Śmiertelny skutek anafilaksji – czynniki wyzwalające, kofaktory, postępowanie, zapobieganie i aspekty medyczno-sądowe
 
Więcej
Ukryj
1
Zakład Medycyny Sądowej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Polska / Department of Forensic Medicine, Poznan University of Medical Sciences, Poland
 
 
Autor do korespondencji
Maciej Kycler   

Zakład Medycyny Sądowej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, ul. Rokietnicka 10, 60-806 Poznań
 
 
Ann. Acad. Med. Siles. 2024;78:187-196
 
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Anafilaksja to stan zagrażający życiu, charakteryzujący się szybkim przebiegiem i wymagający natychmiastowej interwencji. Zachodzi zarówno w mechanizmie immunologicznym, jak i nieimmunologicznym. Wywoływana jest przez różnorodne czynniki, takie jak pokarmy, leki czy jady owadów. Spektrum objawów jest bardzo szerokie; najczęściej obserwuje się objawy skórne, ze strony układu oddechowego oraz pokarmowego. Diagnostyka opiera się na kryteriach klinicznych, a głównym elementem leczenia jest domięśniowe podanie adrenaliny. Prewencja polega na unikaniu wyzwalaczy, a gdy nie jest to możliwe, należy rozważyć przeprowadzenie desensytyzacji. Zgony spowodowane wstrząsem anafilaktycznym są rzadkie i często wynikają z opóźnionej lub niewłaściwej pomocy medycznej oraz braku świadków, którzy mogliby wezwać pomoc. Szacuje się, że około 1% przypadków wstrząsu anafilaktycznego kończy się zgonem. Rzadko dochodzi do zgonu w wyniku samobójczych prób poprzez celowe wywołanie reakcji anafilaktycznej. Diagnostyka pośmiertna stanowi wyzwanie ze względu na brak specyficznych zmian, dlatego należy dokładnie ocenić okoliczności zgonu, historię medyczną oraz wykluczyć inne potencjalne przyczyny. Istotne jest zidentyfikowanie czynników mogących wywołać reakcję anafilaktyczną, takich jak spożyte pokarmy czy kontakt z alergenami. Kluczowa jest szybka i dokładna diagnostyka w celu uniknięcia błędów wynikających z procesów rozkładu ciała po śmierci. Badania histopatologiczne oraz oznaczenie markerów biochemicznych, takich jak poziomy tryptazy i IgE, mogą być pomocne w ustaleniu przyczyny zgonu.
 
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