Fabio Cardinale
UOC di Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera-Universitaria “Consorziale-Policlinico”, Ospedale Pediatrico Giovanni XXIII, Bari, Italy
Doriana Amato
UOC di Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera-Universitaria “Consorziale-Policlinico”, Ospedale Pediatrico Giovanni XXIII, Bari, Italy
Maria Felicia Mastrototaro
UOC di Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera-Universitaria “Consorziale-Policlinico”, Ospedale Pediatrico Giovanni XXIII, Bari, Italy
Carlo Caffarelli
Clinica Pediatrica, Dipartimento di Medicina e Chirurgia, Azienda Ospedaliero-Universitaria, Università di Parma, Italy
Giuseppe Crisafulli
UO Allergologia, Dipartimento di Pediatria, Università di Messina, Italy
Fabrizio Franceschini
UOC Pediatria, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona, Italy
Lucia Liotti
Department of Pediatrics, Senigallia Hospital, Senigallia, Italy
Silvia Caimmi
Pediatric Clinic, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
Paolo Bottau
Pediatric and Neonatology Unit, Imola Hospital, Imola (BO), Italy
Francesca Saretta
Pediatric Department, AAS2 Bassa Friulana-Isontina, Palmanova-Latisana, Italy; Pediatric Allergy Unit, Department of Medicine, Udine, Italy
Francesca Mori
Allergy Unit, Department of Pediatric Medicine, Anna Meyer Children’s University Hospital, Florence, Italy
Roberto Bernardini
Pediatric Unit, “San Giuseppe” Hospital, Empoli, Italy
Keywords
epidemiology, drugs, anaphylaxis, MRGPRX2
Abstract
Anaphylaxis represents one of the most frequent medical emergencies in childhood. However, as compared to adults, drugs are less common triggers of anaphylaxis in children, with a frequency which is increasing from infancy to adolescence. Deaths seldom occur, maybe because of the paucity of comorbidities in children. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are the main elicitors in drug-induced anaphylaxis in children. Both immune-mediated (mainly IgE-mediated) and non immune-mediated may be involved. IgG-mediated and complement-mediated mechanisms has been also hypothesized. Correct management relies on a right diagnosis and prompt therapy. A proper work-up is also important to prevent further potentially fatal re-exposures to the same drug or other structurally similar molecules but also unnecessary avoidance of medications not representing the culprit of the episode.