Anaphylaxis
Keywords:
Anaphylaxis, Hypersensitivity reaction, Adrenaline, Mast cell degranulation, Emergency managementAbstract
Editorial summary prepared for the online archive; the original print article was published without an abstract.
Anaphylaxis is a severe, life-threatening, generalised or systemic hypersensitivity reaction characterised by rapidly developing airway, breathing and/or circulation problems, usually with skin and mucosal changes. This review outlines its history, definition, prognosis, triggers, clinical presentation, diagnosis, management and prevention. Common triggers are foods, insect venom and drugs, and about 20% of cases are idiopathic. Diagnosis rests mainly on the clinical history, supported by the UK Resuscitation Council (2008) criteria and, where appropriate, laboratory tests such as serum tryptase. Management follows the UK Resuscitation Council (2008) and US (2010) guidelines: assessment of airway, breathing and circulation, prompt intramuscular adrenaline (epinephrine) as first-line treatment, positioning, oxygen and intravenous fluids, with antihistamines, inhaled β-agonists and corticosteroids as adjuncts; corticosteroids should never replace or precede adrenaline. Prevention relies on allergen avoidance, patient education and self-management, venom immunotherapy (effective in up to 98% of patients with venom-induced anaphylaxis), and pharmacological prophylaxis or desensitisation in selected cases.
Downloads
References
Cohen SG. The Pharaoh and the wasp. Allergy Proc 1989; 10:149-51. (Historical Article)
Cohen SG. Portier, Richet and the discovery of anaphylaxis. A centennial. J Allergy ClinImmunol 2002; 110: 331-6. (Historical Article)
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(5):832-6.
Yocum MW, Buuerfield JH, Klein JS et al. Epidemiology of anaphylaxis in Olmsted County: A population-based study. J Allergy Clin immunol 1999;104(2 Pt 1): 452-6.
Sampson HA, MunozFurlong A, Bock SA, et al. Symposium on the definition and management of anaphylaxis: summary report. http://www. ncbi. nlm. nih. gov/ pubmed/15753908. 2006.
Allergy Clinic Online. Epidemiology, immune-pathogenesis and management of anaphylaxis. http://allergycliniconline.com /2012/02/26/allergy-pediatric-reference-epidemiology-immunop. 2012.
Lecture Notes in Dentistry. Anaphylactic Shock Clinical Features and Management. http://dentallecnotes.blogspot.com/2011/08 /anaphylactic-shock-clinical-feature-and. html. 2011.
Brown AF, McKinnon D, DeStefano F et al. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. J Allergy Clin Immunol 2001;108(5):861-6.
Bohlke K, Davis RL, DeStefano F et al. epidemiology of anaphylaxis among children and adolescents in a health maintenance organization. J Allergy Cli Immunol 2004;113(3):536-42.
Pumphrey RS, Sheikh A, Strachan DP et al. Burden of allergic disease in the UK: secondary analyses of national databases. Clin Exp Allergy 2004;34(4):520-6.
Gupta R, Sheikh A, Strachan DP et al. Burden of allergic disease in the UK: Secondary analysis of analyses of national databases. Clin Exp Allergy 2004; 34 (4): 520-6.
Simon FE, Ardusso LR, Ebisawa M et al. World Allergy Organization. Anaphylaxis Guidelines: 2013 update of the evidence base. Arch Allergy Immunol. 2013;162(3): 193-204 .
Mustafa M. Anaphylaxis: Treatment and Management. http://emedicine.medscape. com/article/135065-treatment. 2013.
Anand MK. Immediate Hypersensitivity Reactions Workup. http://emedicine. medscape. com/ article/ 136217- workup# a0719. 2012.
National Institute for Health and Care Excellence (NICE). Anaphylaxis (CG123). http://guidance.nice.org.uk/CG134. 2011.
National Guideline Clearinghouse. The diagnosis and management of anaphylaxis practice parameter: 2010 update. http://www. guideline.gov/content.aspx ?id =38449. 2010.
Haymore BR, Carr WW and Frank WT. Anaphylaxis and epinephrine prescribing in a military hospital: underutilization of the intramuscular route. Allergy Asthma Proc 2005;26(5):361-5.
Pediatric Emergency Practice. Allergic Emergencies in Children: The Pivotal Role of Epinephrine. www.ebmedicine. net/ topics.php?paction=showTopic&topic_id= 150. 2007.
Brown SG. Clinical features and severity grading of anaphylaxis. J Allergy Clin Immunol 2004;114(2):371-6.
Johnston SL, Unsworth J, Gomples MM. Adrenaline given outside the context of life threatening allergic reactions. BMJ 2003;83(921):589-90.
Downloads
Published
Issue
Section
License
This article is published open access under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). You may copy, redistribute, adapt and build upon it for non-commercial purposes, provided you credit the authors, cite the original publication in the Journal of Medical Sciences with its DOI, indicate any changes, and distribute any adaptations under the same licence. Copyright rests with the authors. For commercial reuse, please contact the corresponding author. Full terms: https://sebhau.edu.ly/journal/joms/copyright-licensing
