摘要：

Acute anaphylaxis (AAN) is rare in children and is difficult to diagnose especially in cases of inaugural manifestation. A wide range of disorders are seen in paediatric emergency medicine, including allergies. Aim of the study. - Analyse the usefulness of serum tryptase assay in children admitted to a paediatric emergency department (PED) for suspected AAN. Type of study. - Retrospective analysis of 77 children admitted to a PED for suspected acute allergy (AA). Results. Of the 77 eases reviewed, 61 were included because they had clinical manifestations consistent with AA. 40 had symptoms suggestive of AAN, and 21 had isolated urticaria (IU). Average age was the same in both groups (6.47 years vs. 6.07 years). In patients with AAN, the levels of serum tryptase were significantly higher (12.41 +/- 8.9 mu g/l) than those in cases of IU (5.55 +/- 3.17 mu g/l), P = 0.0005. Among the children with AAN, those with the severest symptoms (arterial hypotension) had the highest tryptase values (21.67 +/- 13.77 mu g/l), P < 0.001. A threshold tryptase value of more than 8.9 mu g/l seems to be sufficient for recommending further specialised examinations (specificity 85.6%, sensitivity 60%). All the children with a high tryptase level were referred for consultation with a specialist. Serum tryptase assay should be systematically performed in a paediatric emergency setting in the event of suspected AAN. It helps guide diagnosis and referral to a specialist. (c) 2010 Elsevier Masson SAS. All rights reserved.

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