Anaphylaxis - myths and facts

Anaphylaxis, if not promptly recognised and adequately treated, can rapidly lead to death even in previously healthy individuals. At the same time, a number of myths and misconceptions persist, complicating both its diagnosis and management. It is often assumed, for example, that cutaneous manifestations such as exanthema are a defining feature of anaphylaxis and that symptoms always occur immediately following exposure to an allergen. In clinical practice, treatment is not infrequently initiated with corticosteroids and antihistamines, while adrenaline is reserved for cases of clinical deterioration. There is also a widespread belief that all patients who experience anaphylaxis must invariably be hospitalised. In the following text, we address uncertainties in the diagnosis, treatment, and organisation of care for patients with anaphylaxis. We reflect on current guideline recommendations, with an emphasis on their practical application in everyday clinical practice.