Anafilaxia e urticárias físicas
Anaphylaxis and physical urticarias
Mario Geller
Resumo
As urticárias físicas são condições clínicas associadas a disfunção mastocitária, com diminuição do limiar para liberação de substâncias vasoativas por exposição a estímulos físicos externos. Fatores físicos desencadeantes incluem: fatores mecânicos, térmicos, os relacionados aos exercícios, à exposição ao sol, ou aquagênicos. Extremos de temperatura (frio e calor), pressão, trauma, vibração, contato com a água, com a luz solar, e exercícios aeróbicos (com e sem dependência alimentar), constituem desencadeantes para estas alergias físicas. Vários tipos de urticárias físicas podem coexistir em um mesmo paciente. As urticárias físicas ocorrem em cerca de 1/5 dos pacientes com urticária crônica espontânea. Podem causar anafilaxia potencialmente fatal. São aqui discutidos o diagnóstico diferencial, os testes confirmatórios e a terapia atual disponível para urticárias físicas.
Palavras-chave
Abstract
Physical urticarias are skin conditions associated with mast cell dysfunction, with decreased threshold for release of vasoactive substances upon exposure to external physical stimuli. Physical factors may include mechanical, thermal, exercise related, solar or aquagenic factors. Extreme temperatures (cold and hot), pressure, trauma, vibration, contact with water, sun exposure, and aerobic exercises (with and without food dependence) may trigger these physical allergies. Several types of physical urticarias can coexist in the same patient. One fifth of the patients with chronic spontaneous urticaria have associated physical urticaria. Physical urticarias can cause potentially fatal anaphylaxis. In this paper, we discuss differential diagnosis, confirmatory tests and therapeutic strategies currently available for physical urticarias.
Keywords
Referências
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Submetido em:
14/11/2013
Aceito em:
19/11/2013
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