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Pediatric Anaphylaxis in Emergency Care: A Detailed Analysis of Demographic and Laboratory Findings
Nilay Caliskan1, Recep Okur2, Alper Kacar3
1Department of Pediatric Allergy and Immunology, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Türkiye.
Insights
Pediatric anaphylaxis is a serious allergic reaction, often triggered by medications or food like cow's milk. This study highlights key demographic and clinical findings, emphasizing the need for prompt recognition and treatment by physicians.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Clinical Pediatrics
Background:
- Anaphylaxis is a severe, life-threatening systemic allergic reaction with increasing incidence.
- Prompt recognition and management in pediatric emergency departments (PEDs) are critical.
- Understanding demographic and clinical patterns aids in effective treatment strategies.
Purpose of the Study:
- To analyze the demographic, clinical, and laboratory characteristics of pediatric patients diagnosed with anaphylaxis.
- To identify common triggers and affected systems in pediatric anaphylaxis cases.
- To evaluate tryptase levels in relation to anaphylaxis type and age groups.
Main Methods:
- Retrospective review of 100 pediatric patients diagnosed with anaphylaxis between 2016 and 2023.
- Data collection included patient demographics, trigger identification, affected systems, and tryptase levels.
- Statistical analysis was performed to examine relationships between variables.
Main Results:
- The majority of patients (72%) were over 6 years old, with anaphylaxis most frequently occurring at home (83%).
- Medications were the most common trigger (81%), followed by food (e.g., cow's milk in 8%).
- Skin and mucosa were the most affected systems (97%), and idiopathic cases showed higher average tryptase levels (9.15 ug/L).
Conclusions:
- Anaphylaxis management requires rapid and accurate intervention, with adrenaline as the primary treatment.
- Pediatric emergency physicians are vital in managing anaphylaxis.
- Observed pediatric tryptase levels were often below established cut-offs, suggesting a need for further research to redefine reference ranges.
Objectives:
Anaphylaxis, which has been increasing in frequency parallel to other allergic diseases in recent years, is a life-threatening, acute systemic reaction. Physicians working in pediatric emergency departments (PED) should recognize the signs and symptoms of anaphylaxis and administer initial treatment. This study aims to evaluate the demographic, clinical, and laboratory findings of patients diagnosed with anaphylaxis in the pediatric emergency unit of a tertiary care facility.
Methods:
Patients diagnosed with anaphylaxis in our unit at the PED were retrospectively reviewed between 2016 and 2023.
Results:
A total of 100 patients were diagnosed with anaphylaxis in our pediatric emergency department, including 39 girls and 61 boys. Of these patients, 3% were under 2 years of age, 25% were between 2-6 years, and 72% were over 6 years old. In 83% of the cases, anaphylaxis occurred at home, while 11% occurred during medication administration at a hospital. Triggers were identified in 81% of the patients, whereas 19% were diagnosed with idiopathic anaphylaxis. The most common triggers were medications. Food-related anaphylaxis was the second most common trigger, with cow's milk being the most frequent at 8%. The most commonly affected system was the skin and mucosa in 97% of cases. When examining the relationship between age groups and triggers, food allergies were most frequent in children under 2 years old (p<0.001). The average tryptase level measured during anaphylaxis was 5.27 ug/L (1.43-33.6), with idiopathic cases showing a significantly higher average of 9.15 ug/L (6.29-33.6) (p=0.005).
Conclusion:
Anaphylaxis is a systemic reaction that can be fatal if not treated quickly and accurately. Adrenaline is the single most effective treatment, and pediatric emergency physicians play a crucial role in this context. Our findings suggest that tryptase levels in pediatric patients are often below the widely accepted cut-off; however, larger studies are needed before reference ranges can be redefined.
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