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Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach

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Abstract

Anaphylaxis remains under-diagnosed and under-treated. A better knowledge of patterns and triggers of anaphylaxis might contribute to a better management. In this study we evaluated the demographic and clinical features of anaphylaxis in pediatric patients, as well as its triggers and therapeutic approach. From May 1st 2004 until April 30th 2006 we prospectively collected data on all patients referred for investigation of anaphylaxis to the pediatric department of the University Hospital Gasthuisberg Leuven and to two private pediatric practices. Data were stored in a MYSQL database by use of an online encrypted web form. Sixty-four cases of anaphylaxis occurred in 48 children, aged 6 months to 14.8 years. Twenty-seven episodes (42.2%) occurred at home. The symptoms were dermatologic in 62 (96.9%) episodes, respiratory in 57 (89.1%), gastrointestinal in 19 (29.7%), cardiovascular in 14 (21.8%), and neurological or behavioural in 19 (29.7%). Antihistamines were administered in 41/57 (71.9%) cases, corticosteroids in 26/57 (45.6%), beta-2-mimetics in 14/57 (24.6%), and adrenaline in 11/57 (19.3%). Out of nine cases where Epipen was available at the moment of anaphylaxis, it was administered in one case only. Food was the cause of anaphylaxis in 42/55 (76.4%) cases with identified trigger, while medication, insect stings, latex, and birch pollen triggered 5 (9.1%), 4 (7.3%), 3 (5.5%), and 1 (1.8%) case(s), respectively. Allergy to the trigger was known prior to anaphylaxis in 19/55 (34.5%) cases. In conclusion, anaphylaxis in pediatric patients generally presents with dermatologic and respiratory symptoms, while in 1/5 episodes cardiovascular symptoms occur. Food is by far the most frequent trigger. Allergy to the trigger is known in 1/3 cases only. Anaphylaxis is under-treated, even when appropriate medication is available.

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Abbreviations

SPT:

skin prick test

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Acknowledgements

We would like to thank Johannes Daniels for statistical analysis.

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Authors and Affiliations

  1. Pediatric Allergy, Department of Pediatrics, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium

    Liliane F. A. De Swert, Dominique Bullens & Marc Raes

  2. Pediatric Practice for Allergy and Asthma, Mechelen, Belgium

    Liliane F. A. De Swert & Anna-Maria Dermaux

  3. Pediatric Practice, Hasselt, Belgium

    Marc Raes

  4. Department of Pediatrics, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium

    Liliane F. A. De Swert

Authors
  1. Liliane F. A. De Swert
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  2. Dominique Bullens
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  3. Marc Raes
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  4. Anna-Maria Dermaux
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Corresponding author

Correspondence to Liliane F. A. De Swert.

Additional information

This work has been partially sponsored by an unrestricted grant from UCB, Belgium.

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De Swert, L.F.A., Bullens, D., Raes, M. et al. Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach. Eur J Pediatr 167, 1251–1261 (2008). https://doi.org/10.1007/s00431-007-0661-2

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  • DOI: https://doi.org/10.1007/s00431-007-0661-2

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