Highlights & Basics
- Sudden onset of respiratory or cardiovascular compromise, usually with a history of allergen exposure in sensitized individuals.
- Skin rash, wheezing and inspiratory stridor, hypotension, anxiety, nausea, and vomiting are the cardinal signs and symptoms.
- The diagnosis is clinical. Allergy testing is helpful only for secondary prophylaxis.
- Securing the airway and initiating prompt treatment with epinephrine (adrenaline) may save lives.
- Comorbidities (e.g., coronary artery disease and COPD) may pose a treatment challenge and warrant expert consultation
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992 Aug 6;327(6):380-4.[Abstract]
Simons FE, Ardusso LR, Bilò MB, et al. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol. 2012 Aug;12(4):389-99.[Abstract]
National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. December 2011 [internet publication].[Full Text]
Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015 Nov;115(5):341-84.[Abstract]
Bernstein IL, Li JT, Bernstein DI, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008 Mar;100(3 suppl 3):S1-148.[Abstract]
National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
Dinakar, C. Anaphylaxis in children: current understanding and key issues in diagnosis and treatment. Curr Allergy Asthma Rep. 2012 Dec;12(6):641-9.[Abstract][Full Text]
Sheikh A, Shehata YA, Brown SG, et al. Adrenaline for the treatment of anaphylaxis: Cochrane systematic review. Allergy. 2009 Feb;64(2):204-12.[Abstract][Full Text]
Boyle RJ, Elremeli M, Hockenhull J, et al. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database Syst Rev. 2012 Oct 17;(10):CD008838.[Abstract][Full Text]
Wang J, Sampson HA. Food allergy: recent advances in pathophysiology and treatment. Allergy Asthma Immunol Res. 2009 Oct;1(1):19-29.[Abstract][Full Text]
Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115:341-384.[Abstract]
1. LoVerde D, Iweala OI, Eginli A, et al. Anaphylaxis. Chest. 2017 Aug 8;153(2):528-43.[Abstract][Full Text]
2. World Allergy Organization Allergic Diseases Resource Center. Anaphylaxis. April 2019 [internet publication].
3. DesRoches A, Infante-Rivard C, Paradis L, et al. Peanut allergy: is maternal transmission of antigens during pregnancy and breastfeeding a risk factor? J Investig Allergol Clin Immunol. 2010;20(4):289-94.[Abstract]
4. Pitt TJ, Becker AB, Chan-Yeung M, et al. Reduced risk of peanut sensitization following exposure through breast-feeding and early peanut introduction. J Allergy Clin Immunol. 2017 Sep 12;141(2):620-5.e1.[Abstract][Full Text]
5. Järvinen KM, Westfall J, De Jesus M, et al. Role of maternal dietary peanut exposure in development of food allergy and oral tolerance. PLoS One. 2015 Dec 10;10(12):e0143855.[Abstract][Full Text]
6. Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report - second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006 Feb;117(2):391-7.[Abstract][Full Text]
7. Campbell RL, Hagan JB, Manivannan V, et al. Evaluation of National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria for the diagnosis of anaphylaxis in emergency department patients. J Allergy Clin Immunol. 2012 Mar;129(3):748-52.[Abstract]
8. Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol. 2006 Nov;97(5):596-602.[Abstract]
9. Wood RA, Camargo CA Jr, Lieberman P, et al. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol. 2014 Feb;133(2):461-7.[Abstract][Full Text]
10. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016 Apr;137(4):1128-37;e1.[Abstract][Full Text]
