Estratto
La diagnosi di anafilassi è volta sia a caratterizzare l’evento come tale, sia a precisarne l’eziologia, ma naturalmente anche ad escludere altre patologie che possono entrare nella diagnosi differenziale con quest’affezione. Le indagini utili a confermare il sospetto diagnostico di anafilassi sono indicate nella Tabella 1 [1]. È ovvio che, in presenza di una storia clinica suggestiva e di una sensibilizzazione rilevante verso l’allergene indiziato, la diagnosi eziologica e quella generica di anafilassi coincidono. In altre parole, la dimostrazione di una sensibilizzazione al prick test o al RAST (radioallergosorbent test) nei confronti di uno specifico allergene in un soggetto con una storia di reazione da ipersensibilità severa dopo esposizione allo stesso consentono in un sol tempo di formulare una diagnosi di anafilassi e di identificare l’allergene causale. Pertanto, l’anamnesi clinica finisce con l’essere dirimente in tutti i pazienti con anafilassi. Un recente documento redatto da un apposito comitato di esperti Nord-americani ha enfatizzato come in alcuni casi la storia clinica del paziente possa essere tanto convincente da rendere non necessaria (o addirittura controproducente, specie quando si tratti, ad esempio, di un’anafilassi da farmaci) l’esecuzione di test volti a confermare il sospetto diagnostico [1]. Inoltre, nello stesso documento si afferma che, in questi pazienti, l’esecuzione di un test challenge (e, in misura inferiore, perfino degli skin test) può risultare particolarmente rischiosa e da valutarsi attentamente nel rapporto costi-benefici.
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Calvani, M., Cardinale, F., Martelli, A., Muraro, M.A., Pucci, N., Savino, F. (2007). Diagnosi. In: Calvani, M., Cardinale, F., Martelli, A., Muraro, M.A., Pucci, N., Savino, F. (eds) Anafilassi in pediatria. Springer, Milano. https://doi.org/10.1007/978-88-470-0621-8_9
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