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ÇOCUKLUK DÖNEMİNDE ANAFİLAKSİ: TEK MERKEZ DENEYİMİ

Yıl 2024, Cilt: 31 Sayı: 1, 81 - 88, 18.03.2024
https://doi.org/10.17343/sdutfd.1402856

Öz

Amaç
Anafilaksi ani başlangıçlı, hayatı tehdit eden, sistemik
alerjik bir reaksiyondur. Bu çalışmada anafilaksi tanısı
ile takip ettiğimiz olguların demografik özelliklerini,
klinik bulgularını, anafilaksi tetikleyicilerini ve ilk basamak
tedavide adrenalin kullanım durumunu değerlendirmeyi
amaçladık.
Gereç ve Yöntem
Mayıs 2021- Ekim 2023 tarihleri arasında çocuk alerji
bölümünde anafilaksi tanısı ile takip edilen 0-18 yaş
arasındaki hastalar incelendi. Anafilaksi tanısı alan
olguların demografik özellikleri ve anafilaksi tanı ve
tedavi kayıt bilgileri değerlendirildi.
Bulgular
Toplam 46 anafilaksi hastası değerlendirildi. Hastaların
28’i (%61) erkek olup, ortanca yaş 3,5 (ÇAU: 1-10)
yıl idi. Tüm yaş gruplarında en sık 3 tetikleyici sırasıyla
besin (%61), ilaç (%20) ve böcek zehiri (%20)
idi. Süt, besinler içinde anafilaksiden en çok sorumlu
tetikleyici idi (%22). Olguların %28’ i ağır anafilaksi tanısı
ile takip ediliyordu. Birinci basamak tedavisinde
adrenalin kullanım oranı %52 idi.
Sonuç
Besinler erken çocukluk döneminde anafilaksiden en
çok sorumlu olan tetikleyicilerdir. İlk başvuruda adrenalin
kullanım oranı oldukça düşüktür. Anafilaksi tanı
ve tedavisine yönelik tüm sağlık çalışanlarına yönelik
eğitim programları verilmelidir.

Kaynakça

  • 1. Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology 2020;145(4):1082–123.
  • 2. Wood RA, Camargo CA, Lieberman P, et al. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol 2014;133(2):461–7.
  • 3. Lieberman P, Camargo CA, Bohlke K, et al. Epidemiology of anaphylaxis: Findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol 2006;97(5):596–602.
  • 4. Wang Y, Allen KJ, Suaini NHA, et al. The global incidence and prevalence of anaphylaxis in children in the general population: A systematic review. Allergy. 2019;74(6):1063–80.
  • 5. Motosue MS, Bellolio MF, Van Houten HK, et al. Increasing emergency department visits for anaphylaxis, 2005-2014. J Allergy Clin Immunol Pract 2017;5(1):171-175.e3.
  • 6. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. J Allergy Clin Immunol 2016;137(4):1128-1137.e1.
  • 7. Cardona V, Ansotegui IJ, Ebisawa M, et al. World Allergy Organization Anaphylaxis Guidance 2020. World Allergy Organization Journal 2020;13(10):100472.
  • 8. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014;69(8):1026–45.
  • 9. Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006;117(2):391–7.
  • 10. Muraro A, Roberts G, Clark A, et al. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology. Allergy 2007;62(8):857–71.
  • 11. Cimen SS, Süleyman A, Yücel E, et al. Evaluation of the triggers and the treatment models of anaphylaxis in pediatric patients. North Clin Istanb 2023;10(5):609–17.
  • 12. Orhan F, Canitez Y, Bakirtas A, et al. Anaphylaxis in Turkish children: A multi-centre, retrospective, case study. Clin Exp Allergy 2011;41(12):1767–76.
  • 13. Carrillo E, Hern HG, Barger J. Prehospital administration of epinephrine in pediatric anaphylaxis. Prehospital Emergency Care 2016;3;20(2):239–44.
  • 14. Andrew E, Nehme Z, Bernard S, Smith K. Pediatric anaphylaxis in the prehospital setting: Incidence, characteristics, and management. Prehospital Emergency Care 2018;4;22(4):445–51.
  • 15. Lee WS, An J, Jung YH, et al. Characteristics and treatment of anaphylaxis in children visiting a pediatric emergency department in korea. Biomed Res Int 2020;2020:2014104.
  • 16. Trainor JL, Pittsenbarger ZE, Joshi D, et al. Outcomes and factors associated with prehospital treatment of pediatric anaphylaxis. Pediatr Emerg Care 2022;1;38(1):e69–74.
  • 17. Gaspar Â, Santos N, Faria E, et al. Anaphylaxis in children and adolescents: The Portuguese Anaphylaxis Registry. Pediatr Allergy Immunol 2021;32(6):1278–86.
  • 18. Sousa-Pinto B, Fonseca JA, Gomes ER. Frequency of self- reported drug allergy: A systematic review and meta-analysis with meta-regression. Ann Allergy Asthma Immunol 2017;119(4):362-373.e2.
  • 19. Hsin YC, Hsin YC, Huang JL, et al. Clinical features of adult and pediatric anaphylaxis in Taiwan. Asian Pac J Allergy Immunol 2011;29(4):307–12.
  • 20. Vetander M, Helander D, Flodström C, et al. Anaphylaxis and reactions to foods in children--a population-based case study of emergency department visits. Clin Exp Allergy 2012;42(4):568– 77.
  • 21. Misirlioglu ED, Vezir E, Toyran M, et al. Clinical diagnosis and management of anaphylaxis in infancy. Allergy Asthma Proc 2011;38(1):38–43.
  • 22. Aydogan M, Topal E, Yakıcı N, et al. Food-induced anaphylaxis in early childhood and factors associated with its severity. Allergy Asthma Proc 2021;1;42(5):e135–44.
  • 23. Topal E, Bakirtas A, Yilmaz O, et al. Severe anaphylaxis in children: a single-center experience. Pediatr Neonatol 2014;55(4):320–2.
  • 24. Tanno LK, Gonzalez-Estrada A, Olivieri B, et al. Asthma and anaphylaxis. Current Opinion in Allergy & Clinical Immunology 2019;19(5):447–55.
  • 25. Kim SY, Kim MH, Cho YJ. Different clinical features of anaphylaxis according to cause and risk factors for severe reactions. Allergol Int 2018;67(1):96–102.
  • 26. Kastner M, Harada L, Waserman S. Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy 2010;65(4):435–44.
  • 27. Lin YY, Chang HA, Kao YH, et al. Investigation of the underuse of adrenaline (epinephrine) and prognosis among patients with anaphylaxis at emergency department admission. Front Med (Lausanne) 2023;10:1163817.
  • 28. Simons FER, Ardusso LR, Bilò MB, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J 2014;7(1):9.