11. Lee S, Hess EP, Lohse C, et al. Trends, characteristics, and incidence of anaphylaxis in 2001-2010: a population-based study. J Allergy Clin Immunol. 2017 Jan;139(1):182-8;e2.[Abstract][Full Text]
12. Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis - a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020 Apr;145(4):1082-123.[Abstract][Full Text]
13. Umasunthar T, Leonardi-Bee J, Turner PJ, et al. Incidence of food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin Exp Allergy. 2015 Nov;45(11):1621-36.[Abstract]
14. Bock SA, Muñoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001 Jan;107(1):191-3.[Abstract]
15. Smit DV, Cameron PA, Rainer TH. Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions. J Emerg Med. 2005 May;28(4):381-8.[Abstract]
16. Brown AF, McKinnon D, Chu K. Emergency department anaphylaxis: a review of 142 patients in a single year. J Allergy Clin Immunol. 2001 Nov;108(5):861-6.[Abstract]
17. Sampson HA. Anaphylaxis and emergency treatment. Pediatrics. 2003 Jun;111(6 Pt 3):1601-8.[Abstract][Full Text]
18. Sue MA, Noritake DT, Klaustermeyer WB. Penicillin anaphylaxis: fatality in elderly patients without a history of penicillin allergy. Am J Emerg Med. 1988 Sep;6(5):456-8.[Abstract]
19. Worm M. Epidemiology of anaphylaxis. Chem Immunol Allergy. 2010 Jun 1;95:12-21.[Abstract]
20. Gelincik A, Demirtürk M, Yılmaz E, et al. Anaphylaxis in a tertiary adult allergy clinic: a retrospective review of 516 patients. Ann Allergy Asthma Immunol. 2012 Dec 20;110(2):96-100.[Abstract]
21. Aun MV, Blanca M, Garro LS, et al. Nonsteroidal anti-inflammatory drugs are major causes of drug-induced anaphylaxis. J Allergy Clin Immunol Pract. 2014 May 23;2(4):414-20.[Abstract]
22. McNeil MM, Weintraub ES, Duffy J, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol. 2015 Oct 6;137(3):868-78.[Abstract][Full Text]
23. Castells MC, Horan RF, Sheffer AL. Exercise-induced anaphylaxis. Curr Allergy Asthma Rep. 2003 Jan;3(1):15-21.[Abstract]
24. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992 Aug 6;327(6):380-4.[Abstract]
25. Chung CH, Mirakhur B, Chan E, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008 Mar 13;358(11):1109-17.[Abstract][Full Text]
26. Valentine MD. Anaphylaxis and stinging insect hypersensitivity. JAMA. 1992 Nov 25;268(20):2830-3.[Abstract]
27. Ewan PW, Dugué P, Mirakian R, et al. BSACI guidelines for the investigation of suspected anaphylaxis during general anaesthesia. Clin Exp Allergy. 2010 Jan;40(1):15-31.[Abstract][Full Text]
28. Royal College of Anaesthetists. Anaesthesia, surgery and life-threatening allergic reactions. Report and findings of the Royal College of Anaesthetists' 6th National Audit Project: perioperative anaphylaxis. May 2018 [internet publication].[Full Text]
29. Dewachter P, Mouton-Faivre C. Allergic risk during paediatric anaesthesia [in French]. Ann Fr Anesth Reanim. 2010 Mar;29(3):215-26.[Abstract]
30. De Weck AL, Sanz ML, Gamboa PM, et al. Nonsteroidal anti-inflammatory drug hypersensitivity syndrome: a multicenter study. II. Basophil activation by nonsteroidal anti-inflammatory drugs and its impact on pathogenesis. J Investig Allergol Clin Immunol. 2010;20(1):39-57.[Abstract][Full Text]
31. Verrill L, Bruns R, Luccioli S. Prevalence of self reported food allergy in US adults: 2001, 2006, and 2010. Allergy Asthma Proc. 2015 Oct 8.[Abstract]
32. Kool B, Chandra D, Fitzharris P. Adult food-induced anaphylaxis hospital presentations in New Zealand. Postgrad Med J. 2016 Apr 6;92(1093):640-4.[Abstract]
