Anafilaksia

Dr. Shk. Mehmet Hoxha

Perkufizimi 1-Second Symposium, JACI 2006;117:391-397 2-Simons, JACI 2010;

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Semundje moderne"Pas studimit te hieroglifeve u arrit ne perfundimin se vdekja e faraonit Menes ne 2,600 BCE ishte nga anafilaksia pas pickimit te bletes apo greres

Incidenca1-Emergency treatment of anaphylactic reactions.Guidelines for healthcare providers Working Group of the Resuscitation Council (UK) 20132-EAACI Anaphylaxis Guideline Version 4.5 12 06 2013 3-Tejedor Alonso MA, Moro Moro M, Mugica Garcia MV, Esteban Hernandez J, Rosado Ingelmo A, Vila Albelda C, Gomez Traseira C,Cardenas Contreras R, Sanz Sacristan J, Hernandez Merino A: Incidence of anaphylaxis in the city of Alcorcon (Spain): a populationbased study. Clin Exp Allergy 2012; 42: 578589.4-Cetinkaya F, Incioglu A, Birinci S, Karaman BE, Dokucu AI, Sheikh A: Hospital admissions for anaphylaxis in Istanbul, Turkey. Allergy 2013; 68: 128130.

Prevalenca per te gjithe trigerat 1-F. Estelle R. Simons, MD, FRCPC(J Allergy Clin Immunol 2010;125:S161-81.) 2-EAACI Anaphylaxis Guideline Version 4.5 12 06 2013 3-Anaphylaxis in America: The prevalence and characteristics of anaphylaxis in the United States WOOD ET AL J ALLERGY CLIN IMMUNOL 2013

Note: PowerPoint does not allow you to have nice default tables - but you can cut and paste this one

(J Allergy Clin Immunol 2010;125:S161-81.)

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Mekanizmi I Zhvillimit te Alergjive

Risku per te bere anafilaksi

Sasia e alergenitRruga e sensibilizimitAfiniteti dhe Aviditeti i IgVecorite e alergenitRruga e hyrjes se alergenit

Ko-faktoret dhe faktoret favorizuesWlbing F, Biedermann T. Anaphylaxis: opportunities of stratified medicine for diagnosis and risk assessment. Allergy 2013;

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Wlbing et al. Cofactors of anaphylaxis Allergy 2013

Reference Uguz et al. (17)CICBAA* (18)Treudler et al. (16)Worm et al.(8)Mullins (14)CICBAA* (19) CICBAA* (18)CICBAA* (18) Uguz et al. (17) De Swert et al.(15) Hompes et al. (13)Worm et al. (8)Population Adults Adults Adults Adults Adults and children Adults and children Adults and children Adults and children Children Children Children and adolescents Children

Subpopulation Food allergy Food allergy Food allergy Food allergy Food allergy Food allergy Population size 51107105156432851391147564197115Year 20002001 2002200620062009 19952000 20032007200820002001 20042006 20052008 20062009 Country UK France Germany Germany Australia France France France UK Belgium Germany Germany Cofactor 25.60% 39% 18.30%14%Exercise 0%15.90%3%9.60%20.40%5.90%12.90%12.30%2.50%7.80%10% Alcohol 15.20%3.70%1%9.60% 5.90%10.10%8.90% 0% Infection 6.10% 11%1.30% 2.50% 3%2.60%NSAID 4.70% 1.20%4.30%3.50% 3% (Other) drugs 3.70% 7.10%4.30%2.60% 6%2.60%Others (menstruation, psychological stress) 12.10% Mental stress: 8% 10.30%12.00%

Wlbing et al. Cofactors of anaphylaxis Allergy 2013

Modifikimi i absorbimit te alergernit Wlbing et al. Cofactors of anaphylaxis Allergy 2013

Modifikimi i absorbimitWlbing et al. Cofactors of anaphylaxis Allergy 2013

Wlbing F, Biedermann T. Anaphylaxis: opportunities of stratified medicine for diagnosis and risk assessment. Allergy 2013;

Ko-faktoret qe amplifikojne anafilaksine

KLINIKA

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Common Causative AgentsWorld Allergy Organization AnaphylaxisGuidelines: 2013 Update of the Evidence Base Simons et al.

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TreatmentInitial Symptoms0TimeAnafilaksia Unifazike

*Uniphasic anaphylaxis resolves within hours either spontaneously or with treatment.

Anafilaksia Unifazike e zgjaturTreatmentInitial Symptoms0Time

*Uniphasic anaphylaxis resolves within hours either spontaneously or with treatment.

Anafilaksia bifazikeTreatmentInitial Symptoms0Second-Phase SymptomsTreatment

1ore -8 oreTime1 ore -72 ore

*In biphasic reactions, the initial symptoms resolve spontaneously or with treatment within hours (similar to a uniphasic response). Subsequent to resolution there is an asymptomatic period which can last several hours.

Mekanizmat e veprimit

InsekteMedikamenteUshqimTe tjeraAgregate ImuneAktivizim I sistemit te komplementitAktivizim I sistemit te koagulimitMekanizma autoimuneUshtrimetE ftohtaMedikamenteTe tjera

Mekanizmi I veprimit

Trigerat

Qelizat efektore

Mediatoret

Organet target

Simptomat klinike Simons FER. Anaphylaxis pathogenesis and treatment. Allergy 2011; 66 (Suppl. 95): 3134

Alergenet potenciale per anafilaksiWlbing F, Biedermann T. Anaphylaxis: opportunities of stratified medicine for diagnosis and risk assessment. Allergy 2013;

Te dhenat laboratorike

Diagnoza diferenciale

Diagnoza diferencialeAngioedema joalergjike:Angioedema hereditare tip I, II, IIIAngioedema nga ACE inhibitoretSindromi sistemik I kapilarit rrjedhesSindromi I njeriut te kuq ( Vankomicine)Feokromacitoma ( pergjigja paradoksale)

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*Uniphasic anaphylaxis resolves within hours either spontaneously or with treatment.*Uniphasic anaphylaxis resolves within hours either spontaneously or with treatment.*In biphasic reactions, the initial symptoms resolve spontaneously or with treatment within hours (similar to a uniphasic response). Subsequent to resolution there is an asymptomatic period which can last several hours.

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