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An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period

Christopher D Wright1, Mindy Longjohn2, Phillip L Lieberman3

  • 1Departments of Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|April 10, 2017
PubMed

Insights

Pediatric anaphylaxis is most commonly triggered by food. Many children remain undertreated, and emergency department referrals to allergists are infrequent, highlighting a gap in care for severe allergic reactions.

Area of Science:

  • Pediatric Allergy and Immunology
  • Emergency Medicine
  • Public Health

Background:

  • Anaphylaxis case series vary in scope, and specific data on pediatric cases are limited.
  • Understanding pediatric anaphylaxis is crucial due to its potential severity and impact on children's health.

Purpose of the Study:

  • To characterize confirmed cases of pediatric anaphylaxis in a hospital emergency department setting.
  • To identify common triggers, clinical manifestations, and treatment patterns in pediatric anaphylaxis.

Main Methods:

  • Retrospective review of emergency department visits using ICD-9 codes for allergic reactions and venomous stings.
  • Anaphylaxis cases were confirmed using National Institute of Health/National Institute of Allergy and Infectious Diseases criteria by allergists and emergency medicine physicians.

Main Results:

  • Out of 927 identified visits, 40 met anaphylaxis criteria. The median age was 6.5 years, with 70% being male and 80% African American.
  • Food allergens were the most common trigger (65%), followed by insect stings (12.5%) and medications (5%). All patients exhibited multi-organ involvement.
  • Epinephrine was administered in only 33% of cases, and only 4 patients were seen by an allergist after referral.

Conclusions:

  • Foods are the predominant cause of pediatric anaphylaxis in this cohort.
  • Significant under-treatment and under-referral to allergists were observed in pediatric anaphylaxis cases presenting to the emergency department.
Abstract

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