33. Turner PJ, Gowland MH, Sharma V, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J Allergy Clin Immunol. 2014 Nov 25;135(4):956-63.e1.[Abstract][Full Text]
34. Jerschow E, Lin RY, Scaperotti MM, et al. Fatal anaphylaxis in the United States, 1999-2010: temporal patterns and demographic associations. J Allergy Clin Immunol. 2014 Sep 30;134(6):1318-28.e7.[Abstract][Full Text]
35. Santos AF, Lack G. Food allergy and anaphylaxis in pediatrics: update 2010-2012. Pediatr Allergy Immunol. 2012 Dec;23(8):698-706.[Abstract]
36. Summers CW, Pumphrey RS, Woods CN, et al. Factors predicting anaphylaxis to peanuts and tree nuts in patients referred to a specialist center. J Allergy Clin Immunol. 2008 Jan 18;121(3):632-8.e2.[Abstract][Full Text]
37. Motosue MS, Bellolio MF, Van Houten HK, et al. Risk factors for severe anaphylaxis in the United States. Ann Allergy Asthma Immunol. 2017 Oct;119(4):356-1.e2.[Abstract]
38. LoVerde D, Iweala OI, Eginli A, et al. Anaphylaxis. Chest. 2017 Aug 8;153(2):528-43.[Abstract][Full Text]
39. Lee JM, Greenes DS. Biphasic anaphylactic reactions in pediatrics. Pediatrics. 2000 Oct;106(4):762-6.[Abstract]
40. Macdougall CF, Cant AJ, Colver AF. How dangerous is food allergy in childhood? The incidence of severe and fatal allergic reactions across the UK and Ireland. Arch Dis Child. 2002 Apr;86(4):236-9.[Abstract][Full Text]
41. Toraason M, Sussman G, Biagini R, et al. Latex allergy in the workplace. Toxicol Sci. 2000 Nov;58(1):5-14.[Abstract][Full Text]
42. Ausili E, Tabacco F, Focarelli B, et al. Prevalence of latex allergy in spina bifida: genetic and environmental risk factors. Eur Rev Med Pharmacol Sci. 2007 May-Jun;11(3):149-53.[Abstract]
43. Ricci G, Gentili A, Di Lorenzo F, et al. Latex allergy in subjects who had undergone multiple surgical procedures for bladder exstrophy: relationship with clinical intervention and atopic diseases. BJU Int. 1999 Dec;84(9):1058-62.[Abstract]
44. Garcia-Larsen V, Ierodiakonou D, Jarrold K, et al. Diet during pregnancy and infancy and risk of allergic or autoimmune disease: a systematic review and meta-analysis. PLoS Med. 2018 Feb 28;15(2):e1002507.[Abstract][Full Text]
45. Foong RX, Brough HA, Chan S, et al. US guidelines for the prevention of peanut allergy 2017. Arch Dis Child Educ Pract Ed. 2017 Nov 24;103(5):249-52.[Abstract][Full Text]
46. Lieberman P. Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol. 2005 Sep;95(3):217-26; quiz 226, 258.[Abstract]
47. Douglas DM, Sukenick E, Andrade WP, et al. Biphasic systemic anaphylaxis: an inpatient and outpatient study. J Allergy Clin Immunol. 1994 Jun;93(6):977-85.[Abstract]
48. Stark BJ, Sullivan TJ. Biphasic and protracted anaphylaxis. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 1):76-83.[Abstract]
49. Vanden Hoek TL, Morrison LJ, Shuster M, et al. 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 12.2: cardiac arrest associated with anaphylaxis. Circulation. 2010;122(suppl 3):S829-861.[Full Text]
50. Brown SG. Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis. Curr Opin Allergy Clin Immunol. 2005 Aug;5(4):359-64.[Abstract]
51. Brown SG. Clinical features and severity grading of anaphylaxis. J Allergy Clin Immunol. 2004 Aug;114(2):371-6.[Abstract]
52. Brown SG, Blackman KE, Stenlake V, et al. Insect sting anaphylaxis; prospective evaluation of treatment with intravenous adrenaline and volume resuscitation. Emerg Med J. 2004 Mar;21(2):149-54.[Abstract][Full Text]
53. Simons FE, Ardusso LR, Bilò MB, et al. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol. 2012 Aug;12(4):389-99.[Abstract]
54. National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
