Aggiornamento
Anafilassi: miti, fatti e controversie
Anaphylaxis: myths, facts and controversies - a practical guide
Giuseppe Vieni1, Maria Rita Genovese2, Loretta Biserna1, Giulia Graziani1, Irene Berti2, Federico Marchetti1
1UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
2Clinica Pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Marzo 2019 - pagg. 154 -160
Abstract
Anaphylaxis is a condition that produces great anxiety throughout the scientific community
and that often causes a significant impairment of the quality of life of patients and
their families. The present article critically reports all the (false) myths and controversies
on anaphylaxis on the basis of scientific evidences and clinical practice in real life. In
particular, it shows that anaphylaxis is not lethal and indeed in the majority of cases it is
a self-limiting condition. It may manifest without cutaneous and mucosal symptoms (10-
20% of cases) or with a late onset of such symptoms. It is not always possible to identify
a trigger factor nonetheless the diagnosis cannot be excluded in front of a compatible
clinical picture. Adrenaline, the pivotal therapy for anaphylaxis, is not dangerous if correctly
administered. Antihistamine and cortisone do not cure anaphylaxis and must not
delay administration of adrenaline. Moreover, anaphylaxis is unpredictable and there
are not absolute predictive factors. Many factors may lead to more severe reactions,
however none of them is predictive of death risk. There are not absolute criteria for the
prescription of self-injecting adrenaline, therefore it must be assessed case by case (considering
patients and their families). Anyhow, the sole prescription of adrenaline is not life-
saving. In general, anaphylaxis is not a contraindication for vaccinations and in particular
the one for egg allergy is not a contraindication for MMR and flu vaccines.
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Bibliografia
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Corrispondenza: giuseppe.vieni@auslromagna.it