Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Abstract

BackgroundAnaphylaxis is a serious allergic disease that may lead to death if not immediately recognized and treated. Triggers of anaphylaxis including food, drugs, and insect stings can vary widely. The incidence of anaphylaxis seems to be affected by age, sex, atopy, and geographic location. This study aims to examine the common triggers of anaphylaxis in Qatar.MethodsA total of 1068 electronic medical records were audited using power chart system: 446 from the medical coding system of anaphylaxis and 622 from the epinephrine auto-injectors (EAIs) dispensed during January 2012–December 2017.ResultsOf 1068 patients, 574 (53.5%) had anaphylaxis; male to female ratio was 1.2, and 300 patients (77.9%) were less than 10 years old. The common triggers were food (n = 316, 55.0%), insect stings (n = 161, 28.0%), and drugs (n = 103, 17.9%). Common anaphylaxis food triggers were nuts (n = 173, 30.1%), eggs (n = 89, 15.5%), and seafood (n = 72, 12.5%), and common anaphylaxis medication triggers were antibiotics (n = 49, 8.5%) and nonsteroidal anti-inflammatory drugs (n = 30, 5.2%). Interestingly, 135 anaphylactic patients (23.5%) were due to black ant stings. The anaphylaxis triggers varied significantly between children and adults. Among children (less than 10 years), three quarters of the events were triggered by food (223, 74.3%) while among adults (20–55 years), insect stings (n = 59, 43.0%) and drugs (n = 44, 32.0%) were dominant.DiscussionThis is the first national study stratifying anaphylaxis triggers among different age groups in Qatar. This study will serve as a guide for clinical practice in allergy clinics in Qatar and will help to assess future trends of anaphylaxis in Qatar.Electronic supplementary materialThe online version of this article (10.1186/s40413-018-0200-9) contains supplementary material, which is available to authorized users.

Anaphylaxis in Children: Experience of an Egyptian Center

“…Atopy was repeatedly visualized as a risk factor that might worsen the clinical outcome of anaphylaxis 19 . Abunada and colleagues showed that personal history of atopy for asthma, atopic dermatitis and allergic rhinitis were noted among patients with anaphylaxis; and 56.9% of patients had positive family history which matches our findings 20 . Although a few studies showed no such significant association between atopy and anaphylaxis, several studies stated that anaphylaxis was common among atopic patients 5,16 .…”

“…Retrigo and colleagues documented drug triggered anaphylaxis in 3.1% of preschoolers, 4.1% of school aged and 12.1% of adolescents with analgesics being on the top of list 21 . It is to be noted that majority of anaphylaxis fatalities reported in other studies were caused by medications; with antibiotics and analgesics carrying the highest risk 20,21 . Obviously, presenting signs and symptoms of anaphylaxis were widely variable.…”

Global patterns in anaphylaxis due to specific foods: A systematic review

“…These studies are reported in Fig 2 . 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 …”

World Allergy Organization Anaphylaxis Guidance 2020

“…In central Europe the most frequent elicitors of food-induced anaphylaxis are peanut, tree nuts, seeds like sesame, wheat, and shellfish. 21 , 50 , 51 , 52 , 53 , 54 , 55 , 56 Frequent food allergens in southern Europe are lipid transfer protein containing plant-foods, frequently associated with cofactors, 59 , 60 while sesame seed is a frequent elicitor in the Middle East. 61 Buckwheat is a very common cause of anaphylaxis in Korea.…”