Anafilaksi ve Anafilaksideki Gelişmeler

Year 2011, Volume: 11 Issue: 2, 43 - 53, 01.04.2011

İlknur Bostancı Mahmut Doğru

https://doi.org/10.5222/j.child.2011.043

Abstract

Anafilaksi, ani başlayan ve ölüme yol açabilen ciddi siste- mik bir hipersensitivite reaksiyonudur. Anafilaksi klinik bir acildir. Anafilaksi insidansı özellikle yaşamın ilk iki deka- dında artmaktadır. Yaygın olan tetikleyiciler besinler, ilaç- lar ve böcek sokmalarıdır. Tanısı primer olarak klinik kri- terlere dayanır. Bazı hastalarda anafilaksi tanısı kan test- leri artmış histamin ve total triptaz düzeyi gibi ile doğru- lanabilir. Fakat bu testler anafilaksi için spesifik değildir. Adrenalin anafilaksi tedavisinde ilk seçenek ilaçtır. Hastalar taburcu edilirken adrenalin otoenjektörü reçete edilmeli ve kullanımının eğitimi verilmelidir. Bu makalede anafilaksinin patogenezi, kliniği, tanı ve yeni tedavi yön- temleri sunulmuştur

Keywords

Anafilaksi, tanı, tedavi, adrenalin otoenjektör

Anaphylaxis and Advances in Anaphylaxis

Abstract

Anaphylaxis is a serious hypersensitivity reaction with a rapid onset which might eventually lead to death. Anaphylaxis is a clinical emergency. The incidence anaph- ylaxis is increasing, particularly during the first 2 decades of life. Common triggers include foods, medications, and insect stings. Its diagnosis is based primarily on clinical criteria. In some patients the clinical diagnosis of anaph- ylaxis can be confirmed by means of a blood test i.e., an increased plasma histamine or serum total tryptase level . However, these tests are not specific for anaphylaxis. Adrenaline is the first choice medication in the treatment of anaphylaxis. On discharge from hospital, an autoinjectible epinephrine should be prescribed and appropriate should be providd about its use In this review pathogenesis, clini- cal features, diagnosis and new treatment modalities of anaphylaxis were presented