55. National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
56. Schwartz LB. Diagnostic value of tryptase in anaphylaxis and mastocytosis. Immunol Allergy Clin North Am. 2006 Aug;26(3):451-63.[Abstract]
57. Simons FE, Frew AJ, Ansotegui IJ, et al. Risk assessment in anaphylaxis: current and future approaches. J Allergy Clin Immunol. 2007 Jul;120(1 suppl):S2-24.[Abstract]
58. Kaliner M, Dyer J, Merlin S. Increased urine histamine and contrast media reactions. Invest Radiol. 1984 Mar-Apr;19(2):116-8.[Abstract]
59. Sampson HA, Ho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol. 1997 Oct;100(4):444-51.[Abstract]
60. Rentzos G, Lundberg V, Lundqvist C, et al. Use of a basophil activation test as a complementary diagnostic tool in the diagnosis of severe peanut allergy in adults. Clin Transl Allergy. 2015 Jun 11;5:22.[Abstract][Full Text]
61. Wang J, Sampson HA. Food anaphylaxis. Clin Exp Allergy. 2007 May;37(5):651-60.[Abstract]
62. Boyce JA. Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. J Allergy Clin Immunol. 2006 Jun;117(6):1415-8.[Abstract]
63. Alangari AA, Twarog FJ, Shih MC, et al. Clinical features and anaphylaxis in children with cold urticaria. Pediatrics. 2004 Apr;113(4):e313-7.[Abstract]
64. Lefèbvre PR, Cordonnier M, Baleriaux D, et al. An unusual cause of visual loss: involvement of bilateral lateral geniculate bodies. AJNR Am J Neuroradiol. 2004 Oct;25(9):1544-8.[Abstract][Full Text]
65. National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. December 2011 [internet publication].[Full Text]
66. Hamilton RG, Williams PB, Specific IgE Testing Task Force of the American Academy of Allergy, Asthma & Immunology., et al. Human IgE antibody serology: a primer for the practicing North American allergist/immunologist. J Allergy Clin Immunol. 2010 May 7;126(1):33-8.[Abstract][Full Text]
67. Okudaira H, Ito K, Miyamoto T, et al. Evaluation of new system for the detection of IgE antibodies (CAP) in atopic diseases [in Japanese]. Arerugi. 1991 May;40(5):544-54.[Abstract]
68. Oppenheimer J, Nelson HS. Skin testing. Ann Allergy Asthma Immunol. 2006 Feb;96(2 Suppl 1):S6-12.[Abstract]
69. Sicherer SH, Leung DY. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects. J Allergy Clin Immunol. 2007 Jun;119(6):1462-9.[Abstract]
70. Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010 Feb;125(2 suppl 2):S161-81.[Abstract][Full Text]
71. Golden DB, Demain J, Freeman T, et al. Stinging insect hypersensitivity: a practice parameter update 2016. Ann Allergy Asthma Immunol. 2017 Jan;118(1):28-54.[Abstract]
72. Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015 Nov;115(5):341-84.[Abstract]
73. National Institute of Allergy and Infectious Disease (NIAID). Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010 Dec;126(6 suppl):S1-58.[Abstract][Full Text]
74. Bernstein IL, Li JT, Bernstein DI, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008 Mar;100(3 suppl 3):S1-148.[Abstract]
75. National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. 24 August 2020 [internet publication].[Full Text]
76. Perkins GD, Graesner JT, Semeraro F, et al. European Resuscitation Council guidelines 2021: Executive summary. Resuscitation. 2021 Apr;161:1-60.[Full Text]
77. National Institute for Health and Care Excellence. Food allergy in under 19s: assessment and diagnosis. February 2011 [internet publication].[Full Text]
78. Soar J, Böttiger BW, Carli P, et al. European Resuscitation Council guidelines 2021: adult advanced life support. Resuscitation. 2021 Apr;161:115-51.[Abstract][Full Text]
