Table 1

Brighton criteria for anaphylaxis14

Organ systemsMajor criteriaMinor criteria
Dermatological or mucosal
  • Generalised urticaria (hives) or generalised erythema

  • Angioedema (not hereditary), localised or generalised

  • Generalised pruritus with skin rash

  • Generalised pruritus without skin rash

  • Generalised prickle sensation

  • Localised injection site urticarial

  • Red and itchy eyes

Cardiovascular
  • Measured hypotension

  • Clinical diagnosis of uncompensated shock indicated by at least three of the following:

    • Tachycardia

    • Capillary refill >3 s

    • Reduced central pulse volume

    • Decrease level or loss of consciousness

  • Reduced peripheral circulation as indicted by the combination of at least two of:

    • Tachycardia

    • A capillary refill time of >3 s without hypotension

    • A decreased level of consciousness

Respiratory
  • Bilateral wheeze (bronchospasm)

  • Stridor

  • Upper airway swelling (lip, tongue, throat, uvula or larynx)

  • Respiratory distress, defined by two or more of the following:

    • Tachypnoea

    • Increased use of respiratory muscles

    • Recession

    • Cyanosis

    • Grunting

  • Persistent dry cough

  • Hoarse voice

  • Difficulty breathing without wheeze or stridor

  • Sensation of throat closure

  • Sneezing, rhinorrhoea

Gastrointestinal
  • Diarrhoea

  • Abdominal pain

  • Nausea

  • Vomiting

LaboratoryMast cell tryptase elevation >upper normal limit