Risk factors, clinical symptoms, diagnostic methods, management and treatment of patients with anaphylaxis in Tehran

Abstract

Introduction: Recent studies have evaluated the risk factors, clinical symptoms, diagnostic methods, management and treatment of anaphylaxis in different populations, but the results of various studies are contradictory. The aim of this study was to evaluate the risk factors, clinical symptoms, diagnostic methods, management and treatment of anaphylactic patients referred to the Children's Medical Center of Tehran during the years 2015-2016.Materials and Methods: In this cross-sectional study, 30 patients with anaphylaxis were studied. The study population included all patients who had been diagnosed with anaphylaxis without age limitation and during the period from 2015 to 2016 to undergo serum beta-tryptase examination were referred to the laboratory of the Children's Medical Center of Tehran. The sampling method was census-based and the information was collected through a pre-designed questionnaire by examining patient files or telephone contacts with patients. After collecting data, the data were entered into SPSS 22 software and analyzed statistically. Finally, P<0.05 was considered statistically significant.Results: In our study, we investigated 30 patients with anaphylaxis, an average age of 25±15 years (range 2 to 60 years) among which 13 (43%) were men and 17 (57%) women.The most important cause of anaphylaxis in the studied patients was foods (57%), followed by drugs (20%), unknown (20%) and pollen plants (3%). About 33.7% of patients had allergies to specific allergens. The most routes of exposure with allergens were, oral (56.3%), intravenous (18.7%), unknown (12.6%) and cutaneous (3.1%), respectively. 33.6% of them had positive skin tests. The most common symptoms of anaphylaxis in order of frequency were respiratory (72.9%), cutaneous (48.8%), cardiovascular (18.6%) and gastrointestinal symptoms (6%). Eighty percent of anaphylaxis occurred at home. The most commonly prescribed medications were corticosteroids (83.3%), antihistamine (76%), epinephrine (60%) and beta-agonists (3%). Only 30% of the patients had access to Epipen.Conclusion: According to the results of this study, since most anaphylactic reactions occur in the home and more than one-third of patients had allergic to certain allergens and two-thirds of patients had a history of anaphylaxis, it seems that by providing the necessary training and knowledge to individuals with regard to allergenic substances or allergenic drugs, as well as increased access for patients to Epipen, we can prevent the occurrence and risk of subsequent anaphylaxis in these people.