79. Colquhoun MC, Handley AJ, Evans TR. ABC of resuscitation. 5th ed. London: BMJ Publishing Group; 2004.
80. Chrimes N, Higgs A, Hagberg CA, et al. Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies. Anaesthesia. 2022 Dec;77(12):1395-415. [Abstract][Full Text]
81. Lieberman P, Kemp SF, Oppenheimer J, et al. The diagnosis and management of anaphylaxis: an updated practice parameter. J Allergy Clin Immunol. 2005 Mar;115(3 suppl 2):S483-523.[Abstract]
82. Pumphrey RS. Fatal posture in anaphylactic shock. J Allergy Clin Immunol. 2003 Aug;112(2):451-2.[Abstract]
83. Singletary EM, Charlton NP, Epstein JL, et al; International Liaison Committee on Resuscitation First Aid Task Force. 2015 American Heart Association and American Red Cross guidelines update for first aid. Circulation. 2015 Nov 3;132(18 suppl 2):S574-89.[Abstract][Full Text]
84. Dinakar, C. Anaphylaxis in children: current understanding and key issues in diagnosis and treatment. Curr Allergy Asthma Rep. 2012 Dec;12(6):641-9.[Abstract][Full Text]
85. Sicherer SH, Simons FE. Epinephrine for first-aid management of anaphylaxis. Pediatrics. 2017 Mar;139(3).[Abstract][Full Text]
86. Sheikh A, Simons FE, Barbour V, et al. Adrenaline auto-injectors for the treatment of anaphylaxis with and without cardiovascular collapse in the community. Cochrane Database Syst Rev. 2012 Aug 15;(8):CD008935.[Abstract][Full Text]
87. Sheikh A, Shehata YA, Brown SG, et al. Adrenaline for the treatment of anaphylaxis: Cochrane systematic review. Allergy. 2009 Feb;64(2):204-12.[Abstract][Full Text]
88. Sheikh A, Shehata YA, Brown-Simon GA, et al. Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock. Cochrane Database Syst Rev. 2008 Oct 8;2008(4):CD006312.[Abstract][Full Text]
89. Simons FE, Gu X, Simons KJ. Epinephrine absorption in adults: intramuscular versus subcutaneous injection. J Allergy Clin Immunol. 2001 Nov;108(5):871-3.[Abstract]
90. Simons FE, Roberts JR, Gu X, et al. Epinephrine absorption in children with a history of anaphylaxis. J Allergy Clin Immunol. 1998 Jan;101(1 Pt 1):33-7.[Abstract]
91. Kemp SF, Lockey RF, Simons FE, et al. Epinephrine: the drug of choice for anaphylaxis. A statement of the World Allergy Organization. Allergy. 2008 Aug;63(8):1061-70.[Abstract]
92. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014 Jun 9;69(8):1026-45.[Abstract][Full Text]
93. Medicines and Healthcare products Regulatory Agency. Adrenaline auto-injectors: updated advice after European review. August 2017 [internet publication].[Full Text]
94. Wang J, Sicherer SH. Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics. 2017 Mar;139(3):e20164005.[Abstract][Full Text]
95. Sheikh A, Ten Broek V, Brown SG, et al. H1-antihistamines for the treatment of anaphylaxis: Cochrane systematic review. Allergy. 2007 Aug;62(8):830-7.[Abstract][Full Text]
96. Sheikh A, Ten Broek VM, Brown-Simon GA, et al. H1-antihistamines for the treatment of anaphylaxis with and without shock. Cochrane Database Syst Rev. 2007:(1):CD006160.[Abstract][Full Text]
97. Andreae DA, Andreae MH. Should antihistamines be used to treat anaphylaxis? BMJ. 2009 Jul 10;339:b2489.[Abstract]
98. Boyle RJ, Elremeli M, Hockenhull J, et al. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database Syst Rev. 2012 Oct 17;(10):CD008838.[Abstract][Full Text]
99. Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014 Jun 9;69(8):1008-25.[Abstract][Full Text]
100. Kusminsky RE. Complications of central venous catheterization. J Am Coll Surg. 2007 Apr;204(4):681-96.[Abstract]
101. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003 Mar 20;348(12):1123-33.[Abstract][Full Text]
