Allergy, Asthma and Immunology: Anaphylaxis: diagnosis

Revista da Associação Médica Brasileira

Print version ISSN 0104-4230

Rev. Assoc. Med. Bras. vol.59 no.1 São Paulo Jan./Feb. 2013

http://dx.doi.org/10.1590/S0104-42302013000100004

GUIDELINES IN FOCUS

Authorship

Brazilian Association of Allergy and Immunopathology (Associação Brasileira de Alergia e Imunopatologia)

Brazilian Society of Anesthesiology

(Sociedade Brasileira de Anestesiologia

Participants

Antonio Carlos Pastorino, Maria Cândida Faria Varanda Rizzo, Norma de Paula Motta Rubini, Giovanni W.S. Di Gesu, Giovanni M.S. Di Gesu, Nelson Augusto Rosário Filho, João Negreiros Tebyriça, Dirceu Solé, Luiz Antonio G. Bernd, Maria Anita Costa Spindola, Ricardo dos Santos Simões

Final draft

October 6, 2011

Description of the method for collecting evidence

In order to elaborate this guideline, the following primary and secondary electronic databases were consulted: MEDLINE, Cochrane, Central Register of Controlled Trials - CENTRAL, Embase, and Lilacs. The search for evidence was based on real clinical settings, MeSH terms/descriptors and the following isolated terms were used: Anaphylaxis; Allergens; Anaphylatoxins; Mast Cells; Adult; Chymases; Serine Endopeptidases. The articles were selected after critical evaluation of scientific evidence strength by specialists from the participant societies, and the best publications were used for the recommendations. Recommendations were elaborated after a discussion within the group. The entire guideline was reviewed by an independent group specialized in evidence-based clinical guidelines.

Degrees of recommendation and strength of evidence

A: Experimental or observational studies of higher consistency.

B: Experimental or observational studies of lesser consistency.

C Case reports (non-controlled studies).

D: Opinions without critical evaluation, based on consensus, physiological studies, or animal models.

Objective

Anaphylaxis is a potentially fatal allergic reaction that can be triggered by various etiological agents. Clinical suspicion, along with the identification of etiology, is a fundamental point for safe and adequate approach of patients during an acute event. The etiology of anaphylaxis is varied according to age and especially to the area in which the reaction occurs. In this guideline, the main symptoms and clinical signs are discussed, in order to allow the diagnosis of an anaphylaxis event; its main etiological agents are also discussed.