Çocuklarda Anafilaksi: Nedir? Ne Değildir?

Yıl 2020, Cilt: 12 Sayı: 2, 103 - 113, 01.04.2020

Mustafa Arga Erdem Topal

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 çıkan
hiçbir 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 alerji kliniklerine konsülte edilmelidir.

Anahtar Kelimeler

anafilaksi, adrenalin, çocuk, tanı, tedavi

Kaynakça

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