102. Smith RN, Nolan JP. Central venous catheters. BMJ. 2013 Nov 11;347:f6570.[Abstract][Full Text]
103. Reich DL. Monitoring in anesthesia and perioperative care. Cambridge: Cambridge University Press; 2011.
104. Abbott Northwestern Hospital Internal Medicine Residency. Internal jugular central venous line. 2022 [internet publication].[Full Text]
105. Bishop L, Dougherty L, Bodenham A, et al. Guidelines on the insertion and management of central venous access devices in adults. Int J Lab Hematol. 2007 Aug;29(4):261-78.[Abstract]
106. Practice guidelines for central venous access 2020: an updated report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2020 Jan;132(1):8-43.[Abstract][Full Text]
107. Fletcher SJ, Bodenham AR. Safe placement of central venous catheters: where should the tip of the catheter lie? Br J Anaesth. 2000 Aug;85(2):188-91.[Abstract]
108. Gibson F, Bodenham A. Misplaced central venous catheters: applied anatomy and practical management. Br J Anaesth. 2013 Mar;110(3):333-46.[Abstract][Full Text]
109. Schuster M, Nave H, Piepenbrock S, et al. The carina as a landmark in central venous catheter placement. Br J Anaesth. 2000 Aug;85(2):192-4.[Abstract]
110. Webster J, Osborne S, Rickard CM, et al. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2019 Jan 23;(1):CD007798.[Abstract][Full Text]
111. Soar J, Böttiger BW, Carli P, et al. European Resuscitation Council Guidelines 2021: Adult advanced life support. Resuscitation. 2021 Apr;161:115-51.[Abstract][Full Text]
112. Wood RA. Food allergen immunotherapy: current status and prospects for the future. J Allergy Clin Immunol. 2016 Apr;137(4):973-82.[Abstract][Full Text]
113. Wang J, Sampson HA. Food allergy: recent advances in pathophysiology and treatment. Allergy Asthma Immunol Res. 2009 Oct;1(1):19-29.[Abstract][Full Text]
114. Kleine-Tebbe JB, Huttegger IJ, Saloga U, et al. Specific immunotherapy (hyposensitization) for IgE-mediated allergic diseases. Allergologie. 2010;33:3-34.