ANAPHYLAXIS IN CHILDREN: SINGLE CENTER EXPERIENCE

Yıl 2024, Cilt: 31 Sayı: 1, 81 - 88, 18.03.2024
https://doi.org/10.17343/sdutfd.1402856

Öz

Objective
Anaphylaxis is a sudden-onset, life-threatening,
systemic allergic reaction. In this study, we aimed
to evaluate the demographic characteristics, clinical
findings, triggers of anaphylaxis, and the use of
adrenaline in first-line treatment in pediatric patients
with anaphylaxis.
Material and Method
Patients aged 0-18 years who were followed up
with a diagnosis of anaphylaxis in the pediatric
allergy department between May 2021 and October
2023 were evaluated. Demographic characteristics,
anaphylaxis diagnosis and treatment registry of
patients with anaphylaxis were evaluated.
Results
A total of 46 anaphylaxis patients were evaluated.
Twenty-eight (61%) of the patients were male, and
the median age was 3.5 years (range: 1–10). The
three most common triggers in all age groups were
food (61%), drugs (20%), and insect venom (20%),
respectively. Milk was the most common trigger
responsible for anaphylaxis among foods (22%). 28%
of the cases were followed up with a diagnosis of
severe anaphylaxis. The rate of adrenaline use at the
initial presentation was 52%.
Conclusion
Foods are the triggers most responsible for anaphylaxis
in early childhood. The rate of adrenaline use
at first presentation is very low. Training programs
should be organized for all healthcare professionals
on the diagnosis and treatment of anaphylaxis.

