Prevalência de anafilaxia entre indivíduos portadores de doenças alérgicas no estado de São Paulo através de questionário online
Prevalence of anaphylaxis among individuals with allergic diseases in the state of São Paulo, southeastern Brazil, through an online questionnaire
Isabela Lazaretti Morato Castro; Fabio Fernandes Morato Castro; Elaine Gagete Miranda-da-Silva; Júlia Borges Camargo; Carolina Nigro Corrêa; Lais Barbedo
Resumo
Introdução: Anafilaxia é uma reação sistêmica grave potencialmente fatal, sendo fundamental um diagnóstico rápido e preciso para que o tratamento seja realizado de forma adequada. Apesar da gravidade da doença, os estudos voltados para sua prevalência no Brasil são escassos, limitando o conhecimento do real impacto e dificultando o planejamento de medidas preventivas para a anafilaxia no país. Este estudo objetiva, assim, contribuir para o conhecimento da prevalência da anafilaxia em indivíduos portadores de algum tipo de doença alérgica no estado de São Paulo. Métodos: O estudo foi realizado através da plataforma digital Google Forms com envolvimento anônimo dos participantes residentes do estado de São Paulo, previamente aprovado pelos Comitês de Ética em Pesquisa das instituições envolvidas. Foram divulgados, através de mídias sociais, dois questionários validados direcionados a indivíduos com até 7 anos e acima dessa idade. Resultados: Foram obtidos 309 questionários de indivíduos com sete anos ou mais que referiam ter algum tipo de alergia. Através dos escores sugestivos de anafilaxia, obteve-se 46 pessoas (14,9%) possivelmente anafiláticas. Entre estas, as causas foram medicamentos em 56,5%, alimentos em 47,8%, ferroadas de insetos em 26,0%, látex em 4,3%, e indeterminado em 4,3%. Outros diagnósticos: rinite, 60,8%; dermatite ou eczema, 41,3%; asma, 30,4%; diagnóstico isolado de anafilaxia, 30,4%. Entre crianças de até 6 anos 11 meses e 29 dias, 84 questionários referiram alergia, sendo que 21,4% apresentaram escores sugestivos de anafilaxia, cujas causas foram: alimentos em 72,2%, insetos em 22,2%, e medicamentos em 22,2%. Dermatite apareceu em 38,8% dos questionários, asma em 55,5%, rinite em 44,4%, e anafilaxia isoladamente em 5,55%. Conclusão: A anafilaxia não é doença rara entre portadores de atopia, especialmente nas crianças pequenas, e as causas foram similares às referidas pela literatura médica, predominando medicamentos na população mais velha, e alimentos nas crianças.
Palavras-chave
Abstract
Introduction: Anaphylaxis is a severe, potentially fatal systemic reaction, making rapid and accurate diagnosis essential for adequate treatment. Despite the seriousness of the condition, studies focusing on its prevalence in Brazil are scarce, limiting the understanding of its real impact and hindering the planning of preventive measures for anaphylaxis in the country. This study aimed to contribute to the understanding of the prevalence of anaphylaxis in individuals with allergic diseases in the state of São Paulo, southeastern Brazil. Methods: The study was conducted using the digital platform Google Forms, with anonymous participation from residents of the state of São Paulo, and was previously approved by the Research Ethics Committees of the involved institutions. Two validated questionnaires were disseminated through social media, targeting individuals up to 7 years old and those older than that age. Results: A total of 309 questionnaires were collected from individuals aged 7 years or older who reported having an allergy. Based on suggestive anaphylaxis scores, 46 individuals (14.9%) were potentially anaphylactic. The reported causes were medications (56.5%), foods (47.8%), insect stings (26.0%), latex (4.3%), and undetermined (4.3%). Other diagnoses included rhinitis (60.8%), dermatitis or eczema (41.3%), asthma (30.4%), and isolated anaphylaxis (30.4%). Among children up to 6 years, 11 months, and 29 days, 84 questionnaires indicated allergies, with 21.4% showing suggestive scores of anaphylaxis. The causes in this group were foods (72.2%), insect stings (22.2%), and medications (22.2%). Dermatitis was reported in 38.8% of the questionnaires, asthma in 55.5%, rhinitis in 44.4%, and isolated anaphylaxis in 5.55%. Conclusion: Anaphylaxis is not a rare condition among individuals with atopy, especially in young children. The causes of anaphylaxis reported were similar to those found in the medical literature, with medications predominating in the older population and foods being more common in children.
Keywords
Referências
1. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006 Feb;117(2):391-7.
2. Campbell RL, Hagan JB, Manivannan V, Decker WW, Kanthala AR, Bellolio MF, et al. Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients. J Allergy Clin Immunol. 2012;129(3):748-52.
3. Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S, et al. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020 Oct 30;13(10):100472.
