World allergy organization anaphylaxis guidance 2020

Victoria Cardona*, Ignacio J. Ansotegui, Motohiro Ebisawa, Yehia El-Gamal, Montserrat Fernandez Rivas, Stanley Fineman, Mario Geller, Alexei Gonzalez-Estrada, Paul A. Greenberger, Mario Sanchez Borges, Gianenrico Senna, Aziz Sheikh, Luciana Kase Tanno, Bernard Y. Thong, Paul J. Turner, Margitta Worm

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

433 Scopus citations


Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions. The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies. The rationale of this updated position document is the need to keep guidance aligned with the current state of the art of knowledge in anaphylaxis management. The World Allergy Organization (WAO) anaphylaxis guidelines were published in 2011, and the current guidance adopts their major indications, incorporating some novel changes. Intramuscular epinephrine (adrenaline) continues to be the first-line treatment for anaphylaxis. Nevertheless, its use remains suboptimal. After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management. The limited availability of epinephrine auto-injectors remains a major problem in many countries, as well as their affordability for some patients.

Original languageEnglish (US)
Article number100472
JournalWorld Allergy Organization Journal
Issue number10
StatePublished - Oct 2020


  • Acute systemic allergic reaction
  • Adrenaline
  • Anaphylaxis
  • Antihistamines
  • Cofactors
  • Drug allergy
  • Epinephrine
  • Food allergy
  • Glucocorticoids
  • Guidance
  • Guidelines
  • Venom allergy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Immunology and Allergy
  • Immunology


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