Cardinale Fabio, Amato Doriana, Mastrototaro Maria Felicia, Caffarelli Carlo, Crisafulli Giuseppe, Franceschini Fabrizio, Liotti Lucia, Caimmi Silvia, Bottau Paolo, Saretta Francesca, Mori Francesca, Bernardini Roberto
UOC di Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera-Universitaria "Consorziale-Policlinico", Ospedale Pediatrico Giovanni XXIII, Bari, Italy.
Acta Biomed. 2019 Jan 30;90(3-S):30-35. doi: 10.23750/abm.v90i3-S.8172.
Anaphylaxis represents one of the most frequent medical emergencies in childhood. However, as compared to adults, drugs are less common triggers of anaphylaxis in children, with a frequency which is increasing from infancy to adolescence. Deaths seldom occur, maybe because of the paucity of comorbidities in children. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are the main elicitors in drug-induced anaphylaxis in children. Both immune-mediated (mainly IgE-mediated) and non immune-mediated may be involved. IgG-mediated and complement-mediated mechanisms has been also hypothesized. Correct management relies on a right diagnosis and prompt therapy. A proper work-up is also important to prevent further potentially fatal re-exposures to the same drug or other structurally similar molecules but also unnecessary avoidance of medications not representing the culprit of the episode.
过敏反应是儿童时期最常见的医疗紧急情况之一。然而,与成人相比,药物引发儿童过敏反应的情况较少见,且从婴儿期到青春期,其发生频率呈上升趋势。儿童很少因过敏反应死亡,这可能是因为儿童合并症较少。抗生素和非甾体抗炎药(NSAIDs)是儿童药物性过敏反应的主要诱发因素。免疫介导(主要是IgE介导)和非免疫介导机制都可能参与其中。也有人推测存在IgG介导和补体介导机制。正确的处理依赖于正确的诊断和及时的治疗。进行适当的检查对于防止再次接触同一药物或其他结构相似分子而可能导致的潜在致命后果也很重要,同时也能避免不必要地停用并非此次过敏发作元凶的药物。