Critical view of anaphylaxis epidemiology: open questions and new perspectives

Luciana Kase Tanno^{1

2

3

4}, Ana Luiza Bierrenbach^{5

6}, F Estelle R Simons⁷, Victoria Cardona⁸, Bernard Yu-Hor Thong⁹, Nicolas Molinari¹⁰, Moises A Calderon¹¹, Margitta Worm¹², Yoon-Seok Chang¹³, Nikolaos G Papadopoulos^{14

15}, Thomas Casale¹⁶, Pascal Demoly^{2

3}; on behalf the Joint Allergy Academies

Affiliations

¹ 1Hospital Sírio Libanês, São Paulo, Brazil.
² 2University Hospital of Montpellier, Montpellier, France.
³ 3Sorbonne Université, INSERM, IPLESP, 75013 Paris, France.
⁴ 16Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
⁵ Sanas Epidemiology and Research, São Paulo, Brazil.
⁶ 5Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil.
⁷ 6Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada.
⁸ 7Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
⁹ 8Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
¹⁰ 9IMAG, UMR 5149, DIM CHRU de Montpellier, Montpellier, France.
¹¹ 10Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK.
¹² 11Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
¹³ 12Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea.
¹⁴ 13Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK.
¹⁵ 14Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
¹⁶ 15American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA.

PMID: 29632547
PMCID: PMC5883526
DOI: 10.1186/s13223-018-0234-0

Review

Critical view of anaphylaxis epidemiology: open questions and new perspectives

Luciana Kase Tanno et al. Allergy Asthma Clin Immunol. 2018.

. 2018 Apr 4:14:12.

doi: 10.1186/s13223-018-0234-0. eCollection 2018.

Authors

Affiliations

¹ 1Hospital Sírio Libanês, São Paulo, Brazil.
² 2University Hospital of Montpellier, Montpellier, France.
³ 3Sorbonne Université, INSERM, IPLESP, 75013 Paris, France.
⁴ 16Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
⁵ Sanas Epidemiology and Research, São Paulo, Brazil.
⁶ 5Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil.
⁷ 6Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada.
⁸ 7Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
⁹ 8Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
¹⁰ 9IMAG, UMR 5149, DIM CHRU de Montpellier, Montpellier, France.
¹¹ 10Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK.
¹² 11Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
¹³ 12Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea.
¹⁴ 13Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK.
¹⁵ 14Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
¹⁶ 15American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA.

PMID: 29632547
PMCID: PMC5883526
DOI: 10.1186/s13223-018-0234-0

Abstract

In contrast to the majority of allergic or hypersensitivity conditions, worldwide anaphylaxis epidemiological data remain sparse with low accuracy, which hampers comparable morbidity statistics. Data can differ widely depending on a number of variables. In the current document we reviewed the forms on which anaphylaxis has been defined and classified; and how it can affect epidemiological data. With regards to the methods used to capture morbidity statistics, we observed the impact of the anaphylaxis coding utilizing the World Health Organization's International Classification of Diseases. As an outcome and depending on the anaphylaxis definition, we extracted the cumulative incidence, which may not reflect the real number of new cases. The new ICD-11 anaphylaxis subsection developments and critical view of morbidity statistics data are discussed in order to reach new perspectives on anaphylaxis epidemiology.

Keywords: Anaphylaxis; Classification; Epidemiology; International Classification of Diseases; Rare diseases; World Health Organization.

PubMed Disclaimer

Figures

**Fig. 1**
Similarities and differences in anaphylaxis definitions worldwide [, , −8]

**Fig. 2**
Annual number of publications retrieved from Pubmed Central^® using the search term “anaphylaxis epidemiology”, (accessed November 7, 2016)

**Fig. 3**
General model to explain how definitions of allergic conditions can affect prevalence data (a asthma as a model, b anaphylaxis as a model)

**Fig. 4**
Anaphylaxis epidemiology publications eligibility selection process

See this image and copyright information in PMC

References

1. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, Jr, Bock SA, Branum A, 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;117:391–397. doi: 10.1016/j.jaci.2005.12.1303. - DOI - PubMed
1. Simons FER, Ardusso LR, Bilò MB, Cardona V, Ebisawa M, El-Gamal YM, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014;30(7):9. - PMC - PubMed
1. Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Fernandez-Rivas M, Santos AF, Zolkipli ZQ, Bellou A, Bindslev-Jensen C, Cardona V, Clark AT, Demoly P, Dubois AEJ, Dunn Galvin A, Eigenmann P, Halken S, Harada L, Lack G, Jutel M, Niggemann B, Rueff F, Timmermans F, Vlieg-Boerstra BJ, Werfel T, Dhami S, Panesar S, Sheikh A, on behalf of EAACI Food Allergy and Anaphylaxis Guidelines Group Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014 - PubMed
1. Panesar SS, Javad S, de Silva D, Nwaru BI, Hickstein L, Muraro A, Roberts G, Worm M, Bilò MB, Cardona V, Dubois AEJ, DunnGalvin A, Eigenmann P, Fernandez-Rivas M, Halken S, Lack G, Niggemann B, Santos AF, Vlieg-Boerstra BJ, Zolkipli ZQ, Sheikh A, on behalf of the EAACI Food Allergy and Anaphylaxis Group The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013;68:1353–1361. doi: 10.1111/all.12272. - DOI - PubMed
1. Neugut AI, Ghatak AT, Miller RL. Anaphylaxis in United States: an investigation into its epidemiology. Arch Intern Med. 2001;161(1):15–21. doi: 10.1001/archinte.161.1.15. - DOI - PubMed

Publication types

Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Critical view of anaphylaxis epidemiology: open questions and new perspectives

Affiliations

Critical view of anaphylaxis epidemiology: open questions and new perspectives

Authors

Affiliations

Abstract

Figures

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources

Research Materials