Anaphylaktische Reaktionen im Kindesalter. Akuttherapie und Risikoabschätzung

Recent investigations have found increases in the prevalence of anaphylaxis. Among children the most identifiable cause of anaphylactic reactions is insect sting and food allergy. It is important to consider the risk factors as asthma history and previous respiratory or cardiovascular symptoms after exposure to trace amount of allergen, and finally to treat the anaphylactic reaction immediately. To help distinguished sensitized individuals of minimum or no risk from those at increased risk of developing anaphylaxis measurement of the allergen-specific and total IgE antibodies, mast cell and basophil activation markers and, in particular patients, challenge tests were introduced. Patients with a history of anaphylaxis need an individual management plan on how to recognize the anaphylactic symptoms as well as instructions how to use the emergency medication kit. Epinephrin should be administered preferably intramuscularly, self-injectors are available. The lasting therapeutic strategy for venom hypersensitivity is venom specific immunotherapy and in some cases of food allergy a specific oral tolerance induction.