Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- início agudo
- urticária
- angioedema
- rubor
- dispneia
- sibilância
- rinite
Outros fatores diagnósticos
- ingestão de alérgeno
- picadas ou ferroadas de insetos
- prurido
- estridor inspiratório e rouquidão
- conjuntivite bilateral
- náuseas e vômitos
- cólica ou dor abdominal
- agitação/ansiedade
- confusão/desorientação
- taquicardia
- tontura
- síncope
- sensação de morte iminente (angor animi)
- exercício recente
- exposição ao calor ou ao frio
- hipotensão
- bradicardia
- parada cardíaca
- diarreia
- distúrbios visuais
- tremor
- convulsões
Fatores de risco
- <30 anos de idade: induzida por exercício, associada a alimentos
- atopia/asma
- história de anafilaxia
- exposição a um sensibilizador comum (por exemplo, látex)
- idade adulta: relacionado a alimentos, veneno de inseto e medicamentos
- sexo feminino
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- nível de triptase sérica
Investigações a serem consideradas
- exame de imunoglobulina E (IgE) in vitro
- teste cutâneo
- teste de desafio
Novos exames
- teste de ativação de basófilos
Algoritmo de tratamento
todos os pacientes: início agudo
pacientes com alérgeno identificado
Colaboradores
Autores
Nathan A. Blaseg, MD
Resident Physician
Pediatrics
University of Utah
Salt Lake City
UT
Declarações
NAB declares that he has no competing interests.
Doerthe A. Andreae, MD
Associate Professor
Allergy/Immunology
Department of Dermatology
University of Utah
Salt Lake City
UT
Declarações
DAA is author of an UpToDate article on food allergy, for which she receives royalties. DAA is an author of a number of references cited in this topic.
Agradecimentos
Dr Nathan A. Blaseg and Dr Doerthe A. Andreae would like to gratefully acknowledge Dr Michael Henning Andreae and Dr Andrea Vereda, previous contributors to this topic.
Declarações
AV declares that she is currently employed by Aimmune Therapeutics. AV wrote the main content of this topic before taking up this appointment. MHA is an author of a reference cited in this topic.
Revisores
Frank J. Domino, MD
Associate Professor
Family Medicine and Community Health
University of Massachusetts Medical School
Worcester
MA
Disclosures
FJD declares that he has no competing interests.
Wayne Shreffler, MD, PhD
Assistant Professor of Pediatrics
Mount Sinai School of Medicine
New York
NY
Disclosures
WS declares that he has no competing interests.
Lawrence Youlten, FRCP (Edin), PhD
Visiting Consultant in Allergy
Addenbrooke’s Hospital NHS Trust
Cambridge
UK
Disclosures
LY declares that he has no competing interests.
Grant Hayman, MBChB, MRCP, DTM and H, MSc, FRCPath
Consultant Immunologist
Department of Immunology
Epsom & St Helier University Hospitals NHS Trust
Carshalton
Surrey
UK
Disclosures
GH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis - a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020 Apr;145(4):1082-123.Full text Abstract
Cardona V, Ansotegui IJ, Ebisawa M, et al. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020 Oct 30;13(10):100472.Full text Abstract
Golden DBK, Wang J, Waserman S, et al. Anaphylaxis: a 2023 practice parameter update. Ann Allergy Asthma Immunol. 2024 Feb;132(2):124-76.Full text Abstract
Panchal AR, Bartos JA, Cabañas JG, et al; Adult Basic and Advanced Life Support Writing Group. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-468.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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