F. Estelle R. Simons, MD, FAAAAI, Hugh A. Sampson, MD, FAAAAI

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Presentation transcript:

Anaphylaxis: Unique aspects of clinical diagnosis and management in infants (birth to age 2 years) F. Estelle R. Simons, MD, FAAAAI, Hugh A. Sampson, MD, FAAAAI Journal of Allergy and Clinical Immunology Volume 135, Issue 5, Pages 1125-1131 (May 2015) DOI: 10.1016/j.jaci.2014.09.014 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Clinical diagnosis of anaphylaxis in infants is based on sudden onset of characteristic symptoms and signs in 2 or more body organ systems. Typical symptoms and signs can include generalized urticaria, cough, wheeze, stridor, and/or persistent vomiting. In infants with anaphylaxis, respiratory compromise is more likely than hypotension or shock, and shock is more likely to manifest initially as tachycardia rather than hypotension.1-3 Journal of Allergy and Clinical Immunology 2015 135, 1125-1131DOI: (10.1016/j.jaci.2014.09.014) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 The protocol for initial treatment of anaphylaxis in infants should be posted and rehearsed regularly. As soon as anaphylaxis is diagnosed, steps 4, 5, and 6 should be performed promptly and simultaneously.1-3 IV, Intravenous. Journal of Allergy and Clinical Immunology 2015 135, 1125-1131DOI: (10.1016/j.jaci.2014.09.014) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 After treatment of anaphylaxis in a health care setting, subsequent management includes providing an EAI (or a prescription for an EAI) and an action plan and training the caregiver to recognize anaphylaxis symptoms and use the EAI promptly (top panel). Long-term management involves risk assessment, preferably by an allergy/immunology specialist, to confirm the anaphylaxis triggers and risk reduction and prevention of recurrences through allergen avoidance and immune modulation (bottom panel).1-3 Journal of Allergy and Clinical Immunology 2015 135, 1125-1131DOI: (10.1016/j.jaci.2014.09.014) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions