Related Experiment Videos
Anaphylaxis in children: a 5-year experience
1Division of Emergency Medicine, Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Insights
Anaphylaxis in children is often triggered by latex, food, drugs, or venoms, with respiratory and skin symptoms being most common. Many severe cases occur outside hospitals, and few children with prior anaphylaxis have epinephrine auto-injectors available.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Clinical Pediatrics
Background:
- Anaphylaxis is a severe, life-threatening allergic reaction.
- Understanding pediatric anaphylaxis is crucial for timely intervention.
- Identifying common triggers and clinical presentations aids in management.
Purpose of the Study:
- To determine the causative agents of anaphylaxis in children.
- To describe the signs, symptoms, and disease course.
- To analyze factors associated with severe cases and intensive care unit admission.
Main Methods:
- Retrospective chart review of 55 anaphylaxis cases in 50 pediatric patients (ages 1-19).
- Data collected from urban children's hospital emergency, operating, and inpatient units.
- Analysis of inciting agents, exposure routes, clinical manifestations, and patient history.
Main Results:
- Latex (27%), food (25%), drugs (16%), and venoms (15%) were the most frequent triggers.
- Respiratory (93%) and skin (93%) symptoms were most prevalent.
- Severe cases were associated with latex, nonenteral exposure (91%), and cardiovascular symptoms (45%).
- 35% had a history of allergy to the causative agent.
- Only 5 of 17 patients with prior anaphylaxis had epinephrine auto-injectors available.
Conclusions:
- Anaphylaxis in children commonly presents with respiratory or skin symptoms.
- Severe pediatric anaphylaxis is linked to nonenteral exposures and latex triggers, often occurring within healthcare settings.
- A significant proportion of children lack a documented history of prior reactions to the inciting agent.
- Availability and use of epinephrine auto-injectors remain low among children with a history of anaphylaxis.
Objectives:
To identify the causative agents, presenting signs and symptoms, and course of disease in children diagnosed with anaphylaxis. Design. Five-year retrospective chart review.
Setting:
Urban children's hospital pediatric emergency department, operating suite, and inpatient units.
Participants:
Fifty-five cases of anaphylaxis in 50 patients 1 to 19 years of age.
Interventions:
None.
Results:
The most common inciting agents in this population were latex (27%), food (25%), drugs (16%), and venoms (15%). Thirty-two cases (58%) occurred outside of the hospital, including 3 of 11 severe cases. Nineteen (35%) had histories of prior allergy to the causative agent. Most agent exposures were intravenous (38%), oral (27%), or dermal (20%). The most common systems involved were respiratory (93%), skin (93%), cardiovascular (26%), and neurologic (26%). Features distinguishing the 11 patients requiring intensive care included latex agents (45%), nonenteral route of exposure (91%), and presence of cardiovascular symptoms (45%). Of the 17 patients with known past anaphylaxis, only 5 had epinephrine self-administration devices available, and 3 had used them.
Conclusions:
(1) Most patients with anaphylaxis present with skin or respiratory symptoms. (2) Severely ill children more commonly have nonenteral and/or latex exposures that occur in the hospital. (3) Most children with anaphylaxis have no stated histories of prior reaction to the causative agent. (4) Those patients who have had past episodes of anaphylaxis infrequently have epinephrine self-administration devices available for use.