Anaphylaxis. Clinical case workshop

Anaphylaxis in childhood is a serious, life-threatening disease that needs to be diagnosed and treated immediately by the pediatrician. The main cause of anaphylaxis in childhood is food allergy. Its diagnosis is fundamentally clinical and should be suspected when, in minutes or a few hours, acute skin manifestations appear in a child (urticaria, angioedema), accompanied by respiratory or circulatory manifestations. Occasionally the cutaneous clinic may not appear, which makes diagnosis difficult. The treatment of choice is the early administration, on suspicion, of intramuscular adrenaline on the outer side of the thigh. In the pediatric age there is no contraindication for the use of adrenaline in the case of anaphylaxis. The administration of any other treatment is not a priority and its use will depend on the evolution of anaphylaxis and always after administering intramuscular adrenaline. Every child with anaphylaxis should go to a hospital, even if their anaphylaxis has improved or reversed after adrenaline, and will remain in observation for a few hours. They will be discharged with a written report specifying the possible triggers of the box and how to avoid them, and they will be prescribed at least one adrenaline autoinjector appropriate to their weight. They must be instructed, both the child and his family and caregivers, in the handling of the adrenaline autoinjector at discharge and later on a regular basis by his pediatrician through simulators. They always have to be sent for assessment and study to a specialist in Child Allergy.