Arıkoğlu Tuğba, Ozhan Aylin Kont, Kuyucu Semanur
Department of Pediatric Allergy and Immunology, Faculty of Medicine, Mersin University, Mersin, Turkey.
Curr Pharm Des. 2023;29(3):209-223. doi: 10.2174/1381612829666221021154032.
Although an increase in the incidence of childhood anaphylaxis has been reported, it remains underdiagnosed. Foods are the most common triggers for anaphylaxis, particularly cow's milk, hen's egg, and nuts. Other common causes of anaphylaxis in children and adolescents include venom and drugs. The skin is the most commonly affected organ, but approximately 10% of patients with anaphylaxis may present without skin symptoms, which can lead to misdiagnosis. Recognition of anaphylaxis is a great challenge in children, possibly due to a lack of vigilance among patients, caregivers, and healthcare professionals, but also in part due to discrepancies in the clinical definition of anaphylaxis. In addition, anaphylaxis in infants often poses a distinct challenge because the wide spectrum of clinical manifestations and the inability of infants to describe their symptoms may hinder prompt diagnosis and treatment. Given the rapid onset of anaphylaxis and its unpredictable severity, rapid assessment and appropriate treatment are critical. Although the morbidity and mortality associated with anaphylaxis are potentially preventable with the timely administration of life-saving epinephrine, anaphylaxis is still undertreated worldwide. Long-term management of pediatric anaphylaxis is a patientcentered, multidimensional approach that focuses on the recognition of anaphylaxis, the use of epinephrine auto- injectors, and prevention of recurrences. Therefore, close communication and collaboration between the child, caregivers, healthcare professionals, and schools are the cornerstone of long-term care. This paper is designed to provide a comprehensive overview of current perspectives and concepts related to anaphylaxis in the pediatric population in light of recent guidelines and literature.
尽管已有报道称儿童过敏反应的发病率有所上升,但该病仍未得到充分诊断。食物是过敏反应最常见的诱因,尤其是牛奶、鸡蛋和坚果。儿童和青少年过敏反应的其他常见原因包括毒液和药物。皮肤是最常受影响的器官,但约10%的过敏反应患者可能没有皮肤症状,这可能导致误诊。识别过敏反应对儿童来说是一项巨大挑战,这可能是由于患者、护理人员和医护人员缺乏警惕性,但部分原因也是过敏反应的临床定义存在差异。此外,婴儿过敏反应往往带来独特挑战,因为临床表现范围广泛且婴儿无法描述自身症状,这可能会妨碍及时诊断和治疗。鉴于过敏反应起病迅速且严重程度不可预测,快速评估和适当治疗至关重要。尽管及时注射救命的肾上腺素可潜在预防与过敏反应相关的发病率和死亡率,但全球范围内过敏反应的治疗仍不足。儿科过敏反应的长期管理是以患者为中心的多维度方法,重点在于识别过敏反应、使用肾上腺素自动注射器以及预防复发。因此,儿童、护理人员、医护人员和学校之间的密切沟通与协作是长期护理的基石。本文旨在根据近期指南和文献,全面概述儿科人群过敏反应的当前观点和概念。