Anaphylaxis is the most severe allergic reaction, demanding immediate management by health care providers, which is currently underdiagnosed and undertreated in China. In addition to the classic IgE-mediated pathway, non-IgE dependent pathway has also been extensively studied in the pathogenesis of anaphylaxis. Recently, the atypical symptoms induced by widespread used monoclonal antibodies and biologics have been reported. The goal of this article is to recognize the phenotypes (triggers and presentation) and understand its characteristics through endotypes (mechanisms) of anaphylaxis. Ultimately, the aim is to help allergists and health care providers guide a precision approach to diagnose and manage of anaphylaxis.
严重过敏反应（anaphylaxis）是需要紧急处理的过敏反应最危重的情况。目前在我国仍存在诊断不足和治疗不足的问题。近年来，严重过敏反应发病机制方面除了经典的IgE介导途径外，非IgE依赖的途径研究亦深入。此外，随着生物制剂如单克隆抗体的广泛使用，其诱发严重过敏反应中叠加的非典型症状也逐渐被关注。本文旨在更新认识严重过敏反应的表型（诱因和临床表现），并通过内型（发病机制）更深入了解严重过敏反应的临床特征，为变态反应专科和相关专业医师精准诊断管理严重过敏反应提供参考。.