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What causes anaphylactic shock in children?
Last reviewed: 17.10.2021
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Antigen can enter the body in any way:
- parenterally with the administration of medications - more often penicillin (1 case per 6 million injections of penicillin), vitamin B6, polypeptide hormones (ACTH, parathyroid hormone, insulin), novocaine, lysozyme, etc .; tetanus and other serums; preventive vaccinations;
- orally food allergens (especially nuts, oysters, crabs), preservatives added to food products (methylbisulfate, glutamate, aspartate, etc.), spices, poor quality artificial fats, etc .;
- inhalation;
- Locally - insect bites, snakes.
Repeated intermittent courses of treatment and long intervals between administration of drugs increase the risk of anaphylaxis.
It is possible that anaphylactic shock may occur during food provocative tests after elimination of the product; skin scarification tests with exogenous allergens; when carrying out a specific hyposensitization, especially if it is carried out under conditions of increased exposure to allergens in vivo.
Anaphylaxis on latex (sensitization to residual rubber tree proteins) can occur in the child when using catheters in the treatment of severe diseases of the genito-urinary tract.
Anaphylactoid reaction can appear after sharp cooling, great physical exertion, exposure to iodine-containing X-rays (in 0.1% of patients), dextran, vancomycin, vitamin B6, D-tubocurarine, captopril, acetylsalicylic acid. In recent years, there has been an increase in the incidence of idiopathic anaphylaxis.
Pathogenesis of anaphylactic shock
The consequence of an allergic reaction of an immediate type with massive release of biologically active substances (not only histamine, but also synthesized prostaglandins and leukotrienes) is a pathophysiological reaction of microcirculation disturbance, a drop in systemic arterial pressure, blood deposition in the portal system, bronchospasm, development of laryngeal edema, lungs, and brain. As with any type of shock, divergent intravascular coagulation of the blood naturally develops.
Pseudoallergic anaphylaxis develops without the participation of reactans due to activation of basophils and mast cells by anaphylotoxins C3a and C5a (classical pathway of complement activation), which also leads to the release of mediators of allergy and clinical manifestations of acute vascular collapse.