Recent findings from the anaphylaxis registry: Where are we, where do we want to go?

The anaphylaxis registry collects structured data across Europe regarding elicitors, accompanying circumstances and other diseases as well as the treatment of severe allergic reactions. By March 2024, 16,988 cases had been registered, of which ~ 1/3 were children and 2/3 were adults. Among children, boys are most frequent affected, while among adults, women are most frequently affected. The most common elicitors depend on age and continue to be dominated by the food allergens in children and by insect venom in adults. The occurrence of anaphylaxis without skin symptoms is not uncommon and occurs in children in the range of 5%, regardless of the trigger, while in adults the frequency is generally higher (up to 15%) and there are trigger-dependent differences. The analysis of the rare food allergens that trigger anaphylaxis shows, for example, spices such as saffron and sumac and vegetables such as chicory or spring onions. One case was elicited by a mealworm. Food shows an increase in triggering anaphylaxis in children. The trigger spectrum of foods is large and relevant due to the increasing plant-based diets. Rare allergens can cause anaphylaxis and should be further considered and monitored in the coming years to determine their frequency as triggers of severe reactions.