Anaphylaxis in children: a 5-year experience

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.