Clinical features of adult and pediatric anaphylaxis in Taiwan

Most epidemiologic studies of anaphylaxis have been on Western populations, leaving the clinical and demographic pattern of this acute allergic condition in Asia unclear.

To investigate the clinical characteristics of patients with anaphylaxis in Chang Gung Memorial Hospital, the largest medical center in Taiwan.

We conducted a retrospective analysis of 201 patients who visited the emergency department or were admitted to the hospital for anaphylaxis from 2000 to 2010. We analyzed the causes, clinical presentation, and management, and also compared adult and pediatric cases.

The average patient age was 43.3 years. Mortality from anaphylaxis was 0.5% (1/201). The annual number of cases presenting with anaphylaxis increased throughout the decade we studied. Seven types of etiology were identified: medication (53%), contrast medium (24%), idiopathic condition (8%), food (5%), blood transfusion (4%), insect sting (3%), and others (3%). Skin and respiratory presentations are more common in children than in adults (skin presentation, 81% vs. 51%, p = 0.002); respiratory presentation, 74% vs. 49%, p = 0.011), and cardiovascular presentation is more frequent in adults than in children (83% vs. 61%, p = 0.006). Clinical presentations with angioedema, gastro-intestinal and neurological system involvement, and management were not significantly different between adults and children.

We conclude that anaphylaxis in Taiwan appears to be increasing, just as in the West, but shows a different clinical picture; medication rather than food was the most common cause of anaphylaxis in our population. Moreover, food-induced anaphylaxis in children is not so prevalent in Taiwan.