Kaynakça

  • 1. Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology 2020;145(4):1082–123.
  • 2. Wood RA, Camargo CA, Lieberman P, et al. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol 2014;133(2):461–7.
  • 3. Lieberman P, Camargo CA, Bohlke K, et al. Epidemiology of anaphylaxis: Findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol 2006;97(5):596–602.
  • 4. Wang Y, Allen KJ, Suaini NHA, et al. The global incidence and prevalence of anaphylaxis in children in the general population: A systematic review. Allergy. 2019;74(6):1063–80.
  • 5. Motosue MS, Bellolio MF, Van Houten HK, et al. Increasing emergency department visits for anaphylaxis, 2005-2014. J Allergy Clin Immunol Pract 2017;5(1):171-175.e3.
  • 6. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. J Allergy Clin Immunol 2016;137(4):1128-1137.e1.
  • 7. Cardona V, Ansotegui IJ, Ebisawa M, et al. World Allergy Organization Anaphylaxis Guidance 2020. World Allergy Organization Journal 2020;13(10):100472.
  • 8. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014;69(8):1026–45.
  • 9. Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006;117(2):391–7.
  • 10. Muraro A, Roberts G, Clark A, et al. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology. Allergy 2007;62(8):857–71.
  • 11. Cimen SS, Süleyman A, Yücel E, et al. Evaluation of the triggers and the treatment models of anaphylaxis in pediatric patients. North Clin Istanb 2023;10(5):609–17.
  • 12. Orhan F, Canitez Y, Bakirtas A, et al. Anaphylaxis in Turkish children: A multi-centre, retrospective, case study. Clin Exp Allergy 2011;41(12):1767–76.
  • 13. Carrillo E, Hern HG, Barger J. Prehospital administration of epinephrine in pediatric anaphylaxis. Prehospital Emergency Care 2016;3;20(2):239–44.
  • 14. Andrew E, Nehme Z, Bernard S, Smith K. Pediatric anaphylaxis in the prehospital setting: Incidence, characteristics, and management. Prehospital Emergency Care 2018;4;22(4):445–51.
  • 15. Lee WS, An J, Jung YH, et al. Characteristics and treatment of anaphylaxis in children visiting a pediatric emergency department in korea. Biomed Res Int 2020;2020:2014104.
  • 16. Trainor JL, Pittsenbarger ZE, Joshi D, et al. Outcomes and factors associated with prehospital treatment of pediatric anaphylaxis. Pediatr Emerg Care 2022;1;38(1):e69–74.
  • 17. Gaspar Â, Santos N, Faria E, et al. Anaphylaxis in children and adolescents: The Portuguese Anaphylaxis Registry. Pediatr Allergy Immunol 2021;32(6):1278–86.
  • 18. Sousa-Pinto B, Fonseca JA, Gomes ER. Frequency of self- reported drug allergy: A systematic review and meta-analysis with meta-regression. Ann Allergy Asthma Immunol 2017;119(4):362-373.e2.
  • 19. Hsin YC, Hsin YC, Huang JL, et al. Clinical features of adult and pediatric anaphylaxis in Taiwan. Asian Pac J Allergy Immunol 2011;29(4):307–12.
  • 20. Vetander M, Helander D, Flodström C, et al. Anaphylaxis and reactions to foods in children--a population-based case study of emergency department visits. Clin Exp Allergy 2012;42(4):568– 77.
  • 21. Misirlioglu ED, Vezir E, Toyran M, et al. Clinical diagnosis and management of anaphylaxis in infancy. Allergy Asthma Proc 2011;38(1):38–43.
  • 22. Aydogan M, Topal E, Yakıcı N, et al. Food-induced anaphylaxis in early childhood and factors associated with its severity. Allergy Asthma Proc 2021;1;42(5):e135–44.
  • 23. Topal E, Bakirtas A, Yilmaz O, et al. Severe anaphylaxis in children: a single-center experience. Pediatr Neonatol 2014;55(4):320–2.
  • 24. Tanno LK, Gonzalez-Estrada A, Olivieri B, et al. Asthma and anaphylaxis. Current Opinion in Allergy & Clinical Immunology 2019;19(5):447–55.
  • 25. Kim SY, Kim MH, Cho YJ. Different clinical features of anaphylaxis according to cause and risk factors for severe reactions. Allergol Int 2018;67(1):96–102.
  • 26. Kastner M, Harada L, Waserman S. Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy 2010;65(4):435–44.
  • 27. Lin YY, Chang HA, Kao YH, et al. Investigation of the underuse of adrenaline (epinephrine) and prognosis among patients with anaphylaxis at emergency department admission. Front Med (Lausanne) 2023;10:1163817.
  • 28. Simons FER, Ardusso LR, Bilò MB, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J 2014;7(1):9.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk İmmünolojisi ve Alerji Hastalıkları
Bölüm Araştırma Makaleleri
Yazarlar

İbrahim Cemal Maslak 0000-0001-9708-5490

Yayımlanma Tarihi 18 Mart 2024
Gönderilme Tarihi 10 Aralık 2023
Kabul Tarihi 10 Ocak 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 31 Sayı: 1

Kaynak Göster

Vancouver Maslak İC. ÇOCUKLUK DÖNEMİNDE ANAFİLAKSİ: TEK MERKEZ DENEYİMİ. SDÜ Tıp Fak Derg. 2024;31(1):81-8.

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