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Current Approach to the Diagnosis and Management of Anaphylaxis in Children

Yıl 2018, Cilt: 10 Sayı: 2, 18 - 26, 06.03.2018

Öz

Abstract

Anaphylaxis is a serious allergic reaction that is rapid in onset and maycause death. Its prevelance has increased dramatically throughout the world over thelast two decades. Although anaphylaxis is a clinical diagnosis, there are no specificsigns or symptoms that are diagnostic for anaphylaxis. Further, there is no gold standard laboratory test that can confirm the diagnosis in the acute phase and can be usedin routine practice. Although improved clinical diagnostic criteria have contributed significantly to the resolution of diagnostic problems, diagnosis of many cases canstill be missed in clinical practice. Anaphylaxis is a medical emergency and the only lifesaving treatment is adrenaline. The most important cause of anaphylaxis related death is no or delayed administration of adrenaline. Adrenaline should be administered without any loss of time in any patient who meets the diagnostic criteria for anaphylaxis. Antihistamines and corticosteroids should never be used instead of adrenaline. Every patient should have a certain follow-up time. Patients and/or parents should be instructed for trigger avoidance/prevention before discharge, emergency preparedness should be completed and allergists shouldbe consulted for long-term follow-up.

Kaynakça

  • Kaynaklar 1.Orhan F, Civelek E, Sahiner UM, Arga M, et al. Anaphyla-xis: Turkish National Guideline 2018. Asthma Allergy Immu-nol 2018; 16 (Suppl 1):1-62. 2.Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, et al.Anaphylaxis--a practice parameter update 2015. Ann AllergyAsthma Immunol. 2015 Nov;115(5):341-84. 3.Simons FE, Ardusso LR, Dimov V, Ebisawa M, et al; WorldAllergy Organization. World Allergy Organization Anaphy-laxis Guidelines: 2013 update of the evidence base. Int ArchAllergy Immunol. 2013;162(3):193-204. 4.Muraro A, Roberts G, Worm M, Bilò MB, et al; EAACI FoodAllergy and Anaphylaxis Guidelines Group. Anaphylaxis: gui-delines from the European Academy of Allergy and ClinicalImmunology. Allergy. 2014 Aug;69(8):1026-45. 5.Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010;125(2Suppl 2):S161-81. 6.Simons FER. Anaphylaxis. In: Leung DYM, Szefler SJ, Bonil-la FA, Akdis CA, Sampson HA (eds). Pediatric Allergy Prin-ciples and Practice. 3rd edition. Philadelphia: Saunders Els-evier, 2016:371-76. 7.Brown GA, Kemp SF, Lieberman PL. Anapyhylaxis. In: Ad-kinson NF Jr, Bochner BS, editors. Middleton’s Allergy: principles and practice. 8th ed. Philadelphia: Saunders, Inc; 2014;1237-60. 8.Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiologyof anaphylaxis: findings of the American College of Allergy, Asth-ma and Immunology Epidemiology of Anaphylaxis Working Gro-up. Ann Allergy Asthma Immunol. 2006;97(5):596-602. 9.Liew WK, Williamson E, Tang ML. Anaphylaxis fatalities andadmissions in Australia. J Allergy Clin Immunol.2009;123(2):434-42. 10.Panesar SS, Javad S, de Silva D, Nwaru BI, et al; EAACI FoodAllergy and Anaphylaxis Group. The epidemiology of anaphy-laxis in Europe: a systematic review. Allergy. 2013Nov;68(11):1353-61. 11.Pumphrey RS, Roberts IS. Postmortem findings after fatalanaphylactic reactions. J Clin Pathol. 2000;53(4):273-6. 12.Simons FE. Anaphylaxis in infants: can recognition and ma-nagement be improved? J Allergy Clin Immunol.2007;120(3):537-40. 13.Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NFJr, Bock SA, Branum A, et al. Second symposium on the de-finition and management of anaphylaxis: summary report--Second National Institute of Allergy and InfectiousDisease/Food Allergy and Anaphylaxis Network symposium.J Allergy Clin Immunol. 2006;117(2):391-7 14.Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM,Greenberger PA, et al. International Consensus on drug al-lergy. Allergy 2014;69:420-37. 15.Mirakian R, Ewan PW, Durham SR, Youlten LJ, Dugué P, Fri-edmann PS et al; BSACI. BSACI guidelines for the manage-ment of drug allergy. Clin Exp Allergy. 2009;39:43-61. 16.Golden DB, Demain J, Freeman T, Graft D, Tankersley M,Tracy J, et al. Stinging insect hypersensitivity: A practice pa-rameter update 2016. Ann Allergy Asthma Immunol.2017;118:28-54. 