The 2020 update on anaphylaxis in paediatric population

Area of Science:

• Allergy and Immunology
• Pediatric Medicine
• Emergency Medicine

Background:

• Anaphylaxis is a severe allergic reaction requiring prompt recognition and management.
• Current guidelines and definitions evolve to improve patient outcomes.
• Pediatric anaphylaxis presents unique challenges in diagnosis and treatment.

Purpose of the Study:

• To provide a global overview of recent advancements in pediatric anaphylaxis.
• To summarize updated epidemiological data, diagnostic tools, and therapeutic strategies.
• To highlight the new World Allergy Organization (WAO) 2019 definition of anaphylaxis.

Main Methods:

• Systematic review of recent epidemiological studies on pediatric anaphylaxis.
• Analysis of updated diagnostic approaches, including component-resolved diagnostics.
• Evaluation of current and emerging treatment modalities, focusing on adrenaline use.

Main Results:

• The 2019 WAO definition broadens criteria, aiming for faster adrenaline administration by excluding dermal symptoms.
• Adrenaline is confirmed as the primary treatment for severe anaphylaxis and preventing biphasic reactions.
• Identified five key risk factors for fatal anaphylaxis in children: asthma history, rapid symptom onset, poor appearance, tachycardia, and hypotension.
• Advancements in diagnostics and novel immunotolerance therapies are noted.
• The International Classification of Diseases 11th Revision (ICD-11) includes updated anaphylaxis coding.

Conclusions:

• The revised WAO definition facilitates quicker adrenaline use in pediatric anaphylaxis.
• Effective management relies on prompt adrenaline administration and understanding risk factors.
• Ongoing research is improving diagnostic accuracy and therapeutic options for pediatric anaphylaxis.
• Updated coding systems like ICD-11 better reflect clinical anaphylaxis presentations.