Anagnostou Katherine
Department of Pediatrics, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Feigin Center, 1102 Bates Avenue, Suite 330, MS: BCM320, Houston, Texas, 77030, United States.
Curr Pediatr Rev. 2018;14(3):180-186. doi: 10.2174/1573396314666180507115115.
Anaphylaxis is defined as a serious, generalized or systemic allergic reaction that is rapid in onset and may cause death. It is unpredictable and can be the result of various allergic triggers including food, insect venom and medication. The European Anaphylaxis Registry confirmed food as the major elicitor of anaphylaxis in children, specifically hen's egg, cow's milk and nuts.
It has been reported that the incidence of anaphylaxis is on the rise. In the US, there is a continued trend of increasing food-induced anaphylaxis hospitalizations among children, which is supported by nationally representative data.
Anaphylaxis can occur both in the home and outdoors and can be life-threatening, however, fatalities are a rare occurrence. A recent systematic review and meta-analysis reported that fatal food anaphylaxis is rarer than accidental death in the general population. Studies of fatal and near-fatal allergic reactions have identified potential risk factors for fatalities and have provided important information that may help minimize future risk. Following confirmation of the relevant allergen trigger, prevention of anaphylaxis is through strict avoidance of the allergen and optimal management of existing co-morbidities. The cornerstone in the successful management of anaphylaxis is early recognition of signs and symptoms and the prompt administration of intramuscular adrenaline.
Patients and their families need to be well educated on how to manage potential anaphylactic reactions with training in the use of adrenaline auto-injectors and personalized emergency management plans. Healthcare professionals must be familiar with this clinical emergency and able to respond to anaphylaxis in a timely and appropriate manner.
过敏反应被定义为一种严重的、全身性或系统性的过敏反应，起病迅速，可能导致死亡。它不可预测，可能由各种过敏诱因引起，包括食物、昆虫毒液和药物。欧洲过敏反应登记处证实，食物是儿童过敏反应的主要诱因，尤其是鸡蛋、牛奶和坚果。
据报道，过敏反应的发病率正在上升。在美国，儿童因食物引起的过敏反应住院人数持续增加，这一趋势得到了全国代表性数据的支持。
过敏反应可在家中或户外发生，可能危及生命，然而，死亡情况较为罕见。最近一项系统综述和荟萃分析报告称，致命性食物过敏反应比一般人群中的意外死亡更为罕见。对致命和近乎致命的过敏反应的研究已经确定了死亡的潜在风险因素，并提供了可能有助于将未来风险降至最低的重要信息。在确认相关过敏原诱因后，预防过敏反应的方法是严格避免接触过敏原，并对现有的合并症进行最佳管理。成功管理过敏反应的关键是早期识别症状和体征，并及时注射肾上腺素。
需要对患者及其家属进行关于如何通过使用肾上腺素自动注射器培训和个性化应急管理计划来应对潜在过敏反应的充分教育。医疗保健专业人员必须熟悉这种临床急症，并能够及时、适当地应对过敏反应。
