Overview of allergic disease: Anaphylaxis - WAO White Book on Allergy 2026 - 2.11 - PubMed

4 hours ago

Anaphylaxis is a rapid-onset, potentially fatal systemic hypersensitivity reaction.
Primary drivers are mast-cell activation (often IgE-mediated) and basophil involvement.
Lifetime prevalence is 0.3-5.1%, with rising global incidence in adults and children.
Common triggers vary by age: foods (e.g., milk, peanuts) in children; medications (e.g., beta-lactams, NSAIDs) in adults; insect venoms in some regions.
Diagnosis is clinical, focusing on rapid multisystem involvement, though isolated symptoms may occur.
First-line treatment is immediate intramuscular epinephrine (lateral thigh), with repeat doses if needed; intranasal epinephrine is emerging as an alternative.
Adjunctive measures include oxygen, IV fluids, and bronchodilators; antihistamines/corticosteroids do not replace epinephrine.
Long-term management involves trigger identification (history, IgE/skin testing), though 10% remain idiopathic.
Patients need action plans and epinephrine access, but global availability is limited.
Unmet needs: device access, standardized definitions, education, digital health integration, and research on mechanisms/biomarkers.

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