Çocuklarda Anafilaksi: Nedir? Ne Değildir?

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

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1. Orhan F, Civelek E, Sahiner UM, Arga M, Can D, Çalışkaner AZ, et al. Anaphylaxis: Turkish National Guideline 2018. Asthma Allergy Immunol 2018; 16 (Suppl 1):1-62.
2. Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J, et al. Anaphylaxis--a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-84.
3. Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World Allergy Organization. World Allergy
Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013;162(3):193-204.
4. Shaker MS, Wallace DV, Golden DB, Oppenheimer J, Bernstein JA, Campbell RC, et al. Anaphylaxis-a 2020 Practice Parameter Update, Systematic Review and GRADE Analysis. JAllergy Clin Immunol 2020. pii: S0091-6749(20)30105-6.
5. Vetander M, Helander D, Flodström C, Alfvén T, Ly DH, et al. Anaphylaxis and reactions to foods in children-a population-
based case study of emergency department visits. Clin Exp Allergy 2012; 42(4): 568- 77.
6. Tejedor Alonso MA, Moro Moro M, Múgica García MV. Epidemiology of anaphylaxis. Clin Exp Allergy 2015; 45(6): 1027-39.
7. Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S161-81.
8. Simons FER. Anaphylaxis. In: Leung DYM, Szefler SJ, Bonilla FA, Akdis CA, Sampson HA (eds). Pediatric Allergy Principles
and Practice. 3rd edition. Philadelphia: Saunders Elsevier, 2016:371-76.
9. Brown GA, Kemp SF, Lieberman PL. Anapyhylaxis. In: Adkinson NF Jr, Bochner BS, editors. Middleton’s Allergy: principles
and practice. 8th ed. Philadelphia: Saunders, Inc; 2014; 1237-60.
10. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. J Clin Pathol. 2000;53(4):273-6.
11. Simons FE. Anaphylaxis in infants: can recognition and management be improved? J Allergy Clin Immunol. 2007;120(3):537-40.
12. Sampson HA, Muñoz-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. J Allergy Clin Immunol. 2006;117(2):391-7
13. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International Consensus on drug allergy. Allergy 2014;69:420-37.
14. Mirakian R, Ewan PW, Durham SR, Youlten LJ, Dugué P, Friedmann PS et al. BSACI. BSACI guidelines for the management of drug allergy. Clin Exp Allergy. 2009;39:43-61.
15. Golden DB, Demain J, Freeman T, Graft D, Tankersley M, Tracy J, et al. Stinging insect hypersensitivity: A practice parameter
update 2016. Ann Allergy Asthma Immunol. 2017;118:28-54.
16. González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA. Anaphylaxis epidemiology in patients with and patients without
asthma: a United Kingdom database review. González- Pérez A, Aponte Z, Vidaurre CF, Rodríguez LA. J Allergy Clin Immunol. 2010;125(5):1098-1104.
17. Greenberger PA, Rotskoff BD, Lifschultz B. Fatal anaphylaxis: postmortem findings and associated comorbid diseases. Ann Allergy Asthma Immunol. 2007;98:252-257.
18. Lee S, Bashore C, Lohse CM, Bellolio MF, Chamberlain A, Yuki K,et al. Rate of recurrent anaphylaxis and associated risk
factors among Olmsted County, Minnesota, residents: A population- based study. Ann Allergy Asthma Immunol. 2016;117(6):655-660.
19. Bock SA, Muñoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001-2006. J Allergy Clin Immunol.2007;119(4):1016-8.
20. Simons FE, Sampson HA. Anaphylaxis: Unique aspects of clinical diagnosis and management in infants (birth to age 2 years). J Allergy Clin Immunol. 2015;135(5):1125-31.
21. Topal E, Bakirtas A, Yilmaz O, Ertoy Karagol IH, Arga M, Demirsoy MS, et al. Anaphylaxis in infancy compared with older children. Allergy Asthma Proc. 2013;34(3):233-8.
22. Samady W, Trainor J, Smith B, Gupta R. Food-induced anaphylaxis in infants and children. Ann Allergy Asthma Immunol. 2018;121(3):360-365.
23. Feldweg AM. Exercise-induced anaphylaxis. Immunol Allergy Clin North Am 2015;35:261-75.
24. Dascola CP, Caffarelli C. Exercise-induced anaphylaxis: a clinical view. Ital J Pediatr 2012;38:43.
25. Romano A, Di Fonso M, Giuffreda F, Papa G, Artesani MC, Viola M, et al. Food-dependent exercise-induced anaphylaxis:
clinical and laboratory findings in 54 subjects. Int Arch Allergy Immunol 2001;125:264-72.
26. Shadick NA, Liang MH, Partridge AJ, Bingham C, Wright E, Fossel AH, et al. The natural history of exercise-induced
anaphylaxis: survey results from a 10-year follow- up study. J Allergy Clin Immunol 1999;104:123-27.
27. Perez-Rangel I, Gonzalo-Garijo MA, Perez-Calderon R, Zambonino MA, Corrales-Vargas SI. Wheat-dependent exercise-
induced anaphylaxis in elderly patients. Ann Allergy Asthma Immunol 2013;110:121-23.
28. Greenberger PA. Idiopathic anaphylaxis. Immunol Allergy Clin North Am 2007;27:273-93.
29. Ditto AM, Harris KE, Krasnick J, Miller MA, Patterson R. Idiopathic anaphylaxis: a series of 335 cases. Ann Allergy Asthma Immunol 1996;77:285-91.
30. Steinke JW, Platts-Mills TA, Commins SP. The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):589-96
31. Campbell RL, Li JT, Nicklas RA, Sadosty AT. Members of the Joint Task Force; Practice Parameter Workgroup. Emergency
department diagnosis and treatment of anaphylaxis: a practice parameter. Ann Allergy Asthma Immunol. 2014; 113(6): 599-608.
32. Sicherer SH, Simons FER; Section On Allergy And Immunology. Epinephrine for First-aid Management of Anaphylaxis. Pediatrics. 2017;139(3). pii: e20164006.
33. Ko BS, Kim WY, Ryoo SM, Ahn S, Sohn CH, Seo DW, et al. Biphasic reactions in patients with anaphylaxis treated with corticosteroids. Ann Allergy Asthma Immunol. 2015;115(4): 312-6.
34. Lee S, Sadosty AT, Campbell RL. Update on biphasic anaphylaxis. Curr Opin Allergy Clin Immunol. 2016;16(4):346-51.
35. Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Fernández Rivas M, et al. EAACI Food Allergy and Anaphylaxis Guidelines
Group. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69:1026-45.
36. 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 patients with food allergy in the community. Allergy. 2014;69:1464-72.
37. Çelik GE. Türkiye Ulusal Allerji ve İmmünoloji Derneği İlaç Aşırı Duyarlılık Reaksiyonlarına Yaklaşım, Ulusal Rehber, 2014. Bilimsel Tıp Yayınevi, Ankara, Basım Yılı:2014
38. O'Keefe A, Clarke A, St Pierre Y, Mill J, Asai Y, Eisman H, et al. The Risk of Recurrent Anaphylaxis. J Pediatr. 2017;180: 217-221.
39. 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 Allergy Organ J. 2015 28;8:32.
40.Wang J, Sicherer SH. Section On Allergy And Immunology. Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan. Pediatrics. 2017;139(3). pii: e20164005

ISSN: 1309-0453
Başlangıç: 2009
Yayıncı: Selen Medya Yayıncılık Tanıtım ve Organizasyon Hizmetleri

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