L'anaphylaxie : de la physiopathologie au traitement

Anaphylaxis is a severe hypersensitivity reaction, potentially fatal of IgE-dependent mechanism or not. Its prevalence is estimated at 0.3% in Europe. The authors present the pathophysiological bases of anaphylaxis reaction, its clinical aspects and risk factors, reminding that the prognosis depends on its early diagnosis and treatment. As highlighted by international guidelines, fast administration of epinephrine is essential. Literature reports an under utilisation of this drug. The authors suggest a treatment algorithm of anaphylaxis and a therapeutic strategy based on Ring and Messmer grading of severity. At the end of the hospitalisation, prescription of an emergency kit containing two epinephrine auto-injector pens with training on their use is essential. An explanation of clinical reactions, circumstances of occurrence and treatment should be given to the patient. After an anaphylactic reaction, an allergy check-up is essential within order to identify the culprit allergen and implement a secondary prevention strategy to prevent its recurrence. It should be recommended to the patient and his entourage to keep food and drugs to facilitate the etiological survey by the allergist.