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Unclear Definitions for Anaphylaxis Puts Millions At Risk

(March 8, 2005 - Millions of Americans are at risk for anaphylaxis, a severe systemic allergic reaction that is often caused by food, medications, insect sting and latex. If patients do not have a clear understanding of what anaphylaxis is, they continually run the risk of being improperly diagnosed, inconsistently treated, and left uninformed about what course of action they need to take if they suffer from another severe reaction.

A new report by The Journal of Allergy & Clinical Immunology sets the stage to try to clearly define this life-threatening medical condition. This report was the result of a multi-disciplinary "Symposium on the Definition and Management of Anaphylaxis" co-sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy & Anaphylaxis Network (FAAN), which brought together anaphylaxis experts to discuss a definition, treatment strategies and research objectives.

Anaphylaxis can become life-threateningly fatal within minutes, and it is this reason that scientists believe it is so critical to properly diagnose and treat those at risk for an anaphylactic allergic reaction. But, according to the report, there is a lack of a widely accepted standard “working” definition for anaphylaxis, causing the systemic condition to be under diagnosed.

There are a wide range of signs and symptoms in anaphylaxis that has led to inconsistencies in how anaphylaxis is defined in published studies, according to the study's lead author Hugh Sampson, M.D., Professor of Pediatrics and head of the Jaffe Food Allergy Institute at Mount Sinai Medical Center.

"The current lack of agreement on what constitutes anaphylaxis has resulted in misdiagnosis, inconsistent treatment and lack of education of affected patients. It has hampered research efforts," said Anne Munoz- Furlong, Founder & CEO of FAAN and co-author of the report. Anaphylaxis is under-recognized, under-treated in both the pre-hospital setting and emergency departments. In a review of 19,122 emergency room visits, 17 cases of anaphylaxis were identified but only four had been appropriately diagnosed and coded.

"Lack of patient education has left patients unprepared for future reactions, and has resulted in a number of fatalities. With the prevalence of allergies on the rise, and the potential vaccination of large numbers of individuals for bioterrorism purposes, the need to clearly define anaphylaxis becomes increasingly critical to a growing segment of the population," said Munoz-Furlong.

The experts all agreed that epinephrine is the universally agreed upon medication for the first aid treatment of anaphylaxis. The World Health Organization classifies it as an essential drug.


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