Anafilaxia em idade pediátrica: uma visão global

Autores

  • Maria Luís Marques Serviço de Alergologia e Imunologia Clínica, Centro Hospitalar Universitário do Porto
  • Joana Gouveia Serviço de Alergologia e Imunologia Clínica, Centro Hospitalar Universitário do Porto
  • Inês Machado Cunha Serviço de Alergologia e Imunologia Clínica, Centro Hospitalar Universitário do Porto
  • Eva Rebelo Gomes Serviço de Alergologia e Imunologia Clínica, Centro Hospitalar Universitário do Porto https://orcid.org/0000-0001-8956-9145

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v29.i2.17896

Palavras-chave:

Adolescência, adrenalina, anafilaxia, crianças, reação alérgica sistémica

Resumo

A anafilaxia define-se como uma reação de hipersensibilidade aguda grave, que pode estar associada a risco de vida. A sua prevalência e incidência são difíceis de estimar, mas parecem estar a aumentar, sobretudo na faixa etária pediátrica. A apresentação clínica da anafilaxia varia de acordo com a idade e fatores individuais. Apesar de existirem critérios clínicos já estabelecidos, inclusive em idade pediátrica, o diagnóstico desta entidade pode ser difícil. A alergia alimentar é a causa mais comum de anafilaxia em idade pediátrica, especialmente em idade pré-escolar. As reações desencadeadas por fármacos e por veneno de himenópteros são também importantes, sendo que a sua relevância vai aumentado depois da adolescência. A abordagem desta condição envolve o diagnóstico, identificação apropriada dos agentes implicados, tratamento de fase aguda e planificação da abordagem a longo prazo. A referenciação rápida para um Imunoalergologista é recomendada, uma vez que o estudo alergológico é fundamental para a implementação de medidas preventivas. Nesta revisão, os autores discutem aspetos da anafilaxia em idade pediátrica, com o objetivo de fornecer informação que possa otimizar a abordagem desta entidade.

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Referências

Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet. 1977; 1:466-9.

Simons FER, Ardusso LRF, Bilò MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis. World Allergy Organ J. 2011; 4:13-37.

Simons FER, Ardusso LR, Bilò MB, Cardona B, Ebisawa M, El-Gamal YM, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014; 7:9.

Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Rivas KB, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014; 69:1026-45.

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; 117:391-7.

Tejedor-AlonsoM A, Moro-Moro M, Múgica-García MV. Epidemiology of Anaphylaxis: Contributions From the Last 10 Years. Journal of investigational allergology & clinical immunology. 2015; 25:163-75.

Tejedor Alonso MA, Moro Moro M, Múgica García MV, Hernández JE, Ingelmo AR, Albelda CV, et al. Incidence of anaphylaxis in the city of Alcorcon (Spain): a population-based study. Clin Exp Allergy. 2012; 42:578-89.

Tejedor Alonso MA, Moro MM, Hernández JE, Múgica García MV, Vila Albelda C, Rosado Ingelmo A, et al. Incidence of anaphylaxis in hospitalized patients. Int Arch Allergy Immunol. 2011; 156:212-20.

Rudders SA, Banerji A, Vassallo MF, Clark S, Camargo CA. Trends in pediatric emergency department visits for food-induced anaphylaxis. J Allergy Clin Immunol. 2010; 126:385-8.

Alvarez-Perea A, Ameiro B, Morales C, Zambrano G, Rodríguez A, Guzmán M, et al. Anaphylaxis in the Pediatric Emergency Department: Analysis of 133 Cases After an Allergy Workup. J Allergy Clin Immunol Pract. 2017; 5:1256-63.

Gaspar Â, Santos N, Piedade S, Santa-Marta C, Pires G, Sampaio G, et al. One-year survey of paediatric anaphylaxis in an allergy department. Eur Ann Allergy Clin Immunol. 2015; 47:197-205.

Grabenhenrich LB, Dölle S, Moneret-Vautrin A, Köhli A, Lange A, Spindler T, et al. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. J Allergy Clin Immunol. 2016; 137:1128-37.e1.

Wright CD, Longjohn M, Lieberman PL, Lieberman JA. An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period. Ann Allergy Asthma Immunol. 2017; 118:461-4.

Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 Update. Journal of Allergy and Clinical Immunology. 2010; 126:477-80.e42.

Vetander M, Helander D, Flodström C, Ostblom E, Alfvén T, Ly DH, et al. Anaphylaxis and reactions to foods in children - a population-based case study of emergency department visits. Clinical & Experimental Allergy. 2012; 42:568–77.

Lieberman P, Camargo Jr CA, Bohlke K, Jick H, Miller RL, Sheikh A, et al. Epidemiology of Anaphylaxis: Findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group.; 2006.

Capps JA, Sharma V, Arkwright PD. Prevalence, outcome and pre-hospital management of anaphylaxis by first aiders and paramedical ambulance staff in Manchester, UK. Resuscitation. 2010; 81:653-7.

