ANAPHYLAXIS is a severe, potentially life-threatening hypersensitivity reaction with a rising incidence worldwide. Despite its critical nature, there is no definitive diagnostic test, making clinical judgement essential in identifying and managing cases. Historically, the absence of standardised criteria led to inconsistencies in patient care and research outcomes.
In response to this challenge, the National Institute of Allergy and Infectious Disease (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) established clinical criteria in 2006 to standardise anaphylaxis diagnosis. These criteria have since been widely adopted, though revisions were made in 2020 by the World Allergy Organization (WAO) to improve global applicability. The WAO modifications streamlined the criteria and incorporated isolated respiratory involvement as a key diagnostic factor. However, the existence of multiple criteria has continued to create inconsistencies in clinical practice and research.
To address this, the Global Allergy and Asthma Excellence Network (GA2LEN) convened an international expert panel in 2023 to unify anaphylaxis diagnostic and management criteria. This panel developed three key outputs: an Anaphylaxis Definition, an Anaphylaxis Overview, and a Clinical Support Tool. These resources aim to enhance recognition, treatment, and standardisation across medical disciplines, including emergency medicine, allergy, anaesthesia, and primary care.
The Clinical Support Tool is a significant advancement, integrating clear clinical criteria, epinephrine treatment guidelines, and key symptoms across age groups. It reinforces epinephrine as the first-line treatment, ensuring timely intervention and reducing reliance on adjunctive therapies. Additionally, it provides user-friendly features, such as organ system classifications and visual aids, to aid healthcare providers in high-pressure settings.
A major strength of this consensus approach is its international endorsement by 34 medical and patient advocacy organisations, reflecting its broad applicability. By resolving discrepancies between existing criteria, the GA2LEN initiative enhances clinical decision-making, facilitates epidemiological research, and improves patient outcomes. While clinical judgement remains crucial, these unified guidelines mark a significant step toward optimising anaphylaxis management worldwide.
Katie Wright, EMJ
Reference
Dribin TE et al. Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report. J Allergy Clin Immunol. 2025;DOI:10.1016/j.jaci.2025.01.021.
