World allergy organization anaphylaxis guidance 2020

被引:650
作者
Cardona, Victoria [1 ,2 ]
Ansotegui, Ignacio J. [3 ]
Ebisawa, Motohiro [4 ]
El-Gamal, Yehia [5 ]
Fernandez Rivas, Montserrat [6 ]
Fineman, Stanley [7 ]
Geller, Mario [8 ]
Gonzalez-Estrada, Alexei [9 ]
Greenberger, Paul A. [10 ]
Sanchez Borges, Mario [11 ]
Senna, Gianenrico [12 ,13 ]
Sheikh, Aziz [14 ]
Kase Tanno, Luciana [15 ,16 ,17 ,18 ,19 ]
Thong, Bernard Y. [20 ]
Turner, Paul J. [21 ,22 ]
Worm, Margitta [23 ]
机构
[1] Hosp Valle De Hebron, Allergy Sect, Dept Internal Med, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
[2] ARADyAL Res Network, Barcelona, Spain
[3] Hosp Quironsalud Bizkaia, Dept Allergy & Immunol, Bilbao, Spain
[4] Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan
[5] Ain Shams Univ, Pediat Allergy & Immunol Unit, Cairo, Egypt
[6] Hosp Clin San Carlos, IdISSC, Serv Alergia, Madrid, Spain
[7] Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA
[8] Acad Med Rio de Janeiro, Div Med, Rio De Janeiro, Brazil
[9] Mayo Clin, Div Pulm Allergy & Sleep Med, Dept Med, Jacksonville, FL 32224 USA
[10] Northwestern Univ, Dept Med, Div Allergy Immunol, Feinberg Sch Med, Chicago, IL 60611 USA
[11] Ctr Med Docente La Trinidad & Clin El Avila, Allergy & Clin Immunol Dept, Caracas, Venezuela
[12] Verona Univ & Gen Hosp, Asthma Ctr, Verona, Italy
[13] Verona Univ & Gen Hosp, Allergy Unit, Verona, Italy
[14] Univ Edinburgh, Allergy & Resp Res Grp, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland
[15] Hosp Sirio Libanes, Sao Paulo, Brazil
[16] Univ Hosp Montpellier, Montpellier, France
[17] Sorbonne Univ, Paris, France
[18] WHO Collaborating Ctr Sci Classificat Support, Montpellier, France
[19] WHO ICD 11 Med & Sci Advisory Comm, Geneva, Switzerland
[20] Tan Tock Seng Hosp, Dept Rheumatol Allergy & Immunol, Singapore, Singapore
[21] Imperial Coll London, Natl Heart Lung Inst, London, England
[22] Univ Sydney, Discipline Paediat & Child Hlth, Sch Med, Sydney, NSW, Australia
[23] Charite, Dept Dermatol & Allergol, Berlin, Germany
来源
WORLD ALLERGY ORGANIZATION JOURNAL | 2020年 / 13卷 / 10期
关键词
Anaphylaxis; Acute systemic allergic reaction; Adrenaline; Cofactors; Epinephrine; Guidance; Guidelines; Antihistamines; Glucocorticoids; Food allergy; Venom allergy; Drug allergy; PRACTICE PARAMETER UPDATE; MAST-CELL ACTIVATION; FOOD ALLERGY; 1ST-AID TREATMENT; MANAGEMENT; EPINEPHRINE; EPIDEMIOLOGY; RISK; MECHANISMS; GUIDELINES;
D O I
10.1016/j.waojou.2020.100472
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions. The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies. The rationale of this updated position document is the need to keep guidance aligned with the current state of the art of knowledge in anaphylaxis management. The World Allergy Organization (WAO) anaphylaxis guidelines were published in 2011, and the current guidance adopts their major indications, incorporating some novel changes. Intramuscular epinephrine (adrenaline) continues to be the first-line treatment for anaphylaxis. Nevertheless, its use remains suboptimal. After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management. The limited availability of epinephrine auto-injectors remains a major problem in many countries, as well as their affordability for some patients.
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