Clinical Scenarios in Diagnosing Anaphylaxis

04:10, 11/07/2024

Circular 51/2017/TT-BYT has been signed and promulgated by the Ministry of Health providing guidelines for prevention, diagnosis, and management of anaphylaxis.

According to Circular 51, when diagnosing anaphylaxis, the diagnostician must pay attention to the clinical scenarios related to anaphylaxis as follows:

Clinical Scenario 1: Symptoms appear within seconds to hours on the skin, mucous membranes (hives, angioedema, itching…) and at least one of the following two symptoms:

- Respiratory symptoms (difficulty breathing, stridor, wheezing).- Hypotension (BP) or consequences of hypotension (altered mental state, involuntary defecation, urination…).

Clinical Scenario 2: At least 2 of the following 4 symptoms appear within seconds to hours after the patient is exposed to a suspected factor:

- Manifestations on the skin, mucous membranes: hives, angioedema, itching.- Respiratory symptoms (difficulty breathing, stridor, wheezing).- Hypotension or consequences of hypotension (altered mental state, involuntary defecation, urination…).- Gastrointestinal symptoms (vomiting, abdominal pain…).

Clinical Scenario 3: Hypotension appears within seconds to hours after exposure to a suspected factor that the patient has previously been allergic to:

- Children: reduction of at least 30% in systolic BP (maximum BP) or systolic hypotension relative to age (systolic BP < 70mmHg).- Adults: Systolic BP < 90mmHg or a 30% decrease from baseline systolic BP.

See detailed guidance at Circular 51/2017/TT-BYT effective from February 15, 2018.

- Thanh Lam -

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