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The diagnosis and management of anaphylaxis:
An updated practice parameter
Chief Editors: Phillip Lieberman, MD, Stephen F. Kemp, MD, John Oppenheimer, MD,
David M. Lang, MD, I. Leonard Bernstein, MD, and Richard A. Nicklas, MD *
Workgroup Contributors: John A. Anderson, MD, David I. Bernstein, MD, Jonathan A.
Bernstein, MD, Jordan N. Fink, MD, Paul A. Greenberger, MD, Dennis K.
Ledford, MD, James Li, MD, PhD, Albert L. Sheffer, MD, Roland Solensky, MD, and
Bruce L. Wolf, MD
Task Force Reviewers: Joann Blessing-Moore, MD, David A. Khan, MD, Rufus E.
Lee, MD, Jay M. Portnoy, MD, Diane E. Schuller, MD, Sheldon L. Spector, MD, and
Stephen A. Tilles, MD
These parameters were developed by the Joint Task Force on Practice
Parameters, representing the American Academy of Allergy, Asthma
and Immunology; the American College of Allergy, Asthma and
Immunology; and the Joint Council of Allergy, Asthma and
Immunology.
The American Academy of Allergy, Asthma and Immunology
(AAAAI) and the American College of Allergy, Asthma and
Immunology (ACAAI) have jointly accepted responsibility for
establishing ‘‘The diagnosis and management of anaphylaxis: an
updated practice parameter.’’ This is a complete and comprehensive
document at the current time. The medical environment is
a changing environment, and not all recommendations will be
appropriate for all patients. Because this document incorporated
the efforts of many participants, no single individual, including
those who served on the Joint Task force, is authorized to provide
an official AAAAI or ACAAI interpretation of these practice
parameters. Any request for information about or an interpretation
of these practice parameters by the AAAAI or ACAAI should
be directed to the Executive Offices of the AAAAI, the ACAAI, and
the Joint Council of Allergy, Asthma and Immunology. These
parameters are not designed for use by pharmaceutical companies
in drug promotion.
This is a complete and comprehensive document at
the current time. The medical environment is a
changing environment, and not all recommendations
will be appropriate for all patients.
Published practice parameters of the Joint Task Force
on Practice Parameters for Allergy & Immunology
include the following:
1. Practice parameters for the diagnosis and treatment
of asthma. J Allergy Clin Immunol 1995;96(suppl):
S707-S870.
2. Practice parameters for allergy diagnostic testing.
Ann Allergy 1995;75:543-625.
3. Practice parameters for the diagnosis and management
of immunodeficiency. Ann Allergy 1996;76:
282-94.
4. Practice parameters for allergen immunotherapy.
J Allergy Clin Immunol 1996;98:1001-11.
5. Disease management of atopic dermatitis: a practice
parameter. Ann Allergy 1997;79:197-211.
6. The diagnosis and management of anaphylaxis.
J Allergy Clin Immunol 1998;101(suppl):S465-S528.
7. Algorithm for the diagnosis and management of
asthma: a practice parameter update. Ann Allergy
1998;81:415-20.
8. Diagnosis and management of rhinitis: parameter
documents of the Joint Task Force on Practice Parameters
in Allergy, Asthma and Immunology. Ann
Allergy 1998;81(suppl):S463-S518.
*This parameter was edited by Dr Nicklas in his private capacity and not in his
capacity as a medical officer with the Food and Drug Administration. No
official support or endorsement by the Food and Drug Administration is
intended or should be inferred.
Disclosure of potential conflict of interest: P. Lieberman—none disclosed. S. F.
Kemp has consultant arrangements with MedPointe Pharmaceuticals. J.
Oppenheimer—none disclosed. D. M. Lang—none disclosed. I. L.
Bernstein—none disclosed. R. A. Nicklas—none disclosed. J. A.
Anderson—none disclosed. D. I. Bernstein—none disclosed. J. Bernstein
is on the Speakers’ Bureau for Merck, GlaxoSmithKline, AstraZeneca,
Aventis, Medpointe, Pfizer, Schering-Plough, and IVAX. J. N. Fink—none
disclosed. P. A. Greenberger—none disclosed. D. K. Ledford—none
disclosed. J. Li—none disclosed. A. L. Sheffer—none disclosed.
R. Solensky—none disclosed. B. L. Wolf—none disclosed. J. Blessing-
Moore—none disclosed. D. A. Khan has consultant arrangements with
Pfizer; receives grants/research support from AstraZeneca; and is on the
Speakers’ Bureau for Pfizer, Merck, Aventis, and GlaxoSmithKline. R. E.
Lee—none disclosed. J. M. Portnoy—none disclosed. D. E. Schuller is on
the Speakers’ Bureau for Boehringer-Ingelheim. S.L. Spector has had
consultant arrangements with, has received grants/research support from,
and has been on the Speakers’ Bureau for Abbott, Allen & Hanburys,
AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Fisons, Forest,
ICN, Key, Eli-Lilly, 3M, Miles, Muro, Pfizer, Purdue Frederick,
Schering-Plough, Wallace, and Witby. S. A. Tilles—none disclosed.
Reprint requests: Joint Council of Allergy, Asthma & Immunology, 50 N
Brockway St, #3-3, Palatine, IL 60067.
J Allergy Clin Immunol 2005;115:S483-523.
0091-6749/$30.00
Ó 2005 American Academy of Allergy, Asthma and Immunology
doi:10.1016/j.jaci.2005.01.010
S483