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过敏反应婴儿识别、诊断和管理指南:专家共识。

Guiding Principles for the Recognition, Diagnosis, and Management of Infants with Anaphylaxis: An Expert Panel Consensus.

机构信息

Section of Allergy and Immunology, Food Challenge and Research Unit, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo.

Departments of Pediatrics and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.

出版信息

J Allergy Clin Immunol Pract. 2019 Apr;7(4):1148-1156.e5. doi: 10.1016/j.jaip.2018.10.052. Epub 2019 Feb 5.

Abstract

Infant anaphylaxis is an emerging risk, with food allergy the most common cause. Although the presentation of anaphylaxis involves the same systems as in older children and adults, there are real-world challenges to identifying symptoms of an allergic emergency in nonverbal children, as well as implementing optimal treatment. Recognition of anaphylaxis in infants can be challenging because allergic symptoms and certain normal infant behaviors may overlap. Intramuscular epinephrine is the treatment of choice for infants, as it is for older children and adults, and an epinephrine autoinjector approved by the Food and Drug Administration is now available for infants weighing between 7.5 and 15 kg. A panel of experts sought to develop guiding principles for the recognition, diagnosis, and management of anaphylaxis in infants, and provide a framework for the development of new guidelines and future research. Accordingly, anaphylaxis emergency action planning for infants was addressed by the panel. In considering formation of future infant anaphylaxis guidelines, health care providers should be aware of the needs to improve the recognition, diagnosis, and management of infants with anaphylaxis. Future research should identify and validate clinical criteria for the diagnosis of anaphylaxis in infants, as well as risk factors for the most severe reactions.

摘要

婴儿过敏反应是一个新出现的风险,食物过敏是最常见的原因。虽然过敏反应的表现与年龄较大的儿童和成人相同,但在无法言语的儿童中识别过敏紧急症状并实施最佳治疗存在实际挑战,因为过敏症状和某些正常婴儿行为可能会重叠。由于过敏症状和某些正常婴儿行为可能会重叠,因此识别婴儿过敏反应具有挑战性。与年龄较大的儿童和成人一样,婴儿也首选肌肉内肾上腺素治疗,现在有经过食品和药物管理局批准的肾上腺素自动注射器可用于体重在 7.5 至 15 公斤之间的婴儿。一组专家试图制定指导原则,用于识别、诊断和管理婴儿过敏反应,并为制定新指南和未来研究提供框架。因此,专家组解决了婴儿过敏反应紧急行动计划。在考虑制定未来婴儿过敏反应指南时,医疗保健提供者应认识到需要改善对过敏反应婴儿的识别、诊断和管理。未来的研究应确定和验证用于诊断婴儿过敏反应的临床标准,以及最严重反应的危险因素。

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