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Retrospective Evaluation of Patients Admitted to the Emergency Department Due to Anaphylaxis in Children: A

Emre Aygün1, Ezgi Yalçın Güngören2, İrem Çırpıcı1

  • 1Department of Pediatrics, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, 34371 Istanbul, Turkey.

Children (Basel, Switzerland)
|February 27, 2026
PubMed

Insights

Pediatric anaphylaxis management in emergency departments shows good adherence to guidelines for acute care. However, post-discharge care needs improvement, with low rates of auto-injector prescriptions and allergist referrals for children.

Area of Science:

  • Pediatric Emergency Medicine
  • Allergy and Immunology
  • Clinical Pediatrics

Background:

  • Emergency department management of pediatric anaphylaxis is critical.
  • This study examined medical indicators and physician adherence to international treatment protocols for pediatric anaphylaxis at a Turkish tertiary medical center.

Purpose of the Study:

  • To investigate the triggering factors, clinical presentation, and management of pediatric anaphylaxis.
  • To assess physician adherence to international treatment guidelines.
  • To identify gaps in post-discharge care for pediatric anaphylaxis patients.

Main Methods:

  • Retrospective review of 166 pediatric anaphylaxis patients between September 2014 and July 2025.
  • Data collected included triggering factors, clinical findings, treatment, and quality indicators.

Main Results:

  • Food allergy (53%) and drug reactions (24.7%) were primary causes, varying by age group (infants vs. adolescents).
  • Skin (93.4%) and respiratory (67.5%) symptoms were common. Epinephrine was administered intramuscularly to 97.6% of patients within 30 minutes in 61.1% of cases.
  • Drug-induced anaphylaxis had the highest severe case proportion (81.6%). Biphasic reactions occurred in 6%. Auto-injector prescription (7.8%) and allergist referral (15.7%) rates were low. No deaths were reported.

Conclusions:

  • Acute-phase management of pediatric anaphylaxis generally aligns with international guidelines.
  • Significant deficiencies exist in post-discharge care, evidenced by low auto-injector prescription and allergist referral rates.
Abstract

Keywords:
anaphylaxischildrenemergency departmentepinephrinequality indicators

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