Epidemiological and Clinical Features of Anaphylaxis: Single Center Experience with 109 Children

Abstract

There has been increasing data on pediatric anaphylaxis. In this study, we aim to determine demographics and atopic status of patients, etiology, and clinical feature of anaphylaxis, its management and follow-up over the 9-year period. We made a retrospective medical chart review of patients diagnosed as anaphylaxis in the Pediatric Allergy and Asthma Department of Gazi University Hospital between January 2003 and May 2012. Diagnosis of anaphylaxis was reviewed by 2 pediatric allergists and those compatible with the criteria according to the second symposium on the definition and management of anaphylaxis were included in the analysis. During the study period, 109 patients (66 male, 43 famale) were diagnosed with anaphylaxis. The median age was 72 months. Fourteen patients (12.8%) had more than one episode before diagnosis. Anaphylactic episode was severe in 28 patients (25.7%). Cutaneous symptoms were the most frequent symptoms (91.7%). Blood pressure measurement had been done in 47 patients (43.1%). Treatment of anaphylaxis included antihistamines in 105 patients (96.3%), corticosteroids in 101 patients (92.7%), and adrenaline in 50 patients (45.9%). The most common cause of anaphylaxis differed according to age groups: food in infants (85%), drugs in older children (43.8%). Sixty-six patients were prescribed autoinjector. In follow-up, 10 patients (9.2%) experienced a second episode of anaphylaxis. Nine of them had adrenaline autoinjector, 3 of them carried the autoinjector with them but only one patient used it. Major etiologic factors of anaphylaxis differed according to the age of children. There were inadequancies in management of anaphylaxis related to physicians, such as blood pressure measurement and acute treatment of anaphylaxis in medical centers and related to patients as uncompliances to carry and use adrenaline autoinjector.

Knowledge of general practitioners and medical students regarding the diagnosis and treatment of anaphylaxis

“…Adrenalin yapılmasındaki gecikme ya da yeterli dozda yapılmaması anafilaksiye bağlı mortalite ve morbidite riskini artırmaktadır [22][23][24]. Ülkemizde yapılan çalışmalarda anafilaksi durumunda adrenalin kullanımını bilen hekimler %12.8 ile %45.9 arasında değişmektedir [11,16,25]. Çalışmamızda anafilaksi durumunda adrenalin kullanılması gerekliliği tıp fakültesi öğrencilerinin sadece %59.8'si ve pratisyen hekimlerin sadece %51.3'i tarafından ifade edilmiştir.…”

“…Ülkemizde yapılan çalışmalarda anafilaksi durumunda adrenalin doğru kullanım şeklini bilen hekimler %31.2 ile %45.9 arasında değişmektedir [16,24,27]. Çalışmamızda tıp fakültesi son sınıf öğrencileri ile pratisyen hekimlerin adrenalin kullanımı ile ilgili bilgilerinin benzer olduğu görüldü (sırasıyla %50'ye %48.1).…”

Đặc Điểm Lâm Sàng, Cận Lâm Sàng Và Kết Quả Điều Trị Của Trẻ Bị Sốc Phản Vệ Tại Bệnh Viện Trẻ Em Hải Phòng Năm 2019 - 2020

“…Trong nghiên cứu của chúng tôi, tỉ lệ bệnh nhi được dùng corticoid chiếm tỉ lệ cao (96,3%). Kết quả này tương đồng với nghiên cứu của Erdem Topal và cộng sự (90%) [8].…”

Anafilaksi

“…Anafilaksinin hayat kurtarıcı tedavisi IM adrenalin olmasına rağmen ülkemizde yapılan araştırmalarda anafilaksi nedeniyle sağlık merkezlerine başvuran vakaların tümüne adrenalin tedavisi uygulanmadığı saptanmıştır (12,21,22). Bu sonuçlar da ülkemizde anafilaksi tedavisine yaklaşımda eksiklikler olduğunu göstermektedir.…”