Severe anaphylaxis in children: definitions, etiology, approaches to prevention

Abstract

Anaphylaxis is a generalized allergic reaction, the severe course of which has a potential risk of fatal outcome. The course of each episode of anaphylaxis is the result of a complex interaction of the patient with a number of internal and external factors (concomitant diseases, profile and level of sensitization, features of allergen exposure, intercurrent infections, etc.). Currently, the clinical and biological features of severe anaphylaxis are not well characterized, however, arterial hypotension and/or loss of consciousness are usually observed in these patients, possibly without typical symptoms from the skin, while the outcome of the disease is associated with the possibility of timely emergency medical care. The lack of generally accepted reliable individual prognostic predictors for determining this group of patients is a serious problem. There is very little data on subfatal/fatal anaphylaxis in pediatrics and approaches to it are often based on clinical experience in other age groups. This article presents a systematization of data in the context of severe and subfatal/fatal anaphylaxis in pediatrics, to understand the etiology, risk factors, markers of severe life-threatening allergic reactions in children and the possibilities of their prevention.