17.González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA.Anaphylaxis epidemiology in patients with and patients wit-hout asthma: a United Kingdom database review. González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA. J Allergy ClinImmunol. 2010;125(5):1098-1104. 18.Müller UR, Haeberli G. Use of beta-blockers during immu-notherapy for Hymenoptera venom allergy. J Allergy Clin Im-munol. 2005;115(3):606-10. 19.Lee S, Bashore C, Lohse CM, Bellolio MF, et al. Rate of re-current anaphylaxis and associated risk factors among Olms-ted County, Minnesota, residents: A population-based study.Ann Allergy Asthma Immunol. 2016;117(6):655-660. 20.Bock SA, Muñoz-Furlong A, Sampson HA. Further fatalitiescaused by anaphylactic reactions to food, 2001-2006. J AllergyClin Immunol.2007;119(4):1016-8. 21.Simons FE, Sampson HA. Anaphylaxis: Unique aspects of cli-nical diagnosis and management in infants (birth to age 2 ye-ars). J Allergy Clin Immunol. 2015;135(5):1125-31. 22.Greenberger PA, Rotskoff BD, Lifschultz B. Fatal anaphyla-xis: postmortem findings and associated comorbid diseases.Ann Allergy Asthma Immunol. 2007;98:252-257. 23.Campbell RL, Li JT, Nicklas RA, Sadosty AT; Members of theJoint Task Force; Practice Parameter Workgroup. Emergencydepartment diagnosis and treatment of anaphylaxis: a prac-tice parameter. Ann Allergy Asthma Immunol.2014;113(6):599-608. 24.Sicherer SH, Simons FER; SECTION ON ALLERGY AND IM-MUNOLOGY. Epinephrine for First-aid Management ofAnaphylaxis. Pediatrics. 2017;139(3). pii: e20164006. 25.Ko BS, Kim WY, Ryoo SM, Ahn S, et al. Biphasic reactions inpatients with anaphylaxis treated with corticosteroids. AnnAllergy Asthma Immunol. 2015;115(4):312-6. 26.Lee S, Sadosty AT, Campbell RL. Update on biphasic anaphy-laxis. Curr Opin Allergy Clin Immunol. 2016;16(4):346-51. 27.Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Fer-nández Rivas M, et al; EAACI Food Allergy and Anaphyla-xis Guidelines Group. Anaphylaxis: guidelines from the Eu-ropean Academy of Allergy and Clinical Immunology. Allergy.2014;69:1026-45. 28.Muraro A, Agache I, Clark A, Sheikh A, Roberts G, Akdis CA,et al; European Academy of Allergy and Clinical Immunology.EAACI food allergy and anaphylaxis guidelines: managing pa-tients with food allergy in the community. Allergy.2014;69:1464-72. 29.Çelik GE. Türkiye Ulusal Allerji ve İmmünoloji Derneği İlaçAşırı Duyarlılık Reaksiyonlarına Yaklaşım, Ulusal Rehber,2014. Bilimsel Tıp Yayınevi, Ankara, Basım Yılı:2014 30.O'Keefe A, Clarke A, St Pierre Y, Mill J, et al. The Risk of Re-current Anaphylaxis. J Pediatr. 2017;180:217-221. 31.Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY,Worm M, Tanno LK, et al. 2015 update of the evidence base:World Allergy Organization anaphylaxis guidelines. World Al-lergy Organ J. 2015 28;8:32. 32.Wang J, Sicherer SH; SECTION ON ALLERGY AND IMMU-NOLOGY. Guidance on Completing a Written Allergy andAnaphylaxis Emergency Plan. Pediatrics. 2017;139(3). pii:e20164005

Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım

Yıl 2018, Cilt: 10 Sayı: 2, 18 - 26, 06.03.2018

Öz

Öz

Anafilaksi, yaşamı tehdit eden ve ölümle sonuçlanabilen ani başlangıçlı sistemik aşırı duyarlılık reaksiyonudur. Anafilaksi sıklığı son yirmi yılda tüm dünya genelinde önemli oranda artmıştır. Anafilaksi klinik bir tanı olmasına rağmen ortaya çıkanhiçbir belirti ve bulgu anafilaksiye özgün değildir. Aynı zamanda akut dönemde tanıyı doğrulayabilecek ve rutin pratikte kullanılabilecek altın standart bir laboratuvar testte yoktur. Geliştirilmiş klinik tanı kriterleri tanısal sorunların çözümüne önemli oranda katkıda bulunmuş olsa da halen klinik pratikte birçok olgunun tanısı atlanabilmektedir. Anafilaksi tedavisi acil bir durumdur ve tek hayat kurtarıcı tedavi adrenalindir. Anafilaksiye bağlı ölümler için bilinen en önemli neden adrenalinin uygulanmaması ya da geç uygulanmasıdır. Bu nedenle anafilaksi tanı kriterlerini karşılayan her hastada adrenalin vakit kaybedilmeden uygulanmalıdır. Antihistaminler ve kortikosteroidler hiçbir zaman adrenalin yerine kullanılmamalıdır. Mutlaka her hastanın bir izlem süresi olmalıdır. Taburcu edilmeden önce hasta ve/veya ebeveynlere tetikleyicilerden kaçınma/korunma yöntemleri anlatılmalı, acil durum hazırlığı tamamlanmalı ve uzun süreli izlem için allerji kliniklerine konsülte edilmelidir.

