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Does anaphylaxis masquerade as asthma in children?
N Sargant1, M Erlewyn-Lajeunesse2, J Benger3
1Children's Emergency Department, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, UK.
Emergency Medicine Journal : EMJ
|September 26, 2014
Summary
Anaphylaxis in children can mimic asthma symptoms, leading to diagnostic confusion. This study found that a significant number of severe asthma cases showed features of anaphylaxis, emphasizing the need for careful evaluation.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Respiratory Medicine
Background:
- Anaphylaxis in children often presents with respiratory symptoms.
- Diagnostic confusion between anaphylaxis and acute asthma is a clinical concern.
- Severe asthma exacerbations require intensive care, presenting a critical diagnostic challenge.
Purpose of the Study:
- To investigate the potential for diagnostic confusion between anaphylaxis and acute asthma in children.
- To determine the prevalence of anaphylaxis features in children admitted to intensive care for asthma.
Main Methods:
- Retrospective analysis of 84 pediatric intensive care unit cases initially diagnosed with asthma.
- Exclusion of 11 cases based on predefined criteria.
- Application of established anaphylaxis diagnostic criteria to the remaining 73 cases.
Main Results:
- 17.8% (13/73) of cases met sufficient clinical criteria for anaphylaxis to be considered.
- 4.1% (3/73) of cases were deemed highly likely to be anaphylaxis.
- Respiratory symptoms are a common presentation for pediatric anaphylaxis, overlapping with asthma.
Conclusions:
- Anaphylaxis should be considered in the differential diagnosis of children presenting with severe asthma.
- Diagnostic criteria for anaphylaxis are crucial for accurate identification in pediatric respiratory emergencies.
- Improved recognition of anaphylaxis can lead to timely and appropriate management, improving patient outcomes.
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