylaxis in elderly peopleVentura, Maria Teresaa; Boni, Elisab; Taborda-Barata, Luisc,d; Blain, Huberte; Bousquet, Jeanf,g,h Author Information aUnit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy bAllergologia e Autoimmunità LUM, Maggiore Hospital, AUSL Bologna, Italy cUBIAir – Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã and CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal dDepartment of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal eDepartment of Geriatrics, Montpellier University Hospital, MUSE, Montpellier, France fInstitute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany gFraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany hUniversity Hospital Montpellier, France Correspondence to Prof. Maria Teresa Ventura, Unit of Geriatric Immunoallergology, University Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy. E-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: December 2022 - Volume 22 - Issue 6 - p 435-440 doi: 10.1097/ACI.0000000000000855 Buy Metrics Abstract Purpose of review Anaphylaxis is common in old-age adults but is insufficiently understood by physicians, and may be underdiagnosed. This review discusses the specificities of anaphylaxis in this age group and stresses the importance of adrenaline in its management. Recent findings Data from the European Anaphylaxis Registry on elderly patients is a major finding. Other findings include the prevention of possible anaphylactic reactions in coronavirus disease 2019 vaccination as well as some new epidemiologic data. Summary The most common risk factors are hymenoptera venom and food and drug allergy. Cardiovascular symptoms are the most important ones to reverse in old-age adults, especially due to the multiple comorbidities. Anaphylaxis in old-age adults has a more severe outcome than in younger ones. Polypharmacy is a specific factor to be considered. The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) algorithm is applicable in all clinical emergencies for immediate assessment and treatment, and should be considered for all patients. Adrenaline is the mainstay of the management of the condition. There are no absolute contraindications to the prescription of self-injectable adrenaline in elderly individuals at risk of anaphylaxis. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.