Keywords

Anaphylaxis, diagnosis, treatment, adrenaline autoinjector

References

• 1. Portier MM, Richet C. De l’action anaphylactique de certains venims. Comptes Rendus des Seances Mem Soc Biol 1902;54:170-2.
• 2. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: Report of the nomenclature review committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004;113:832-6. http://dx.doi.org/10.1016/j.jaci.2003.12.591 PMid:15131563
• 3. Simons FE. Anaphylaxis. J Allergy Clin Immunol 2010;125(2 Suppl 2):161-81. http://dx.doi.org/10.1016/j.jaci.2009.12.981 PMid:20176258
• 4. Lieberman P, Camargo CA Jr, Bohlke K, Jick H, Miller RL, Sheikh A, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol 2006;97:596-602. http://dx.doi.org/10.1016/S1081-1206(10)61086-1
• 5. Decker WW, Campbell RL, Manivannan V, Luke A, St Sauver JL, Weaver A, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008;122:1161-5. http://dx.doi.org/10.1016/j.jaci.2008.09.043 PMid:18992928 PMCid:2704497
• 6. Shen Y, Li L, Grant J, Rubio A, Zhao Z, Zhang X, et al. Anaphylactic deaths in Maryland (US) and Shanghai: a review of forensic autopsy cases from 2004 to 2006. Forensic Sci Int 2009;186:1-5. http://dx.doi.org/10.1016/j.forsciint.2008.12.007 PMid:19217731
• 7. Yocum MW, Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD. Epidemiology of anaphylaxis in Olmsted County: a population-based study. J Allergy Clin Immunol 1999;104:452-6. http://dx.doi.org/10.1016/S0091-6749(99)70392-1
• 8. Lin RY, Anderson AS, Shah SN, Nurruzzaman F. Increasing anaphylaxis hospitalization in the first two decades of life: New York State, 1990-2006. Ann Allergy Asthma Immunol 2008;101:387-93. http://dx.doi.org/10.1016/S1081-1206(10)60315-8
• 9. Simons FE. Anaphylaxis: Recent advances in assessment and treatment. J Allergy Clin Immunol 2009;124(4):625-36. http://dx.doi.org/10.1016/j.jaci.2009.08.025 PMid:19815109
• 10. Moneret-Vautrin DA, Morisset M, Flabbee J, Beaudouin E, Kanny G. Epidemiology of life threatening and lethal anaphylaxis: a review. Allergy 2005;60:443-51. http://dx.doi.org/10.1111/j.1398-9995.2005.00785.x PMid:15727574
• 11. Pumphrey RS. Fatal anaphylaxis in the UK, 1992–2001. Novartis Found Symp 2004;257:116-28. http://dx.doi.org/10.1002/0470861193.ch10
• 12. Yilmaz R, Yuksekbas O, Erkol Z, Bulut ER, Arslan MN. Postmortem findings after anaphylactic reactions to drugs in Turkey. Am J Forensic Med Pathol 2009;30:346-9. http://dx.doi.org/10.1097/PAF.0b013e3181c0e7bb PMid:19901808
• 13. Ben-Shoshan M, Clarke AE. Anaphylaxis: past, present and future. Allergy 2011;66(1):1-14. http://dx.doi.org/10.1111/j.1398-9995.2010.02422.x PMid:20560905
• 14. Lieberman PL. Anaphylaxis. In: Adkinson NF Jr, Bochner BS, Busse WW, Holgate ST, Lemanske RF Jr, Simons FER, ed. Middleton’s allergy: principles and practice. 7th ed China, Elsevier, 2009:1027-49.
• 15. Sampson HA, Burks AW. Adverse reactions to foods. In: Adkinson NF Jr, Bochner BS, Busse WW, Holgate ST, Lemanske RF Jr, Simons FER, editors. Middleton’s allergy: principles and practice. 7th ed. China, Elsevier, 2009:1139- 67.
• 16. Shek LPC, Lee BW. Food allergy in Asia. Curr Opin Allergy Clin Immunol 2006;6:197-201. http://dx.doi.org/10.1097/01.all.0000225160.52650.17 PMid:16670514
• 17. Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol 2010;126(3):477-80.1-42.
• 18. Kishimoto TK, Viswanathan K, Ganguly T, Elankumaran S, Smith S, Pelzer K, et al. Contaminated heparin associated with adverse clinical events and activation of the contact system. N Engl J Med 2008;358:2457-67. http://dx.doi.org/10.1056/NEJMoa0803200 PMid:18434646
• 19. Brockow K, Romano A, Aberer W, Bircher AJ, Barbaud A, Bonadonna P, et al. Skin testing in patients with hypersensitivity reactions to iodinated contrast media-a European multicenter study. Allergy 2009;64:234-41. http://dx.doi.org/10.1111/j.1398-9995.2008.01832.x PMid:19178403
• 20. Simons FER, Peterson S, Black C. Epinephrine dispensing for out-of-hospital treatment of anaphylaxis in infants and children: a population-based study. Ann Allergy Asthma Immunol 2001;86:622-6. http://dx.doi.org/10.1016/S1081-1206(10)62289-2
• 21. Lieberman P. Epidemiology of anaphylaxis. Curr Opin Allergy Clin Immunol 2008;8:316-20. http://dx.doi.org/10.1097/ACI.0b013e3283036a69 PMid:18596588
• 22. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report – second National Institute of Allergy and Infectious Disease/ Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med 2006;47:373-80. http://dx.doi.org/10.1016/j.annemergmed.2006.01.018 PMid:16546624
• 23. Biteker M, Duran NE, Biteker FS, Civan HA, Kaya H, Gokdeniz T et al. Allergic myocardial infarction in childhood: Kounis syndrome. Eur J Pediatr 2010;169:27-9. http://dx.doi.org/10.1007/s00431-009-0965-5 PMid:19277706
• 24. Brown SG, Blackman KE, Stenlake V, Heddle RJ. Insect sting anaphylaxis; prospective evaluation of treatment with intravenous adrenaline and volume resuscitation. Emerg Med J 2004;21:149-54. http://dx.doi.org/10.1136/emj.2003.009449 PMid:14988337 PMCid:1726302
• 25. Von Hoff DD, Kuhn JG, Burris HA, Miller LJ. Does intraosseous equal intravenous? A pharmacokinetic study. Am J Emerg Med 2008;26:31-8. http://dx.doi.org/10.1016/j.ajem.2007.03.024 PMid:18082778
• 26. Lieberman P. Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol 2005;95:217-26. http://dx.doi.org/10.1016/S1081-1206(10)61217-3
• 27. Evora PR, Simon MR. Role of nitric oxide production in anaphylaxis and its relevance for the treatment of anaphylactic hypotension with methylene blue. Ann Allergy Asthma Immunol 2007;99:306-13. http://dx.doi.org/10.1016/S1081-1206(10)60545-5
• 28. Cauwels A, Janssen B, Buys E, Sips P, Brouckaert P. Anaphylactic shock depends on PI3K and eNOS-derived NO. J Clin Invest 2006;116:2244-51. http://dx.doi.org/10.1172/JCI25426 PMid:16886062 PMCid:1523420