Aytekin Güvenir Funda, Yörüsün Gökhan, Dere Ragıp, Selmanoğlu Ahmet, Şengül Emeksiz Zeynep, Dibek Mısırlıoğlu Emine
Ankara Bilkent City Hospital, Department of Pediatric Allergy/Immunology, Ankara, Turkey.
University of Health Sciences, Department of Pediatric Allergy/Immunology, Ankara, Turkey.
World Allergy Organ J. 2024 Oct 24;17(11):100982. doi: 10.1016/j.waojou.2024.100982. eCollection 2024 Nov.
Anaphylaxis is an emergency that must be correctly recognized and treated by every health care professional. With the update of the World Allergy Organization (WAO) criteria in 2020, differences between the European Academy of Allergy and Immunology (EAACI)/The National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) and WAO criteria have come to the fore.
The aim of our study is to compare the effectiveness of these 2 criteria in diagnosing anaphylaxis in pediatric patients.
Patients aged 0-18 years who applied to Ankara Bilkent City Hospital Pediatric Immunology and Allergy Clinic between September 1, 2020 and September 1, 2023 due to systemic allergic reaction and were diagnosed with anaphylaxis were evaluated retrospectively. The clinical findings of the patients were re-evaluated accordingto WAO 2020 and NIAID/FAAN/EAACI criteria.
Included in the study were 492 patients who met the inclusion criteria. Median age was 3.8 years (IQR: 0.9-11.4). The majority of patients were male (59.6%). There were 466 patients (94.1%) diagnosed with anaphylaxis according to both NIAID/FAAN/EAACI and WAO criteria. Three patients (0.6%) with isolated laryngeal involvement and 23 (4.7%) patients with isolated respiratory findings (bronchospasm) were diagnosed only according to WAO Criterion 2, for a total of 26 patients (5.3%).
Although the majority of patients were diagnosed with both criteria, 5.3% were diagnosed only according to the WAO criteria. After contact with a suspected or known allergen, the presence of isolated respiratory or laryngeal findings without skin findings should be a warning before anaphylaxis progresses to more serious stages.
过敏反应是一种紧急情况,每位医疗保健专业人员都必须正确识别并进行治疗。随着世界过敏组织(WAO)标准在2020年的更新,欧洲变态反应和临床免疫学会(EAACI)/美国国立过敏和传染病研究所(NIAID)与食物过敏和过敏反应网络(FAAN)标准与WAO标准之间的差异已凸显出来。
我们研究的目的是比较这两种标准在诊断儿科患者过敏反应中的有效性。
对2020年9月1日至2023年9月1日因全身性过敏反应到安卡拉比尔肯特市医院儿科免疫学和过敏诊所就诊并被诊断为过敏反应的0至18岁患者进行回顾性评估。根据WAO 2020标准和NIAID/FAAN/EAACI标准对患者的临床发现进行重新评估。
纳入研究的492例患者符合纳入标准。中位年龄为3.8岁(四分位间距:0.9 - 11.4)。大多数患者为男性(59.6%)。根据NIAID/FAAN/EAACI标准和WAO标准,有466例患者(94.1%)被诊断为过敏反应。仅根据WAO标准2诊断出3例(0.6%)孤立性喉部受累患者和23例(4.7%)有孤立性呼吸道表现(支气管痉挛)的患者,共计26例(5.3%)。
尽管大多数患者根据两种标准均被诊断为过敏反应,但有5.3%的患者仅根据WAO标准被诊断。在接触疑似或已知过敏原后,在过敏反应进展到更严重阶段之前,出现无皮肤表现的孤立性呼吸道或喉部表现应予以警示。