Panesar SS, Javad S, de Silva D, Nwaru BI, Hickstein L, Muraro A, et al. The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013; 68:1353-61.

Turner PJ, Gowland MH, Sharma V, Ierodiakonou D, Harper N, Garcez T, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J Allergy Clin Immunol. 2015; 135:956-63.e1.

Muraro A, Roberts G, Clark A, Eigenmann PA, Halken S, Lack G, et al. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology. Allergy. 2007; 62:857-71.

Sole D, Ivancevich JC, Borges MS, Coelho MA, Rosario NA, Ardusso LRF, et al. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA). Clinics. 2011; 66:943-7.

Amaral R, Morais-Almeida M, Gaspar Â, Sa‑Sousa A, Martins H, Fonseca J. A anafilaxia em Portugal: Primeiros registos do Catálogo Português de Alergias e outras Reacções Adversas. Revista Portuguesa de Imunoalergologia. 2014; 22:23-32.

Lee S, Hess EP, Lohse C, Gilani W, Chamberlain AM, Campbell RL. Trends, characteristics, and incidence of anaphylaxis in 2001-2010: A population-based study. J Allergy Clin Immunol. 2017; 139:182-8.e2.

Gupta R, Sheikh A, Strachan DP, Anderson HR. Time trends in allergic disorders in the UK. Thorax. 2007; 62:91-6.

Jerschow E, Lin RY, Scaperotti MM, McGinn AP. Fatal anaphylaxis in the United States, 1999-2010: temporal patterns and demographic associations. J Allergy Clin Immunol. 2014; 134:1318-28.e7.

Liew WK, Williamson E, Tang MLK. Anaphylaxis fatalities and admissions in Australia. J Allergy Clin Immunol. 2009; 123:434-42.

Tejedor-Alonso MA, Moro-Moro M, Mosquera González M, Rodriguez-Alvarez M, Pérez Fernández E, Zamalloa PL, et al. Increased incidence of admissions for anaphylaxis in Spain 1998-2011. Allergy. 2015; 70:880-3.

Lin RY, Anderson AS, Shah SN, Nurruzzaman F. Increasing anaphylaxis hospitalizations in the first 2 decades of life: New York State, 1990–2006. Annals of Allergy, Asthma & Immunology. 2008; 101:387-93.

Poulos LM, Waters A-M, Correll PK, Loblay RH, Marks GB. Trends in hospitalizations for anaphylaxis, angioedema, and urticaria in Australia, 1993-1994 to 2004-2005. J Allergy Clin Immunol. 2007; 120:878-84.

Russell S, Monroe K, Losek JD. Anaphylaxis management in the pediatric emergency department: opportunities for improvement. Pediatr Emerg Care. 2010; 26:71-6.

Bernstein DI, Wanner M, Borish L, Liss GM, the Immunotherapy Committee of the American Academy of Allergy A and I. Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990-2001. Journal of Allergy and Clinical Immunology. 2004; 113:1129-36.

Chipps BE. Update in Pediatric Anaphylaxis: A Systematic Review. Clin Pediatr (Phila). 2013; 52:451-61.

Smith G. Alabama Boy, 3, Dies of Severe Reaction During Baked Milk Challenge Test. allergicliving.com. Published August 2017. https://www.allergicliving.com/2017/08/02/alabama-boy-3-dies-of-severe-reaction-during-baked-milk-challenge-test/.

Simons FER. Anaphylaxis: Recent advances in assessment and treatment. J Allergy Clin Immunol. 2009; 124:625-36; quiz 637-8.

de Silva IL, Mehr SS, Tey D, Tang MLK. Paediatric anaphylaxis: a 5 year retrospective review. Allergy. 2008; 63:1071-6.

Alangari AA, Twarog FJ, Shih M-C, Schneider LC. Clinical Features and Anaphylaxis in Children With Cold Urticaria. Pediatrics. 2004; 113:e313-7.

Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Rivas MF, et al. Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology. Allergy: European Journal of Allergy and Clinical Immunology. 2014; 69:1026–45.

Simons FER, Ardusso LR, Bilò MB, Cardona V, Ebisawa M, El-Gamal YM, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014; 7:9.

Castells MC, Horan RF, Sheffer AL. Exercise-induced Anaphylaxis. Curr Allergy Asthma Rep. 2003; 3:15-21.

Campbell RL, Hagan JB, Manivannan V, Decker WW, Kanthala AR, Bellolio MF, et al. Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients. J Allergy Clin Immunol. 2012; 129:748-52.

Thomson H, Seith R, Craig S. Downstream consequences of diagnostic error in pediatric anaphylaxis. BMC Pediatr. 2018; 18:40.

EAACI_White_Paper.pdf. Accessed May 2, 2019. http://www.eaaci.org/documents/EAACI_White_Paper.pdf.

