Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- ingestão de leite, ovos, nozes, peixe, marisco, trigo ou soja
- sintomas reprodutíveis
- rubor, urticária ou angioedema cutâneo
- espirros, rinorreia ou congestão nasal
- dispneia, taquipneia, sibilância, tosse ou cianose
- rouquidão, estridor ou sensação de sufocamento
- náuseas e vômitos
- cólica ou distensão abdominal
- diarreia
- hiperemia conjuntival ou lacrimejamento
- edema periorbital
- início abrupto dos sintomas
- reação causada por uma pequena quantidade de alimento
- presença de outras doenças alérgicas
- edema laríngeo
Outros fatores diagnósticos
- taquicardia ou bradicardia
- reação exacerbada por exercícios ou esforço físico
- ingestão de medicamentos ou de bebidas alcoólicas antes da reação
- arritmia cardíaca
- hipotensão
Fatores de risco
- história familiar de alergia alimentar
- dermatite atópica
- neonatos
- exposição perinatal a óleo de amendoim
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- imunoensaio da imunoglobulina E (IgE) específica in vitro
- teste alérgico cutâneo por puntura ("prick test")
Investigações a serem consideradas
- testes de desencadeamento alimentar
- diagnósticos resolvidos por componentes
Novos exames
- testes de adesivo atópico
Algoritmo de tratamento
reação anafilática
sintomas cutâneos
broncoespasmo
rinoconjuntivite
após a estabilização
Colaboradores
Autores
A. Wesley Burks, MD
Curnen Distinguished Professor and Chair
Department of Pediatrics
University of North Carolina
Chapel Hill
NC
Declarações
AWB receives grant support to his institution from the National Institutes of Health and the Burroughs Wellcome Fund; royalties from UpToDate; consulting honorariums from Astella Pharma Global Development, Allergy Therapeutics (UK) Ltd, DBV Technologies, Kaléo, N-Fold, LLC, ALK-Abelló Inc, and UKKO Inc, as well as Aimmune Therapeutics, Consortia TX Inc, and Prota Therapeutics for his service on their respective Scientific Advisory Boards. AWB owns stock in Allertein and Mastcell Pharmaceuticals. These interests do not directly relate to the article but are being shared for full disclosure. AWB is an author of references cited in this topic.
J. Andrew Bird, MD
Associate Professor
Department of Pediatrics
Division of Allergy and Immunology
University of Texas Southwestern Medical Center
Dallas
TX
Declarações
JAB has received personal fees from Abbot, grants and personal fees from Aimmune, personal fees from AllerGenis, personal fees from Allergy Therapeutics, personal fees from Before Brands, grants and personal fees from DBV Technologies, grants and personal fees from FARE, personal fees from HAL Allergy, grants and personal fees from Novartis, personal fees from Nutricia, personal fees from Prota Therapeutics, grants from Astellas, grants from Genentech, grants from NIH-NIAID, grants from Regeneron; and Vedanta Biosciences, Independent Study Monitor (uncompensated).
Revisores
Justin Skripak, MD
Assistant Professor of Pediatric Allergy and Immunology
Mount Sinai School of Medicine
New York
NY
Declarações
JS declares that he has no competing interests.
Hugh A. Sampson, MD
Professor of Pediatrics
Mount Sinai School of Medicine
New York
NY
Declarações
HAS holds a 4% interest in a biotech company, Allertein Pharmaceuticals LLC, which is developing an engineered recombinant protein vaccine for peanut allergy, and 45% interest in a virtual company, Herbal Springs LLC, that holds a patent application on an herbal product for treating asthma and another for treating food allergy. HAS is an author of a number of references cited in this topic.
Adam Fox, MA(Hons) Cantab., MSc, MBBS, DCH, FRCPCH, FHEA, Dip. Allergy
Consultant and Honorary Senior Lecturer in Paediatric Allergy
Evelina Children's Hospital
Guy's & St Thomas' Hospitals NHS Foundation Trust
London
UK
Declarações
AF declares that he has no competing interests.
Diagnósticos diferenciais
- Dermatite atópica
- Urticária
- Síndrome auriculotemporal
Mais Diagnósticos diferenciaisDiretrizes
- BSACI guidelines for the management of egg allergy
- A consensus approach to the primary prevention of food allergy through nutrition: guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology
Mais DiretrizesFolhetos informativos para os pacientes
Alergia alimentar: o que é?
Alergia alimentar: que tratamentos estão disponíveis?
Mais Folhetos informativos para os pacientes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal