First study of pattern of anaphylaxis in a large tertiary care hospital in Saudi Arabia

Abstract

BackgroundAnaphylaxis is a serious allergic reaction that may cause death. The signs and symptoms of anaphylaxis have not been examined in the Saudi population before.ObjectiveThe present study examined the signs, symptoms, triggers, and demographic patterns of patients treated for anaphylaxis at a large tertiary care hospital in Riyadh, Saudi Arabia.MethodsAll the patients who were prescribed new prescriptions of adrenaline auto-injectors (AAs) between February 1, 2010 and December 31, 2011 were included in this study. Information was collected using a standardized form.ResultsThere were 238 patients who were analyzed. The median age at the time of first AA prescription was 15.5 years. Female to male ratio was 52:48 and 54% of the subjects were more than 18 years of age. There were some differences in the presenting signs and symptoms observed in our study compared with similar studies from around the world. Urticaria and angioedema were the most common at about 70% across all ages, followed by shortness of breath at 28%. Some triggers were found to be more common in our region. Food was the commonest trigger for anaphylaxis including tree nuts, egg, and sesame. Drug allergy was also a common trigger, with penicillins and nonsteroidal anti-inflammatory drugs being the commonest. Regarding insect allergy, samsam ant was the commonest trigger in our study.ConclusionTo our knowledge, this is the first study on anaphylaxis in Saudi Arabia. Some of the manifestations of anaphylaxis are significantly different in our population study compared to previously published data from other parts of the world. While managing anaphylaxis, we should be mindful of these differences. This improved understanding should help reduce the morbidity and mortality associated with anaphylaxis in our region.

Cause and Clinical Presentation of Anaphylaxis in Singapore: From Infancy to Old Age

“…Our study demonstrated that food anaphylaxis in adults was the most common type, as opposed to drug anaphylaxis seen in reports from Western [18][19][20] and some Asian [21,22] countries. Food was the most common cause of anaphylaxis in prior studies of adults in Singapore [9], China [23], and Saudi Arabia [24], and in the general population in Thailand [25] and Hong Kong [17]. Shellfish was the most common food allergen in our study, echoing findings from Asian countries such as Thailand [25], Taiwan [26], and Hong Kong [17].…”

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“…Most of these were employees of the hospital or their dependents. The signs, symptoms and triggers of anaphylaxis from these patients have already been described previously [18].…”

“…The mean age was 22.9 years, (2 years to 73 years) SD ± 18.2. Male to female ratio was 48:52 and 54% of the patients were 18 or older.…”

Hypersensitivities to sesame and other common edible seeds

“…In a pediatric series, the median age was 1 year (5). In a study from Saudi Arabia, sesame was the third most common trigger of food-induced anaphylaxis (6). According to a multicenter study in Italy (7) by the EpidemAAITO (Associazione Allergologi Immunologi Territoriali e Ospedalieri) consortium, of 351 adults sensitized to various fruits and vegetable, there were five with systemic symptoms to seeds (sesame and sunflower).…”