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Published on: October 14, 2014
Paediatric anaphylaxis: a 5 year retrospective review
I L de Silva1, S S Mehr, D Tey
1Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Vic., Australia.
Insights
Most childhood anaphylaxis cases occur at home, triggered by food like peanuts and cashews. Many children experience their first reaction, with delayed therapy administration being a significant concern.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Clinical Pediatrics
Background:
- Anaphylaxis in children is a critical medical emergency.
- Understanding triggers and presentation is vital for timely intervention.
- Previous studies on childhood anaphylaxis have varied in scope and population.
Purpose of the Study:
- To characterize demographic, clinical, and therapeutic aspects of childhood anaphylaxis.
- To identify common causative agents and settings for pediatric anaphylaxis.
- To analyze the timeliness of treatment administration in pediatric anaphylaxis cases.
Main Methods:
- Retrospective case note review of pediatric anaphylaxis cases.
- Study conducted over a 5-year period at a major children's hospital Emergency Department (ED).
- Inclusion criteria focused on confirmed anaphylaxis presentations in children.
Main Results:
- 123 cases in 117 patients were analyzed; one fatality occurred.
- Food, particularly peanuts and cashews, was the most frequent trigger (85%).
- Most reactions (48%) occurred at home, with respiratory symptoms being predominant (97%).
Conclusions:
- This study represents the largest reported series on childhood anaphylaxis.
- First-time anaphylactic reactions are common in children presenting to the ED.
- Significant delays in therapy administration were observed, highlighting a critical area for improvement.
Objective:
To describe the demographic characteristics, clinical features, causative agents, settings and administered therapy in children presenting with anaphylaxis.
Methods:
This was a retrospective case note study of children presenting with anaphylaxis over a 5-year period to the Emergency Department (ED) at the Royal Children's Hospital, Melbourne.
Results:
One-hundred and twenty-three cases of anaphylaxis in 117 patients were included. There was one death. The median age of presentation was 2.4 years. Home was the most common setting (48%) and food (85%) the most common trigger. Peanut (18%) and cashew nut (13%) were the most common cause of anaphylaxis. The median time from exposure to anaphylaxis for all identifiable agents was 10 min. The median time from onset to therapy was 40 min. Respiratory features were the principal presenting symptoms (97%). Seventeen per cent of subjects had experienced anaphylaxis previously.
Conclusions:
This is the largest study of childhood anaphylaxis reported. Major findings are that most children presenting to the ED with anaphylaxis are first-time anaphylactic reactions and the time to administration of therapy is often significantly delayed. Most reactions occurred in the home. Peanut and cashew nut were the most common causes of anaphylaxis in this study population, suggesting that triggers for anaphylaxis in children have not changed significantly over the last decade.
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