Publication: Anafilaxia en urgencias: incidencia, diagnóstico y manejo clínico
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2016-08-11
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Universidad Complutense de Madrid
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Abstract
La anafilaxia fue descrita en 1902, sin embargo, sigue sin existir una definición de anafilaxia universalmente aceptada. La más utilizada, en la actualidad, es la publicada en el documento de consenso del simposio sobre la definición y el manejo de la anafilaxia del año 2005, que la describe como “una reacción alérgica de inicio rápido que puede producir la muerte”. Actualmente, la anafilaxia se clasifica en inmunológica (IgE dependiente o independiente) y no inmunológica (por ejemplo, la originada por algunos contrastes iodados). Sus síntomas están causados por una liberación masiva de mediadores, principalmente de mastocitos y basófilos, que pueden tener como diana cualquier órgano. Los datos epidemiológicos acerca de la anafilaxia son escasos. La prevalencia se estima entre el 0,05% y el 2%, aunque su incidencia parece estar aumentando. En los últimos años, se han publicado varios estudios que han intentado establecer la incidencia de anafilaxia en los servicios de urgencias de diversos hospitales. Los datos publicados en estos estudios oscilan entre el 0,07% y el 0,4%. Esta variabilidad puede deberse a características de la población y zona geográfica, y también a limitaciones metodológicas, condicionadas principalmente por la falta de consenso en cuanto a su definición, las dificultades para la codificación de la anafilaxia mediante códigos CIE y el funcionamiento de los servicios de urgencias. Además, la mayor parte de estos estudios se centran en pacientes adultos, y en menos ocasiones analizan las características de los pacientes en edad pediátrica...
Anaphylaxis was described in 1902. However, universal consensus on the definition of anaphylaxis is still lacking. The most widely used definition of anaphylaxis was published in 2005 in the consensus document resulting from the second symposium on the definition and management of anaphylaxis, which describes it as “a severe allergic reaction that is rapid in onset and can be fatal”. Anaphylaxis is currently classified into immunologic anaphylaxis (IgE-mediated or non-IgE-mediated) and non-immunologic anaphylaxis (e.g., reactions caused by iodinated contrast media). Anaphylaxis’ symptoms are the result of a massive mediators’ release, mainly by mast cells and basophils, which can target any organ. There are few data on the epidemiology of anaphylaxis. Prevalence is estimated from 0,05 to 2%, although incidence seems to be increasing. Several recent studies have attemptd to establish the incidence of anaphylaxis in the Emergency Department (ED) of different hospitals. Data published in these studies vary from 0.07% to 0.4%. Variability may be due to different populations and geographic regions, but it may also be caused by methodological limitations. These studies are hampered by the lack of consensus on the definition of anaphylaxis, difficulties to encode the disease with ICD codes and the conditions of the ED. Additionally, most of these studies have investigated anaphylaxis in adult patients and, less frequently, pediatric populations...
Anaphylaxis was described in 1902. However, universal consensus on the definition of anaphylaxis is still lacking. The most widely used definition of anaphylaxis was published in 2005 in the consensus document resulting from the second symposium on the definition and management of anaphylaxis, which describes it as “a severe allergic reaction that is rapid in onset and can be fatal”. Anaphylaxis is currently classified into immunologic anaphylaxis (IgE-mediated or non-IgE-mediated) and non-immunologic anaphylaxis (e.g., reactions caused by iodinated contrast media). Anaphylaxis’ symptoms are the result of a massive mediators’ release, mainly by mast cells and basophils, which can target any organ. There are few data on the epidemiology of anaphylaxis. Prevalence is estimated from 0,05 to 2%, although incidence seems to be increasing. Several recent studies have attemptd to establish the incidence of anaphylaxis in the Emergency Department (ED) of different hospitals. Data published in these studies vary from 0.07% to 0.4%. Variability may be due to different populations and geographic regions, but it may also be caused by methodological limitations. These studies are hampered by the lack of consensus on the definition of anaphylaxis, difficulties to encode the disease with ICD codes and the conditions of the ED. Additionally, most of these studies have investigated anaphylaxis in adult patients and, less frequently, pediatric populations...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 10-12-2015