Global Trends in Anaphylaxis Epidemiology and Clinical Implications. Miércoles 14 de octubre
Global Trends in Anaphylaxis Epidemiology and Clinical Implications
Authors: Paul J Turner 1 , Dianne E Campbell 2 , Megan S Motosue 3 , Ronna L Campbell 4
Abstract
The true global scale of anaphylaxis remains elusive, because many episodes occur in the community without presentation to health care facilities, and most regions have not yet developed reliable systems with which to monitor severe allergic events. The most robust data sets currently available are based largely on hospital admissions, which are limited by inherent issues of misdiagnosis, misclassification, and generalizability. Despite this, there is convincing evidence of a global increase in rates of all-cause anaphylaxis, driven largely by medication- and food-related anaphylaxis. There is no evidence of parallel increases in global all-cause anaphylaxis mortality, with surprisingly similar estimates for case-fatality rates at approximately 0.5% to 1% of fatal outcomes for hospitalizations due to anaphylaxis across several regions. Studying regional patterns of anaphylaxis to certain triggers have provided valuable insights into susceptibility and sensitizing events: for example, the link between the mAb cetuximab and allergy to mammalian meat. Likewise, data from published fatality registers can identify potentially modifiable risk factors that can be used to inform clinical practice, such as prevention of delayed epinephrine administration, correct posturing during anaphylaxis, special attention to populations at risk (such as the elderly on multiple medications), and use of venom immunotherapy in individuals at risk of insect-related anaphylaxis.
Muchos episodios de anafilaxia ocurren en la comunidad sin que se presenten en los centros de atención médica, por lo que su epidemiologia es difícil de determinar, ademas que la mayoría de las regiones aún no han desarrollado sistemas confiables para monitorear eventos alérgicos graves. Los datos más sólidos actualmente disponibles se basan en gran medida en los registros hospitalarios, que están limitados por cuestiones inherentes de diagnóstico erróneo y clasificación errónea. A pesar de esto, existe evidencia convincente de un aumento global en las tasas de anafilaxia por todas las causas, en gran medida por la anafilaxia relacionada con los medicamentos y los alimentos. Cabe recalcar la falta del conocimiento medico acerca del tema, enlazo estudio de interes realizado por el servicio de Alergologia clínica UdeA en cabeza del Dr Ricardo Cardona https://revistaalergia.mx/ojs/index.php/ram/article/view/524/1015
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