4. Arruda LK, Melo JML. A epidemia de alergia: por que as alergias estão aumentando no Brasil e no mundo? Braz J Allergy Immunol. 2015;3(1):1-6.
5. Motosue MS, Li JT, Campbell RL. Anaphylaxis: Epidemiology and Differential Diagnosis. Immunol Allergy Clin North Am. 2022 Feb;42(1):13-25.
6. Sole D, Ivancevich JC, Borges MS, Coelho MA, Rosario NA, Ardusso LR, et al. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA). Clinics (Sao Paulo). 2011;66(6):943-7.
7. Gagete E, Delazari Dos Santos L, Gomes de Pontes L, Morato Castro F. Who has anaphylaxis in Brazil? Validation of a questionnaire for population studies. World Allergy Organ J. 2017 Nov 8;10(1):40.
8. Prática clínica [site na Internet]. Análise de cálculo amostral. Disponível em: https://praticaclinica.com.br/anexos/ccolaborativacalculo-amostral/ccolaborativa-calculo-amostral.php. Acessado em: 29/10/23.
9. Brasil, Instituto Brasileiro de Geografia e Estatística - IBGE [Internet]. Disponível em: https://cidades.ibge.gov.br/brasil/sp/panorama. Acessado em: 29/10/23.
10. Turner PJ, Campbell DE, Motosue MS, Campbell RL. Global Trends in Anaphylaxis Epidemiology and Clinical Implications. J Allergy Clin Immunol Pract. 2020 Apr;8(4):1169-76.
11. Huang F, Chawla K, Järvinen KM, Nowak-Wegrzyn A. Anaphylaxis in a New York City pediatric emergency department: triggers, treatments, and outcomes. J Allergy Clin Immunol. 2012;129(1):162-8.
12. Tanno LK, Demoly P. Epidemiology of anaphylaxis. Curr Opin Allergy Clin Immunol. 2021 Apr 1;21(2):168-174.
13. Solé D, Camelo-Nunes IC, Wandalsen GF, Mallozi MC. Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC). Rev Paul Pediatr. 2014 Mar;32(1):114-25. doi: 10.1590/s0103- 05822014000100018.
14. Sole D, Ivancevich JC, Borges MS, Coelho MA, Rosario NA, Ardusso LR, et al.; Latin American Anaphylaxis Working Group. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA). Clinics (Sao Paulo). 2011;66(6):943-7.
15. Hoyos-Bachiloglu R, Ivanovic-Zuvic D, Álvarez J, Linn K, Thöne N, de los Ángeles Paul, et al. Prevalence of parent-reported immediate hypersensitivity food allergy in Chilean school-aged children. Allergol Immunopathol. 2014;42:527-32.
16. Ontiveros N, Valdez-Meza EE, Vergara-Jiménez MJ, Canizalez - Román A, Borzutzky A, Cabrera-Chávez F. Parent-reported prevalence of food allergy in Mexican schoolchildren: A population-based study. Allergol Immunopathol (Madr). 2016 Nov- Dec;44(6):563-70. doi: 10.1016/j.aller.2016.03.003.
17. Cabrera-Chávez F, Rodríguez-Bellegarrigue CI, Figueroa-Salcido OG, Lopez-Gallardo JA, Arámburo-Gálvez JG, Vergara-Jiménez MJ, et al. Food Allergy Prevalence in Salvadoran Schoolchildren Estimated by Parent-Report. Int J Environ Res Public Health. 2018 Nov 2;15(11):2446. doi: 10.3390/ijerph15112446.
18. Boechat JL, Moraes JR, Taborda-Barata L, Lozoya-Ibáñez C, Sarinho ESC, Solé D. Alergia alimentar autodeclarada em idosos no Brasil: prevalência e características clínicas - Protocolo de estudo. Arq Asma Alerg Imunol. 2022;6(4):483-90.
19. Sousa CFA, Oliveira MS, e-Silva-Junior AF, Figueredo RC, Gagete E. Anafilaxia em estudantes acima de sete anos nas escolas públicas de Imperatriz do Maranhão - MA. Arq Asma Alerg Imunol. 2021;5(3):279-90.
20. Carter MC, Park J, Vadas P, Worm M. Extrinsic and Intrinsic Modulators of Anaphylaxis. J Allergy Clin Immunol Pract. 2023 Jul;11(7):1998-2006.
21. Thomander T, Toppila-Salmi S, Salimäki J, Jantunen J, Huhtala H, Pallasaho P, et al. Allergic multimorbidity is associated with selfreported anaphylaxis in adults-A cross-sectional questionnaire study. Clin Transl Allergy. 2022 Jul 21;12(7):e12184.
22. Tanno LK, Caminati M, Pouessel G, Senna G, Demoly P. Epidemiology of anaphylaxis: is the trend still going up? Curr Opin Allergy Clin Immunol. 2023 Oct 1;23(5):349-56.
Submetido em:
19/09/2024
Aceito em:
21/12/2024
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