115. Enrique E, Pineda F, Malek T, et al. Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol. 2005 Nov;116(5):1073-9.[Abstract]
116. Mondoulet L, Dioszeghy V, Ligouis M, et al. Epicutaneous immunotherapy on intact skin using a new delivery system in a murine model of allergy. Clin Exp Allergy. 2010 Apr;40(4):659-67.[Abstract]
117. Larché M. Peptide immunotherapy for allergic diseases. Allergy. 2007 Mar;62(3):325-31.[Abstract][Full Text]
118. Worm M, Patel D, Creticos PS. Cat peptide antigen desensitisation for treating cat allergic rhinoconjunctivitis. Expert Opin Investig Drugs. 2013 Aug 21;22(10):1347-57.[Abstract][Full Text]
119. Incorvaia C, Montagni M, Ridolo E. The efficiency of peptide immunotherapy for respiratory allergy. Expert Rev Clin Pharmacol. 2016 Mar 7;9(6):831-7.[Abstract]
120. Li XM, Srivastava K, Grishin A, et al. Persistent protective effect of heat-killed Escherichia coli producing "engineered", recombinant peanut proteins in a murine model of peanut allergy. J Allergy Clin Immunol. 2003 Jul;112(1):159-67.[Abstract]
121. Li XM, Srivastava K, Huleatt JW, et al. Engineered recombinant peanut protein and heat-killed Listeria monocytogenes coadministration protects against peanut-induced anaphylaxis in a murine model. J Immunol. 2003 Mar 15;170(6):3289-95.[Abstract][Full Text]
122. Prickett SR, Voskamp AL, Phan T, et al. Ara h 1 CD4+ T cell epitope-based peptides: candidates for a peanut allergy therapeutic. Clin Exp Allergy. 2013 Jun;43(6):684-97.[Abstract][Full Text]
123. Pascal M, Konstantinou GN, Masilamani M, et al. In silico prediction of Ara h 2 T cell epitopes in peanut-allergic children. Clin Exp Allergy. 2013 Jan;43(1):116-27.[Abstract]
124. Tighe H, Takabayashi K, Schwartz D, et al. Conjugation of immunostimulatory DNA to the short ragweed allergen amb a 1 enhances its immunogenicity and reduces its allergenicity. J Allergy Clin Immunol. 2000 Jul;106(1 Pt 1):124-34.[Abstract]
125. Zhu FG, Kandimalla ER, Yu D, et al. Oral administration of a synthetic agonist of Toll-like receptor 9 potently modulates peanut-induced allergy in mice. J Allergy Clin Immunol. 2007 Jun 20;120(3):631-7.[Abstract][Full Text]
126. Chang TW, Wu PC, Hsu CL, et al. Anti-IgE antibodies for the treatment of IgE-mediated allergic diseases. Adv Immunol. 2007;93:63-119.[Abstract]
127. Leung DY, Sampson HA, Yunginger JW, et al. Effect of anti-IgE therapy in patients with peanut allergy. N Engl J Med. 2003 Mar 13;348(11):986-93.[Abstract][Full Text]
128. Ramesh M, Karagic M. New modalities of allergen immunotherapy. Hum Vaccin Immunother. 2018;14(12):2848-63.[Abstract][Full Text]
129. Li XM, Srivastava K. Traditional Chinese medicine for the therapy of allergic disorders. Curr Opin Otolaryngol Head Neck Surg. 2006 Jun;14(3):191-6.[Abstract]
130. Qu C, Srivastava K, Ko J, et al. Induction of tolerance after establishment of peanut allergy by the food allergy herbal formula-2 is associated with up-regulation of interferon-gamma. Clin Exp Allergy. 2007 Jun;37(6):846-55.[Abstract]
131. Lisann L, Song Y, Wang J, et al. Successful prevention of extremely frequent and severe food anaphylaxis in three children by combined traditional Chinese medicine therapy. Allergy Asthma Clin Immunol. 2014 Dec 20;10(1):66.[Abstract][Full Text]
132. Arias K, Baig M, Colangelo M, et al. Concurrent blockade of platelet-activating factor and histamine prevents life-threatening peanut-induced anaphylactic reactions. J Allergy Clin Immunol. 2009 Aug;124(2):307-14;e1-2.[Abstract][Full Text]
133. Mertes PM, Malinovsky JM, Jouffroy L, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21(6):442-53.[Abstract]
134. Kastner M, Harada L, Waserman S. Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy. 2010 Apr;65(4):435-44.[Abstract]
135. Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115:341-384.[Abstract]
136. Bilò BM, Bonifazi F. Epidemiology of insect-venom anaphylaxis. Curr Opin Allergy Clin Immunol. 2008 Aug;8(4):330-7.[Abstract]
137. Food and Drug Administration. Letter: Important safety information on the EpiPen® and EpiPen Jr® auto-injectors and their authorized generic versions. 23 March 2020 [internet publication].[Full Text]
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