Quoc Quang Luu, Bich Tra Cao Thi, Jang Jae-Hyuk, Park Hae-Sim
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Department of Biomedical Sciences, Ajou University School of Medicine, Suwon, Korea.
Clin Exp Emerg Med. 2021 Sep;8(3):160-172. doi: 10.15441/ceem.21.121. Epub 2021 Sep 30.
Anaphylaxis is a life-threatening systemic allergic reaction presenting various clinical manifestations. Its prevalence has increased in almost all age groups and both sexes. Food, venom, and drugs are major causes in both children and adults; a higher prevalence of food-induced anaphylaxis is noted in children, while a higher prevalence of drug-induced anaphylaxis is noted in adults. The pathogenic mechanism is mediated by immunologic and nonimmunologic mechanisms, where mast cells and basophils are key cells that release mediators. A diagnosis of anaphylaxis is mainly based on clinical symptoms and physical findings; however, an increased serum tryptase level is a useful biomarker. Epinephrine is the first-line drug to treat acute symptoms, and an epinephrine auto-injector should be prescribed for each patient. Antihistamines and systemic corticosteroids are used to relieve symptoms. This review updates current issues in the management of anaphylaxis as well as the new guidelines for proper diagnosis and treatment.
过敏反应是一种危及生命的全身性过敏反应,具有多种临床表现。几乎在所有年龄组和男女中其患病率都有所上升。食物、毒液和药物是儿童和成人过敏反应的主要原因;儿童中食物诱发的过敏反应患病率较高,而成人中药物诱发的过敏反应患病率较高。其发病机制由免疫和非免疫机制介导,其中肥大细胞和嗜碱性粒细胞是释放介质的关键细胞。过敏反应的诊断主要基于临床症状和体征;然而,血清类胰蛋白酶水平升高是一种有用的生物标志物。肾上腺素是治疗急性症状的一线药物,应为每位患者开具肾上腺素自动注射器。抗组胺药和全身性皮质类固醇用于缓解症状。本综述更新了过敏反应管理中的当前问题以及正确诊断和治疗的新指南。