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著者: Marcus S Shaker, Dana V Wallace, David B K Golden, John Oppenheimer, Jonathan A Bernstein, Ronna L Campbell, Chitra Dinakar, Anne Ellis, Matthew Greenhawt, David A Khan, David M Lang, Eddy S Lang, Jay A Lieberman, Jay Portnoy, Matthew A Rank, David R Stukus, Julie Wang, Collaborators, Natalie Riblet, Aiyana M P Bobrownicki, Teresa Bontrager, Jarrod Dusin, Jennifer Foley, Becky Frederick, Eyitemi Fregene, Sage Hellerstedt, Ferdaus Hassan, Kori Hess, Caroline Horner, Kelly Huntington, Poojita Kasireddy, David Keeler, Bertha Kim, Phil Lieberman, Erin Lindhorst, Fiona McEnany, Jennifer Milbank, Helen Murphy, Oriana Pando, Ami K Patel, Nicole Ratliff, Robert Rhodes, Kim Robertson, Hope Scott, Audrey Snell, Rhonda Sullivan, Varahi Trivedi, Azadeh Wickham, Chief Editors, Marcus S Shaker, Dana V Wallace, Workgroup Contributors, Marcus S Shaker, Dana V Wallace, Jonathan A Bernstein, Ronna L Campbell, Chitra Dinakar, Anne Ellis, David B K Golden, Matthew Greenhawt, Jay A Lieberman, Matthew A Rank, David R Stukus, Julie Wang, Joint Task Force on Practice Parameters Reviewers, Marcus S Shaker, Dana V Wallace, David B K Golden, Jonathan A Bernstein, Chitra Dinakar, Anne Ellis, Matthew Greenhawt, Caroline Horner, David A Khan, Jay A Lieberman, John Oppenheimer, Matthew A Rank, Marcus S Shaker, David R Stukus, Julie Wang
雑誌名: J Allergy Clin Immunol. 2020 Apr;145(4):1082-1123. doi: 10.1016/j.jaci.2020.01.017. Epub 2020 Jan 28.
Abstract/Text
Anaphylaxis is an acute, potential life-threatening systemic allergic reaction that may have a wide range of clinical manifestations. Severe anaphylaxis and/or the need for repeated doses of epinephrine to treat anaphylaxis are risk factors for biphasic anaphylaxis. Antihistamines and/or glucocorticoids are not reliable interventions to prevent biphasic anaphylaxis, although evidence supports a role for antihistamine and/or glucocorticoid premedication in specific chemotherapy protocols and rush aeroallergen immunotherapy. Evidence is lacking to support the role of antihistamines and/or glucocorticoid routine premedication in patients receiving low- or iso-osmolar contrast material to prevent recurrent radiocontrast media anaphylaxis. Epinephrine is the first-line pharmacotherapy for uniphasic and/or biphasic anaphylaxis. After diagnosis and treatment of anaphylaxis, all patients should be kept under observation until symptoms have fully resolved. All patients with anaphylaxis should receive education on anaphylaxis and risk of recurrence, trigger avoidance, self-injectable epinephrine education, referral to an allergist, and be educated about thresholds for further care.
Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
PMID 32001253 J Allergy Clin Immunol. 2020 Apr;145(4):1082-1123. doi: 10.1016/j.jaci.2020.01.017. Epub 2020 Jan 28.
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