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Clinical and Treatment Evaluation of Anaphylaxis in Children Aged 0-2 Years: Multicenter Study
Ahmet Selmanoglu1, Idil Akay Haci2, Fatih Sultan Mehmet Koc3
1Department of Pediatric Allergy and Immunology, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
Insights
Diagnosing anaphylaxis in infants is challenging due to vague symptoms. This study highlights food, especially cow's milk, as the primary trigger in children under two, emphasizing increased awareness and autoinjector use.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pediatrics
- Emergency Medicine
Background:
- Diagnosing anaphylaxis in infants (0-2 years) presents challenges due to nonspecific signs and symptoms.
- Infant anaphylaxis may exhibit distinct clinical presentations, potentially leading to diagnostic delays.
Purpose of the Study:
- To define the phenotype of anaphylaxis in children under two years of age.
- To enhance awareness of anaphylaxis in this vulnerable pediatric population.
Main Methods:
- Retrospective analysis of 402 anaphylaxis episodes in 360 children (0-2 years).
- Inclusion of cases diagnosed by pediatric allergists across 11 tertiary hospitals.
- Identification of causative agents, clinical findings, and management strategies.
Main Results:
- Food allergens were the predominant trigger (93%), with cow's milk (44.6%) and egg being most common.
- Cutaneous (95%) and respiratory (72%) symptoms were most frequent; nonspecific signs like weakness were also noted.
- Adrenaline autoinjector use was low (3/41 parents).
Conclusions:
- Infant anaphylaxis commonly occurs at home, triggered mainly by foods like cow's milk and egg.
- Increased maternal awareness of anaphylaxis symptoms and proper autoinjector use are crucial for effective management.
- Recognizing the unique presentation of infant anaphylaxis is vital for timely diagnosis and treatment.
Background:
Diagnosing anaphylaxis in children within the first 2 years of life can be difficult due to the often confusing and nonspecific signs and symptoms.
Objective:
This study focuses on the phenotype of anaphylaxis in children within the first 2 years of life and aims to increase awareness of anaphylaxis in this age group.
Methods:
The study included children between 0 and 2 years who were diagnosed as having anaphylaxis by pediatric allergists in 11 tertiary hospitals.
Results:
A total of 402 anaphylaxis episodes experienced by 360 patients (68.7% males) were included in the study. Food was the most common causative agent (n = 374, 93%), with the most common foods being cow's milk (n = 179, 44.6%). Drugs were the second most common trigger (n = 15, 3.7%). The most common clinical findings were cutaneous (95%) and respiratory (72%); nonspecific symptoms such as weakness (n = 63, 15.6%) and hoarseness (n = 14, 3.4%) were also reported. There was a biphasic course in 3 infants (0.8%). Only 3 of the 41 parents who had an adrenaline autoinjector used it during anaphylaxis.
Conclusion:
Infants experience anaphylaxis most often when they are at home with their mothers, and the most common triggers are foods, particularly cow's milk and egg. Greater awareness of anaphylaxis symptoms and autoinjector use among mothers can facilitate management.
Impact:
Infant anaphylaxis cases may present with different symptoms compared to classic presentations, potentially leading to diagnostic oversight. The study elucidates the clinical course of anaphylaxis in children under 2 years of age. It details the treatment strategies employed in managing these cases. Anaphylaxis triggers were identified over several years. Cases from 11 regions of Turkey were included, representing a population reflective of national data. The study highlights the distinctiveness of anaphylaxis cases in children within the first 2 years of life.
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