Anaphylaxis in Turkish children: a multi‐centre, retrospective, case study

Orhan, Fazıl; Canıtez, Yakup; Bakırtaş, Arzu; Yılmaz, Özge; Boz, Adil; Can, Demet; Kuyucu, Semanur; Harmancı, Koray; Tahan, Fulya; Reisli, İsmail; Karakas, Taner; Baki, Ali; Çokuğraş, Haluk; Çakır, Murat; Yüksel, Hasan

doi:10.1111/j.1365-2222.2011.03859.x

Cited by 70 publications

(90 citation statements)

References 54 publications

(143 reference statements)

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“…In our study, male predominancy was obvious in venom induced anaphylaxis (68%) and in children £ 2 years old (74%). Similar to the results of our study, Orhan et al 7 also concluded the predominance of male gender in infants.…”

Section: Discussionsupporting

confidence: 94%

“…5,7,12,13 Novembre et al 13 found out male predominance of 2:1 and hypothesized that it might be attributable to the larger number of boys with hymenoptera sting or exercise-induced anaphylaxis. In our study, male predominancy was obvious in venom induced anaphylaxis (68%) and in children £ 2 years old (74%).…”

Section: Discussionmentioning

confidence: 98%

“…[2][3][4] Retrospective studies on anaphylaxis in children has increased in recent years and data from them indicate an increase in anaphylaxis in children. [5][6][7] Even though the first drug of choice is intramuscular adrenaline, there are still inadequancies in doctors and in patients who have selfinjectable adrenaline devices. 8,9 The purpose of this study is to determine the demographics and atopic status of patients, etiology, clinical features of anaphylaxis, its management and follow-up over the 9-year period at a tertiary care center in Ankara.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiological and Clinical Features of Anaphylaxis: Single Center Experience with 109 Children

Topal

Bakırtaş

Yılmaz

et al. 2013

Pediatric Allergy, Immunology, and Pulmonology

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There has been increasing data on pediatric anaphylaxis. In this study, we aim to determine demographics and atopic status of patients, etiology, and clinical feature of anaphylaxis, its management and follow-up over the 9-year period. We made a retrospective medical chart review of patients diagnosed as anaphylaxis in the Pediatric Allergy and Asthma Department of Gazi University Hospital between January 2003 and May 2012. Diagnosis of anaphylaxis was reviewed by 2 pediatric allergists and those compatible with the criteria according to the second symposium on the definition and management of anaphylaxis were included in the analysis. During the study period, 109 patients (66 male, 43 famale) were diagnosed with anaphylaxis. The median age was 72 months. Fourteen patients (12.8%) had more than one episode before diagnosis. Anaphylactic episode was severe in 28 patients (25.7%). Cutaneous symptoms were the most frequent symptoms (91.7%). Blood pressure measurement had been done in 47 patients (43.1%). Treatment of anaphylaxis included antihistamines in 105 patients (96.3%), corticosteroids in 101 patients (92.7%), and adrenaline in 50 patients (45.9%). The most common cause of anaphylaxis differed according to age groups: food in infants (85%), drugs in older children (43.8%). Sixty-six patients were prescribed autoinjector. In follow-up, 10 patients (9.2%) experienced a second episode of anaphylaxis. Nine of them had adrenaline autoinjector, 3 of them carried the autoinjector with them but only one patient used it. Major etiologic factors of anaphylaxis differed according to the age of children. There were inadequancies in management of anaphylaxis related to physicians, such as blood pressure measurement and acute treatment of anaphylaxis in medical centers and related to patients as uncompliances to carry and use adrenaline autoinjector.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiological and Clinical Features of Anaphylaxis: Single Center Experience with 109 Children

Topal

Bakırtaş

Yılmaz

et al. 2013

Pediatric Allergy, Immunology, and Pulmonology

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“…Helbing et al reported that epinephrine was administered to 47.9% of patients [16]. Orhan et al found that only 32.2% of their patients received epinephrine as treatment for anaphylaxis [17]. Beyer et al also found a low percentage of use of epinephrine in the ED in Berlin, where it was used in only 22.7% of cases [18].…”

Section: Discussionmentioning

confidence: 98%

Adherence to Anaphylaxis Guidelines: Real-World Data From the Emergency Department of a Tertiary Hospital

