Characteristics of anaphylaxis in children referred to a tertiary care center

Abstract

Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiology and the clinical characteristics in developing countries. This study aimed to investigate the clinical characteristics of anaphylaxis patients attending our pediatric allergy clinic. We conducted a prospective analysis of patients who were admitted to our allergy clinic for anaphylaxis from 2010 to 2012. Ninety-six patients were evaluated during the study period. The mean age was 7.4 ± 5.2 years. Venom, food, and drugs were the most common causative agents responsible for 31 (32.3%), 30 (31.3%), and 26 (27.1%) of the cases, respectively. Foods implicated most frequently were peanuts and nuts (n = 9; 30.0%), cow's milk (n = 7; 23.3%), and egg white (n = 6; 20.0%). The clinical manifestations during anaphylaxis in order of frequency were cutaneous (97.9%), respiratory (86.5%), gastrointestinal (42.7%), neurological (37.5%), and cardiovascular symptoms (30.2%). A biphasic course was noticed in five cases (5.2%). Of the 91 patients, 79 (86.8%) received H1-antihistamines, 73 (80.2%) received corticosteroids, 40 (44.4%) received adrenaline, 38 (41.8%) received fluid replacement therapy, 18 (19.8%) received β2-mimetics, and 8 (8.8%) received H2-antihistamines. According to severity, 7.3% of patients had mild, 59.4% had moderate, and 33.3% had severe anaphylaxis. Food and bee venom allergy were the most common etiologies. Adrenaline, the first-line treatment of anaphylaxis, was administered in only 44.4% of our cases.

Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

“…38 The association of a biphasic reaction with the severity of the initial reaction has just recently emerged as a potential risk factor. 39 23,34 Although these studies provide some insight about this association, the reported cases are too small to reliably predict this association. Also, the definition of severity used in these studies is inconsistent and not based on objective scoring.…”

Glucocorticoids and Hospital Length of Stay for Children with Anaphylaxis: A Retrospective Study

“…9,10 PBA occurs infrequently in adults with anaphylaxis, with a prevalence ranging from 0 to 20%. [6][7][8]11,12 Few studies have evaluated the association between glucocorticoid use and anaphylaxis in adults. In one Canadian ED, 55% of patients with uniphasic anaphylaxis and 35% of those with biphasic anaphylaxis received glucocorticoids, a difference that did not achieve statistical significance.…”

Diagnosis and management of drug‐induced anaphylaxis in children: An EAACI position paper

“…In another Turkish study on pediatric anaphylaxis in children, which included 96 patients seen at a pediatric allergy clinic in a tertiary care center, 27% of the cases were attributed to drugs and, in another report on 34 cases of severe anaphylaxis in children seen in a pediatric allergy department, 61.8% of the cases analyzed were caused by drugs …”