小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 急性发作
- 荨麻疹
- 血管性水肿
- 冲洗
- 呼吸困难
- 哮鸣音
- 鼻炎
其他诊断因素
- 变应原摄入
- 昆虫叮咬
- 瘙痒
- 吸气相鸣音和声音嘶哑
- 双侧结膜炎
- 恶心和呕吐
- 腹部绞痛或疼痛
- 激动/焦虑
- 意识模糊/定向障碍
- 心动过速
- 头晕
- 晕厥
- 感到不安（濒死感）
- 起病前运动情况
- 受热或受冷
- 低血压
- 心动过缓
- 心搏骤停
- 腹泻
- 视觉障碍
- 震颤
- 惊厥
危险因素
- 成年：食物、昆虫毒素及药物相关
- 30 岁以下人群：食物相关运动诱发
- 女性
- 特应性疾病/哮喘
- 全身过敏反应既往史
- 接触常见致敏物（例如乳胶）
诊断性检查
首要检查
- 血清类胰蛋白酶水平
需考虑的检查
- 体外 IgE 检测
- 皮肤试验
- 激发试验
新兴检查
- 嗜碱细胞活化试验
治疗流程
所有患者：急性发病
确定了变应原的患者
撰稿人
作者
Doerthe Adriana Andreae, MD
Assistant Professor
Pediatric Allergy and Immunology
Penn State Health Milton S. Hershey Medical Center
Hershey
PA
利益声明
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.
Michael Henning Andreae, MD
Associate Professor
Department of Anesthesiology
Penn State Health Milton S. Hershey Medical Center
Hershey
PA
利益声明
MHA is an author of a reference cited in this topic.
鸣谢
Dr Doerthe Adriana Andreae and Dr Michael Henning Andreae would like to gratefully acknowledge Dr Andrea Vereda, a previous contributor to this topic.
利益声明
AV declares that she is currently employed by Aimmune Therapeutics. AV wrote the main content of this topic before taking up this appointment.
同行评议者
Frank J. Domino, MD
Associate Professor
Family Medicine and Community Health
University of Massachusetts Medical School
Worcester
MA
利益声明
FJD declares that he has no competing interests.
Wayne Shreffler, MD, PhD
Assistant Professor of Pediatrics
Mount Sinai School of Medicine
New York
NY
利益声明
WS declares that he has no competing interests.
Lawrence Youlten, FRCP (Edin), PhD
Visiting Consultant in Allergy
Addenbrooke’s Hospital NHS Trust
Cambridge
UK
利益声明
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
利益声明
GH declares that he has no competing interests.
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