Urticaria is a common disease with marked effects on QOL. The lifetime prevalence of 8.8% for urticaria must be regarded as a lower limit as it is based on conservative prevalence rate calculations, and under-reporting of previous disease can be expected in a questionnaire-based study.

The study gives for the first time information about the point prevalence of both immunological and nonimmunological adverse reactions to food and underlines the relevance of this issue in public health. The data also show that an individualized stepwise approach including provocation tests is mandatory to confirm the diagnosis.

The results of this large pan-European study demonstrate for the first time sensitization patterns for different inhalant allergens in patients across Europe. The standardized skin prick test with the standardized allergen battery should be recommended for clinical use and research. Further EU-wide monitoring of sensitization patterns is urgently needed.

The perception of food-related symptoms is common among children and adolescents from the general population. Self-reports could be confirmed in around one out of 10 individuals, still resulting in 4.2% of proven clinical symptoms. However, most reactions were mild and mainly because of pollen-associated FA, while NAFH reactions were less common. Severe IgE-mediated FA was observed in individuals with pre-existing atopic disease, who should be fully investigated for clinically relevant FA.

Background: Anaphylaxis is the most severe manifestation of an IgE-dependent allergy. Standardized acquired clinical data from large cohorts of well-defined cases are not available. The aim of this study was to analyse the symptom profile and risk factors of anaphylaxis in a large Central European cohort. Methods: We acquired data from patients in Germany, Austria and Switzerland who experienced a severe allergic reaction defined by the onset of severe pulmonary and/or severe cardiovascular symptoms. The data were gained via an online questionnaire from 83 medical centres specialized in allergy. Data were collected from 2006 to 2010 and analysed by using a multinomial regression model. Results: A total of 2012 paediatric and adult patients were included into the present analysis. The skin (84%) was the most frequently affected organ followed by the cardiovascular (72%) and the respiratory (68%) system. The regression model analysing the onset of cardiovascular versus respiratory symptoms revealed a strong impact of age (adjusted OR = 6.08; 95% CI, 3.35-11.01; P < 0.001). Furthermore, the elicitor food (adjusted OR = 0.29; 95% CI, 0.21-0.41, P < 0.001) and the presence of atopic diseases (adjusted OR = 0.54; 95% CI, 0.40-0.73, P < 0.001) were significantly associated with the onset of respiratory symptoms. Conclusion: Data from individuals who experienced anaphylaxis can support the identification of risk factors. The present study indicates that age, the elicitor itself and the presence of atopic diseases have an impact on the symptom profile of anaphylaxis. Identifying further risk factors of anaphylaxis is of significant importance for clinical practice in the future.Anaphylaxis is defined as a serious hypersensitivity reaction that is rapid in onset and may cause death (1, 2). The incidence rate of anaphylaxis varies from 7.9 to 49.8 per 10 000 personyears depending on the region, but more importantly on the definition and inclusion criteria applied (3-5). The literature citing the causes of anaphylaxis indicates that drugs, insect venom and food are the most frequent triggers (6, 7). Anaphylaxis can present with various clinical symptoms involving different organ systems including the skin, gastrointestinal and respiratory tract and the cardiovascular system. The involvement of the skin is most frequent and has been documented in 80-90% of reported episodes (8,9). The respiratory tract is affected in up to 70% of patients, and the cardiovascular system and the gastrointestinal tract have been reported to be less Abbreviations aOR(s) adjusted odds ratio(s); CI confidence interval; CVD cardiovascular diseases; ENT ear, nose and throat; IgE immunoglobulin E; SD standard deviation. Allergy 67 (2012) 691-698 © 2012 John Wiley & Sons A/S 691 Allergy Allergy 67 (2012) 691-698

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