Guevara

Laffond

Bara

et al. 2018

J Investig Allergol Clin Immunol

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Background:To date, few studies have evaluated the degree of compliance with recommendations of anaphylaxis guidelines in emergency departments (EDs). Objective: The objective of this study was to evaluate adherence to anaphylaxis guidelines recommendations in an ED of a tertiary hospital. Methods: Medical records of patients that were assisted in the ED of the University Hospital of Salamanca (Spain) were reviewed. Those patients fulfilling anaphylaxis criteria proposed by the NIAID/FAAN were selected. Results: During one year period, we identified 89 patients, 74 adults and 15 children. In the 65% of adults the anaphylactic reaction was moderate, in 34% severe and in 1% very severe. In children, all reactions were moderate. Less than half (42%) of patients received adrenaline at ED, which was administered intramuscularly only in 19% of the cases. Regarding the severity of the reaction, 65% of patients with moderate reactions and 42% with severe reactions were no treated with adrenaline. At discharge from ED, an adrenaline auto-injector was recommended only to 5.6% of patients. Fifty-two percent of patients received a documented allergy referral (57% adults vs. 27% children, p=0.047), 29% instructions about avoidance of triggers (31% adults vs. 20% children, n.s.), and 51% written instructions for recognition of anaphylaxis warning signs (41% adults vs. 100% children, p<0.001). Conclusion: The results of the study show a large discrepancy between guidelines recommendations and anaphylaxis management in ED. Additional efforts in education to improve the treatment of patients with anaphylactic reactions are needed.

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“…como es complejo predecir cuáles son los pacientes que tienen probabilidades de desarrollar una anafilaxia, la indicación de los autoinyectores debe ser juiciosa 54 y es necesario recordar que la mayor parte de las reacciones anafilácticas ocurren en el hogar; 55 los alimentos son la causa más frecuente. [56][57][58] La indicación correcta de autoinyectores contribuye a la reducción de costos directos en el tratamiento de la anafilaxia.…”

Section: Actualización En Las Recomendaciones Del Tratamiento Del Chounclassified

Actualización en las recomendaciones del tratamiento del choque anafiláctico: novedades sobre el uso de adrenalina

2015

Arch Argent Pediat

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ResumenEn 1998, la Sociedad Argentina de Pediatría publicó la recomendación del tratamiento del choque anafiláctico. Mientras en dicha recomendación se sugería el uso de adrenalina por vía subcutánea, actualmente se considera la vía intramuscular como la más adecuada. Aspectos farmacodinámicos determinan esta preferencia. Para el tratamiento extrahospitalario, el uso de autoinyectores de manera correcta puede colaborar en el control rápido y eficaz de la afección. El uso del resto de las medicaciones propuestas en la recomendación de 1998 se mantiene sin cambios. Palabras clave: anafilaxia, adrenalina intramuscular, autoinyectores de adrenalina. ABsTRACTIn 1998, the Sociedad Argentina de Pediatría issued the recommendation of the treatment of anaphylactic shock. While this recommendation suggested the use of subcutaneous epinephrine, currently the intramuscular via is considered the most appropriate one. Pharmacological aspects determine this preference. For outpatient treatment, the correct use of autoinjectors can control anaphylaxis quickly and effectively. The use of other medications in the proposed 1998 recommendation remains unchanged. InTRODuCCIÓnEn 1998, la Sociedad Argentina d e P e d i a t r í a ( S A P ) p u b l i c ó l a recomendación sobre el tratamiento integral del choque anafiláctico. 1 Dicho documento tuvo como objetivo unificar las medidas necesarias para el tratamiento de una entidad que requiere precisión en la identificación del paciente y en la elección del tratamiento adecuado para el rescate del niño con este problema.2,3 La anafilaxia es de aparición súbita, potencialmente mortal, por lo general, subdiagnosticada y mal tratada. 4 Esta recomendación es útil y debería considerarse en los programas de entrenamiento de las emergencias pediátricas.N o v e d a d e s i n t r o d u c i d a s e n estos últimos años obligan a realizar una actualización sobre algunos conceptos básicos de las definiciones y tratamiento del choque anafiláctico.Actualmente, se considera que existen dos definiciones de anafilaxia: una fisiopatológica y otra clínica. La primera está relacionada con la propuesta por la recomendación de 1998 y dice: "Cuadro clínico caracterizado por aquellas reacciones sistémicas atribuibles a la liberación de mediadores químicos debidas a causas conocidas (inmunológicas y no inmunológicas) o desconocidas (idiopáticas)". La segunda aclara sobre el tipo de reacción sistémica a la que se hace referencia en la primera: "Reacción alérgica generalizada multisistémica rápidamente evolutiva caracterizada por uno o más síntomas o signos de compromiso respiratorio y/o cardiovascular, y que también involucra a otros sistemas como la piel o el aparato gastrointestinal".

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Anaphylaxis in Turkish children: a multi‐centre, retrospective, case study

Abstract: Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.

Cited by 70 publications

References 54 publications

Epidemiological and Clinical Features of Anaphylaxis: Single Center Experience with 109 Children

Epidemiological and Clinical Features of Anaphylaxis: Single Center Experience with 109 Children

Adherence to Anaphylaxis Guidelines: Real-World Data From the Emergency Department of a Tertiary Hospital

Actualización en las recomendaciones del tratamiento del choque anafiláctico: novedades sobre el uso de adrenalina

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