Anaphylaxis in children: Effect of age and atopic status.

IF 2.3 4区 医学 Q3 ALLERGY Asian Pacific journal of allergy and immunology Pub Date : 2024-01-06 DOI:10.12932/AP-310723-1664
Nutthakit Wong-Onta, Adithep Sawatchai, Watcharoot Kanchongkittiphon, Wiparat Manuyakorn
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Abstract

Background: Anaphylaxis is a life-threatening allergic reaction with rising incidence worldwide. Young children's limited ability to express symptoms adds unique diagnostic challenges.

Objective: To study on anaphylaxis in children, including triggers, symptoms, treatment, atopic status impact, and adrenaline injection time intervals.

Methods: In-patient medical records of children who were diagnosed with anaphylaxis during 2014-2021 were reviewed.

Results: One hundred thirty-three anaphylaxis events were identified. Food (47%) was the most common trigger, followed by drugs (31%), blood components (17%), insects (3%), and idiopathic causes (2%). Ten cases of refractory anaphylaxis, 2 cases of biphasic reactions, and 1 case of persistent anaphylaxis were found. There were no reported fatalities. The most common presentations involved the skin (94%), followed by the respiratory (73%), gastrointestinal (47%), and cardiovascular (42%) systems. In atopic patients, wheezing was more prominent than in those without atopy (p-value = 0.017). In the non-atopic patients, there was a higher incidence of cardiovascular symptoms, particularly hypotension (p-value = 0.001), compared to individuals with atopy. Children under 5 years old with mild-moderate anaphylaxis required more time to reach the hospital (147.0 vs. 45.0 minutes, p = 0.033) and to receive adrenaline injections (35.0 vs. 9.0 minutes, p-value = 0.017) than those with severe anaphylaxis.

Conclusion: Childhood anaphylaxis is prevalent. Children with mild-moderate anaphylaxis experienced delays in hospital visits and adrenaline administration. Education on allergies is needed to improve the identification and prompt response to anaphylactic reactions, especially in young children.

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儿童过敏性休克:年龄和特应性状态的影响。
背景:过敏性休克是一种危及生命的过敏反应,在全球的发病率不断上升。幼儿表达症状的能力有限,这给诊断带来了独特的挑战:研究儿童过敏性休克,包括诱因、症状、治疗、特应性状态影响和肾上腺素注射时间间隔:方法:查阅 2014-2021 年间被诊断为过敏性休克的儿童住院病历:结果:共发现 133 起过敏性休克事件。食物(47%)是最常见的诱发因素,其次是药物(31%)、血液成分(17%)、昆虫(3%)和特发性原因(2%)。共发现 10 例难治性过敏性休克、2 例双相反应和 1 例持续性过敏性休克。没有死亡病例的报告。最常见的症状涉及皮肤系统(94%),其次是呼吸系统(73%)、胃肠道系统(47%)和心血管系统(42%)。在特应性患者中,喘息比非特应性患者更明显(P 值 = 0.017)。与特应病患者相比,非特应病患者出现心血管症状,尤其是低血压(p 值 = 0.001)的几率更高。与重度过敏性休克患者相比,患有轻度-中度过敏性休克的 5 岁以下儿童需要更多时间到达医院(147.0 分钟对 45.0 分钟,p = 0.033)和接受肾上腺素注射(35.0 分钟对 9.0 分钟,p 值 = 0.017):结论:儿童过敏性休克很普遍。结论:过敏性休克在儿童中普遍存在,轻度至中度过敏性休克的儿童在医院就诊和肾上腺素注射方面都会出现延误。需要开展过敏教育,以提高过敏反应的识别能力和及时应对能力,尤其是在幼儿中。
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来源期刊
CiteScore
12.80
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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