University of Virginia School of Medicine, Department of Emergency Medicine, Charlottesville, VA.
Associate Professor of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA.
Emerg Med Pract. 2022 Jul;24(7):1-24. Epub 2022 Jul 1.
An acute allergic reaction is a rapid-onset, IgE-mediated hypersensitivity reaction. Although it is most commonly caused by food, insect stings, and medications, there are many additional causes. Symptoms can range from mild urticaria and swelling, to abdominal cramping, to respiratory collapse. Anaphylaxis and anaphylactic shock are the most severe, life-threatening forms of allergic reaction, with fast onset and decompensation, requiring urgent airway monitoring and support. This issue reviews the current evidence on managing allergy and anaphylaxis with epinephrine, and reviews the evidence on corticosteroids, antihistamines, and other adjunctive therapies. Guidelines are reviewed to offer assistance with grading of symptoms, which can help determine treatment and disposition. Biphasic reactions and allergic reactions caused by alpha-gal, scombroid poisoning, and Kounis syndrome are also reviewed.
急性过敏反应是一种快速发作的 IgE 介导的过敏反应。虽然它最常见于食物、昆虫叮咬和药物，但还有许多其他原因。症状范围从轻度荨麻疹和肿胀，到腹痛，到呼吸衰竭。过敏反应和过敏性休克是最严重的、危及生命的过敏反应形式，具有快速发作和代偿失调的特点，需要紧急气道监测和支持。本问题回顾了使用肾上腺素治疗过敏和过敏反应的现有证据，并回顾了皮质类固醇、抗组胺药和其他辅助治疗的证据。审查了指南，以帮助对症状进行分级，这有助于确定治疗和处置方法。还回顾了双相反应和由α-半乳糖、鲭鱼中毒和 Kounis 综合征引起的过敏反应。