Kaynakça

  • Kaynaklar 1.Orhan F, Civelek E, Sahiner UM, Arga M, et al. Anaphyla-xis: Turkish National Guideline 2018. Asthma Allergy Immu-nol 2018; 16 (Suppl 1):1-62. 2.Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, et al.Anaphylaxis--a practice parameter update 2015. Ann AllergyAsthma Immunol. 2015 Nov;115(5):341-84. 3.Simons FE, Ardusso LR, Dimov V, Ebisawa M, et al; WorldAllergy Organization. World Allergy Organization Anaphy-laxis Guidelines: 2013 update of the evidence base. Int ArchAllergy Immunol. 2013;162(3):193-204. 4.Muraro A, Roberts G, Worm M, Bilò MB, et al; EAACI FoodAllergy and Anaphylaxis Guidelines Group. Anaphylaxis: gui-delines from the European Academy of Allergy and ClinicalImmunology. Allergy. 2014 Aug;69(8):1026-45. 5.Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010;125(2Suppl 2):S161-81. 6.Simons FER. Anaphylaxis. In: Leung DYM, Szefler SJ, Bonil-la FA, Akdis CA, Sampson HA (eds). Pediatric Allergy Prin-ciples and Practice. 3rd edition. Philadelphia: Saunders Els-evier, 2016:371-76. 7.Brown GA, Kemp SF, Lieberman PL. Anapyhylaxis. In: Ad-kinson NF Jr, Bochner BS, editors. Middleton’s Allergy: principles and practice. 8th ed. Philadelphia: Saunders, Inc; 2014;1237-60. 8.Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiologyof anaphylaxis: findings of the American College of Allergy, Asth-ma and Immunology Epidemiology of Anaphylaxis Working Gro-up. Ann Allergy Asthma Immunol. 2006;97(5):596-602. 9.Liew WK, Williamson E, Tang ML. Anaphylaxis fatalities andadmissions in Australia. J Allergy Clin Immunol.2009;123(2):434-42. 10.Panesar SS, Javad S, de Silva D, Nwaru BI, et al; EAACI FoodAllergy and Anaphylaxis Group. The epidemiology of anaphy-laxis in Europe: a systematic review. Allergy. 2013Nov;68(11):1353-61. 11.Pumphrey RS, Roberts IS. Postmortem findings after fatalanaphylactic reactions. J Clin Pathol. 2000;53(4):273-6. 12.Simons FE. Anaphylaxis in infants: can recognition and ma-nagement be improved? J Allergy Clin Immunol.2007;120(3):537-40. 13.Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NFJr, Bock SA, Branum A, et al. Second symposium on the de-finition and management of anaphylaxis: summary report--Second National Institute of Allergy and InfectiousDisease/Food Allergy and Anaphylaxis Network symposium.J Allergy Clin Immunol. 2006;117(2):391-7 14.Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM,Greenberger PA, et al. International Consensus on drug al-lergy. Allergy 2014;69:420-37. 15.Mirakian R, Ewan PW, Durham SR, Youlten LJ, Dugué P, Fri-edmann PS et al; BSACI. BSACI guidelines for the manage-ment of drug allergy. Clin Exp Allergy. 2009;39:43-61. 16.Golden DB, Demain J, Freeman T, Graft D, Tankersley M,Tracy J, et al. Stinging insect hypersensitivity: A practice pa-rameter update 2016. Ann Allergy Asthma Immunol.2017;118:28-54. 17.González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA.Anaphylaxis epidemiology in patients with and patients wit-hout asthma: a United Kingdom database review. González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA. J Allergy ClinImmunol. 2010;125(5):1098-1104. 18.Müller UR, Haeberli G. Use of beta-blockers during immu-notherapy for Hymenoptera venom allergy. J Allergy Clin Im-munol. 2005;115(3):606-10. 19.Lee S, Bashore C, Lohse CM, Bellolio MF, et al. Rate of re-current anaphylaxis and associated risk factors among Olms-ted County, Minnesota, residents: A population-based study.Ann Allergy Asthma Immunol. 2016;117(6):655-660. 20.Bock SA, Muñoz-Furlong A, Sampson HA. Further fatalitiescaused by anaphylactic reactions to food, 2001-2006. J AllergyClin Immunol.2007;119(4):1016-8. 21.Simons FE, Sampson HA. Anaphylaxis: Unique aspects of cli-nical diagnosis and management in infants (birth to age 2 ye-ars). J Allergy Clin Immunol. 2015;135(5):1125-31. 22.Greenberger PA, Rotskoff BD, Lifschultz B. Fatal anaphyla-xis: postmortem findings and associated comorbid diseases.Ann Allergy Asthma Immunol. 2007;98:252-257. 23.Campbell RL, Li JT, Nicklas RA, Sadosty AT; Members of theJoint Task Force; Practice Parameter Workgroup. Emergencydepartment diagnosis and treatment of anaphylaxis: a prac-tice parameter. Ann Allergy Asthma Immunol.2014;113(6):599-608. 24.Sicherer SH, Simons FER; SECTION ON ALLERGY AND IM-MUNOLOGY. Epinephrine for First-aid Management ofAnaphylaxis. Pediatrics. 2017;139(3). pii: e20164006. 25.Ko BS, Kim WY, Ryoo SM, Ahn S, et al. Biphasic reactions inpatients with anaphylaxis treated with corticosteroids. AnnAllergy Asthma Immunol. 2015;115(4):312-6. 26.Lee S, Sadosty AT, Campbell RL. Update on biphasic anaphy-laxis. Curr Opin Allergy Clin Immunol. 2016;16(4):346-51. 27.Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Fer-nández Rivas M, et al; EAACI Food Allergy and Anaphyla-xis Guidelines Group. Anaphylaxis: guidelines from the Eu-ropean Academy of Allergy and Clinical Immunology. Allergy.2014;69:1026-45. 28.Muraro A, Agache I, Clark A, Sheikh A, Roberts G, Akdis CA,et al; European Academy of Allergy and Clinical Immunology.EAACI food allergy and anaphylaxis guidelines: managing pa-tients with food allergy in the community. Allergy.2014;69:1464-72. 29.Çelik GE. Türkiye Ulusal Allerji ve İmmünoloji Derneği İlaçAşırı Duyarlılık Reaksiyonlarına Yaklaşım, Ulusal Rehber,2014. Bilimsel Tıp Yayınevi, Ankara, Basım Yılı:2014 30.O'Keefe A, Clarke A, St Pierre Y, Mill J, et al. The Risk of Re-current Anaphylaxis. J Pediatr. 2017;180:217-221. 31.Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY,Worm M, Tanno LK, et al. 2015 update of the evidence base:World Allergy Organization anaphylaxis guidelines. World Al-lergy Organ J. 2015 28;8:32. 32.Wang J, Sicherer SH; SECTION ON ALLERGY AND IMMU-NOLOGY. Guidance on Completing a Written Allergy andAnaphylaxis Emergency Plan. Pediatrics. 2017;139(3). pii:e20164005
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm makale
Yazarlar

