Anaphylaxis in primary care

What is anaphylaxis? NICE defines anaphylaxis as ‘a severe, lifethreatening, generalised or systemic hypersensitivity reaction’. It is characterised by rapidly developing problems involving the airway (pharyngeal or laryngeal oedema) and/or breathing (bronchospasm) and/or circulation (hypotension). Usually there are associated skin and mucosal changes (urticaria, angioedema) (Box 1). NICE also says that anaphylaxis may be an allergic response that is immunologically mediated, or a nonimmunologically mediated response, or idiopathic.[1] The commonest causes of immunoglobulin E (IgE)- mediated allergic anaphylaxis are foods (e.g., egg, milk, peanuts, tree nuts, fish, shell fish), insect venoms, some drugs and latex. Many drugs can also induce