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. Author manuscript; available in PMC: 2021 Mar 29.
Published in final edited form as: J Allergy Clin Immunol. 2020 Aug 24;146(5):1089–1096. doi: 10.1016/j.jaci.2020.08.015

TABLE III.

Clinical criteria for diagnosing persistent and biphasic nonanaphylactic reactions

Persistent allergic reactions are highly likely when the following criterion is fulfilled*:

  • Presence of symptoms and/or examination findings that do not fulfill the 2006 NIAID/FAAN anaphylaxis criteria that persist for at least 4 hours.1

Biphasic allergic reactions are highly likely when all of the following 4 criteria are fulfilled†:

  1. New or recurrent symptoms and/or examination findings do not fulfill the 2006 NIAID/FAAN anaphylaxis criteria.1

  2. The initial symptoms and/or examination findings must be completely resolved before the onset of new or recurrent symptoms and/or examination findings.

  3. There can be no allergen reexposure before the onset of new or recurrent symptoms and/or examination findings.

  4. New and/or recurrent symptoms and/or examination findings must occur within 1 to 48 hours from complete resolution of initial symptoms and/or examination findings.
*

The diagnosis of persistent allergic reaction is independent of management of the initial reaction.

†

The diagnosis of biphasic allergic reaction is independent of management of the initial reaction.