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超越表象:探索过敏反应鉴别诊断的复杂性。

Beyond the appearances: exploring complexities in anaphylaxis differential diagnosis.

机构信息

Immunology and Allergy Unit, Mauriziano Hospital, Department of Medical Sciences, University of Turin, Turin, Italy.

出版信息

Curr Opin Allergy Clin Immunol. 2024 Oct 1;24(5):313-321. doi: 10.1097/ACI.0000000000001016. Epub 2024 Jul 24.

Abstract

PURPOSE OF REVIEW

Anaphylaxis is a severe, and potentially life-threatening hypersensitivity reaction whose diagnosis is based on clinical signs and symptoms and their prompt recognition. The presence of mimics and unusual presentations necessitate a careful evaluation and expertise in the field, due to potential diagnostic errors and hence a delay in the treatment.The aim of this review is to analyze and make an overview of the potential differential diagnosis of anaphylaxis, focusing on the clinical challenges of recognizing these conditions effectively among similar others.

RECENT FINDINGS

The presence of mimics and unusual presentations of anaphylaxis necessitate a careful evaluation, emphasizing the importance of a comprehensive diagnostic approach.Tryptase is well known marker of mast cells activation, and a useful tool assisting the diagnosis of anaphylaxis, helping to differentiate it from atypical mimickers.

SUMMARY

The differential diagnosis of anaphylaxis comprises a very wide setting, and a systematic approach assessing different categories of cardiovascular, skin, respiratory airway, neuropsychiatric, and hematologic systems, can facilitate recognition of the correct diagnosis of this complex and life-threatening condition.

摘要

目的综述

过敏反应是一种严重的、潜在危及生命的过敏反应,其诊断基于临床症状和体征,并需要迅速识别。由于潜在的诊断错误和治疗延误,需要对类似疾病进行仔细评估和专业领域的知识,以识别出过敏反应的类似表现和不典型表现。本文的目的是分析和概述过敏反应的潜在鉴别诊断,重点关注在类似疾病中有效识别这些疾病的临床挑战。

最近的发现

过敏反应的类似表现和不典型表现需要仔细评估,强调综合诊断方法的重要性。类胰蛋白酶是肥大细胞激活的标志物,是辅助诊断过敏反应的有用工具,有助于将其与非典型的类似疾病区分开来。

总结

过敏反应的鉴别诊断范围非常广泛,通过系统评估心血管、皮肤、呼吸道、神经精神和血液系统等不同类别的疾病,可以帮助识别这种复杂且危及生命的疾病的正确诊断。

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