Pediatric idiopathic anaphylaxis: practical management from infants to adolescents

Francesca Mori; Francesca Saretta; Mattia Giovannini; Mariannita Gelsomino; Lucia Liotti; Simona Barni; Carla Mastrorilli; Luca Pecoraro; Riccardo Castagnoli; Stefania Arasi; Lucia Caminiti; Angela Klain; Michele Miraglia Del Giudice; Elio Novembre

doi:10.1186/s13052-024-01712-y

Pediatric idiopathic anaphylaxis: practical management from infants to adolescents

Ital J Pediatr. 2024 Aug 9;50(1):145. doi: 10.1186/s13052-024-01712-y.

Authors

Affiliations

¹ Allergy Unit, Meyer Children's Hospital IRCCS, Florence, 50139, Italy.
² Pediatric Department, General Pediatrician, Azienda Sanitaria Universitaria Friuli Centrale, Udine, 33100, Italy.
³ Department of Health Sciences, University of Florence, Florence, 50139, Italy.
⁴ Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS Catholic University of the Sacred Heart Rome, Rome, Italy. mariannita.gelsomino@gmail.com.
⁵ Department of Mother and Child Health, Pediatric Unit, Salesi Children's Hospital, Ancona, 60123, Italy.
⁶ Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, Bari, 70126, Italy.
⁷ Pediatric Unit, Department of Surgical Sciences, Destiny, Gynecology and Pediatrics, University of Verona, Verona, 37126, Italy.
⁸ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 27100, Italy.
⁹ Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
¹⁰ Division of Allergy, Translational Research in Pediatric Specialties Area, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy.
¹¹ Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, Messina, 98124, Italy.
¹² Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy.

Abstract

Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis.

Keywords: Adrenaline autoinjectors; Diagnostic workup; Idiopathic anaphylaxis; Prevention.

Publication types

Review

MeSH terms

Adolescent
Algorithms
Anaphylaxis* / diagnosis
Anaphylaxis* / drug therapy
Anaphylaxis* / etiology
Anaphylaxis* / therapy
Child
Child, Preschool
Diagnosis, Differential
Humans
Infant