Sala-Cunill A, Cardona V, Labrador-Horrillo M, Luengo O, Esteso O, Garriga T, et al. Usefulness and limitations of sequential serum tryptase for the diagnosis of anaphylaxis in 102 patients. Int Arch Allergy Immunol. 2013; 160:192-9.

Worm M, Edenharter G, Ruëff F, Scherer K, Pföhler C, Mahler V, et al. Symptom profile and risk factors of anaphylaxis in Central Europe. Allergy. 2012; 67:691-8.

Rudders SA, Banerji A, Clark S, Camargo CA. Age-related differences in the clinical presentation of food-induced anaphylaxis. J Pediatr. 2011; 158:326-8.

Topal E, Bakirtas A, Yilmaz O, Karagol IHE, Arga M, Demirsoy MS, et al. Anaphylaxis in infancy compared with older children. Allergy Asthma Proc. 2013; 34:233-8.

Simons FER, Frew AJ, Ansotegui IJ, Bochner BS, Golden DBK, Finkelman FD, et al. Risk assessment in anaphylaxis: current and future approaches. J Allergy Clin Immunol. 2007; 120:S2-24.

Simons FER. Anaphylaxis in infants: Can recognition and management be improved? Journal of Allergy and Clinical Immunology. 2007; 120:537-40.

Dosanjh A. Infant anaphylaxis: the importance of early recognition. J Asthma Allergy. 2013; 6:103-7.

Gallagher M, Worth A, Cunningham-Burley S, Sheikh A. Strategies for living with the risk of anaphylaxis in adolescence: qualitative study of young people and their parents. Prim Care Respir J. 2012; 21:392-7.

Marrs T, Lack G. Why do few food-allergic adolescents treat anaphylaxis with adrenaline?--Reviewing a pressing issue. Pediatr Allergy Immunol. 2013; 24:222-9.

Muñoz-Furlong A. Food allergy in schools: concerns for allergists, pediatricians, parents, and school staff. Ann Allergy Asthma Immunol. 2004; 93:S47-50.

Sheikh A, Shehata YA, Brown SGA, Simons FER. Adrenaline for the treatment of anaphylaxis: cochrane systematic review. Allergy. 2009; 64:204-12.

Burks AW, Jones SM, Boyce JA, Sicherer SH, Wood RA, Assa’ad A, et al. NIAID-sponsored 2010 guidelines for managing food allergy: applications in the pediatric population. Pediatrics. 2011; 128:955-65.

Liberman DB, Teach SJ. Management of anaphylaxis in children. Pediatr Emerg Care. 2008; 24:861-6; quiz 867-9.

Mehr S, Liew WK, Tey D, Tang MLK. Clinical predictors for biphasic reactions in children presenting with anaphylaxis. Clin Exp Allergy. 2009; 39:1390-6.

Tole JW, Lieberman P. Biphasic anaphylaxis: review of incidence, clinical predictors, and observation recommendations. Immunol Allergy Clin North Am. 2007; 27:309-26.

Simons FER. Anaphylaxis, killer allergy: long-term management in the community. J Allergy Clin Immunol. 2006; 117:367-77.

Carneiro-Leão L, Santos N, Gaspar Â. Anafilaxia na comunidade - Materiais educacionais. Revista Portuguesa de Imunoalergologia. 2018; 26:121-6.

Dinakar C. Anaphylaxis in Children: Current Understanding and Key Issues in Diagnosis and Treatment. Curr Allergy Asthma Rep. 2012; 12:641-9.

Järvinen KM, Celestin J. Anaphylaxis avoidance and management: educating patients and their caregivers. J Asthma Allergy. 2014; 7:95-104.

Kapoor S, Roberts G, Bynoe Y, Gaughan M, Habibi P, Lack G. Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions. Allergy. 2004; 59:185-91.

Moffitt JE, Golden DBK, Reisman RE, Lee R, Nicklas R, Freeman T, et al. Stinging insect hypersensitivity: a practice parameter update. J Allergy Clin Immunol. 2004; 114:869-86.

Gaspar Â, Faria E. Alergia ao látex. Revista Portuguesa de Imunoalergologia. 2012; 20:173-92.

Robson-Ansley P, Toit GD. Pathophysiology, diagnosis and management of exercise-induced anaphylaxis. Curr Opin Allergy Clin Immunol. 2010; 10:312-7.

Manassis K. Managing Anxiety Related to Anaphylaxis in Childhood: A Systematic Review. Journal of Allergy. 2012; 2012:1-7.

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Publicado

2020-06-26

Como Citar

1.
Marques ML, Gouveia J, Cunha IM, Gomes ER. Anafilaxia em idade pediátrica: uma visão global. REVNEC [Internet]. 26 de Junho de 2020 [citado 25 de Abril de 2025];29(2):92-100. Disponível em: https://revistas.rcaap.pt/nascercrescer/article/view/17896

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