Doç. Dr. Mustafa Arga

Yayımlanma Tarihi 6 Mart 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 10 Sayı: 2

Kaynak Göster

APA Arga, D. D. M. (2018). Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım. Klinik Tıp Pediatri Dergisi, 10(2), 18-26.
AMA Arga DDM. Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım. Pediatri. Mart 2018;10(2):18-26.
Chicago Arga, Doç. Dr. Mustafa. “Çocuklarda Anafilaksi’nin Tanı Ve Tedavisine Güncel Yaklaşım”. Klinik Tıp Pediatri Dergisi 10, sy. 2 (Mart 2018): 18-26.
EndNote Arga DDM (01 Mart 2018) Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım. Klinik Tıp Pediatri Dergisi 10 2 18–26.
IEEE D. D. M. Arga, “Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım”, Pediatri, c. 10, sy. 2, ss. 18–26, 2018.
ISNAD Arga, Doç. Dr. Mustafa. “Çocuklarda Anafilaksi’nin Tanı Ve Tedavisine Güncel Yaklaşım”. Klinik Tıp Pediatri Dergisi 10/2 (Mart 2018), 18-26.
JAMA Arga DDM. Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım. Pediatri. 2018;10:18–26.
MLA Arga, Doç. Dr. Mustafa. “Çocuklarda Anafilaksi’nin Tanı Ve Tedavisine Güncel Yaklaşım”. Klinik Tıp Pediatri Dergisi, c. 10, sy. 2, 2018, ss. 18-26.
Vancouver Arga DDM. Çocuklarda Anafilaksi’nin Tanı ve Tedavisine Güncel Yaklaşım. Pediatri. 2018;10(2):18-26.