Evaluation of clinical and laboratory features of cases with infant anaphylaxis

Yıl 2023, Cilt: 16 Sayı: 3, 483 - 494, 18.12.2023

Aylin Kont Özhan , Aysu İlhan Yalaki , Veysi Akbey , Nazan Tökmeci , Ali Demirhan , Tuğba Arıkoğlu , Semanur Kuyucu

Öz

Aim: The incidence of infant anaphylaxis has been increasing. The diagnosis of anaphylaxis in this age group is very difficult and there is limited data in the literature. In our study, we aimed to determine the etiology, clinical and laboratory features of anaphylaxis cases observed in the infantile age group. Method: The records of 16 children under two years of age who were followed with the diagnosis of infant anaphylaxis in the Pediatric Immunology and Allergy Clinic of Mersin University Faculty of Medicine between January 2020 and January 2023 were evaluated retrospectively. Results: A total of 16 infant anaphylaxis patients; 10 (62.5%) boys and six (37.5%) girls, were included in the study. The mean age at the onset of anaphylaxis was 5.68±3.75 months. Food was identified as the trigger in 14 patients (87.5%) and drugs in two cases (12.5%). Milk (n=8, 50%) was the most common causative agent. Five (31.2%) of our patients had atopic dermatitis and three (18.7%) had episodic wheezing. Skin and/or mucous membrane involvement were the most common ivolvement (n=15, 93.7%), followed by respiratory system involvement (n=12, 75%). The most common clinical finding was urticaria with a rate of 68.7%, and wheezing (62.5%) and dyspnea (62.5%) were other common findings. All patients with a history of food anaphylaxis had positive skin prick test and/or specific immunglobulin-E with the responsible food. Adrenaline was administered intramuscularly in seven patients (43.7%). Seven patients (43.7%) were prescribed adrenaline auto-injectors as prophylaxis after anaphylaxis. Conclusion: In our study, it was found that the most common triggering agents were cow's milk and egg. The most commonly involved system was the skin, but cardiovascular and neurologic involvement were also possible. Adrenaline administration as the first-line treatment and adrenaline auto-injector prescription rate were low, and the use of auto-injectors by parents was low. There is a need to raise awareness and educate healthcare professionals, parents and caregivers about infant anaphylaxis.

Anahtar Kelimeler

Infant, anaphylaxis, adrenaline

İnfant anafilaksi olgularının klinik ve laboratuvar özelliklerinin değerlendirilmesi

Öz

Amaç: İnfant anafilaksi insidansı giderek artmaktadır. Bu yaş grubunda anafilaksi tanısının konulması oldukça zordur ve literatürde bu konu ile ilgili veriler kısıtlıdır. Çalışmamızda infantil yaş grubunda gözlenen anafilaksi olgularının etiyolojileri, klinik ve laboratuvar özelliklerinin belirlenmesi amaçlanmıştır. Yöntem: Mersin Üniversitesi Tıp Fakültesi Çocuk İmmünoloji ve Alerji Kliniği’nde Ocak 2020-Ocak 2023 tarihleri arasında infant anafilaksisi tanısıyla izlenen iki yaş altı 16 çocuğun dosyaları retrospektif olarak değerlendirildi. Bulgular: Çalışmaya 10 (%62.5) erkek, altı (%37.5) kız olmak üzere toplam 16 infant anafilaksi hastası dahil edildi. Anafilaksi geçirme yaşı ortalama 5.68±3.75 aydı. Hastaların 14’ünde (%87.5) tetikleyici olarak besin, iki olguda ise ilaç (%12.5) olarak belirlendi. Besinlerden ise en sık süt (n=8, %50) nedensel ajan olarak belirlendi. Hastalarımızın beşinde (%31.2) atopik dermatit, üçünde (%18.7) epizodik hışıltı eşlik etmekteydi. Hastalarımızda en sık deri ve/veya mukoza tutulumu görülürken (n=15, %93.7), bunu solunum sistemi tutulumu takip etti (n=12, %75). En sık görülen klinik bulgu %68.7 oranında ürtiker olup, hışıltı (%62.5) ve solunum sıkıntısı (%62.5) diğer sık görülen bulgulardı. Besin anafilaksisi öyküsü olan hastaların tamamında sorumlu besin ile yapılan deri prik testi ve/veya spesifik immünglobulin E pozitifti. Tedavi olarak yedi hastaya (%43.7) adrenalin intramuskuler uygulandı. Profilaksi olarak yedi hastaya (%43.7) anafilaksi sonrası adrenalin oto-enjektör reçete edildiği görüldü. Sonuç: Çalışmamızda en yaygın tetikleyici ajanın inek sütü ve yumurta, en sık tutulan sistemin deri olduğu ancak kardiyovasküler ve nörolojik tutulumunda olabileceği, ilk tedavi olarak adrenalin uygulamasının ve adrenalin oto-enjektör reçeteleme oranlarının düşük olduğu, ebeveynlerde oto-enjektör kullanımının az olduğu saptanmıştır. İnfant anafilaksisi konusunda sağlık çalışanlarının, ebeveynlerin ve diğer bakım verenlerin bilinçlendirilmesi ve eğitilmesi gerekmektedir.

Anahtar Kelimeler

İnfant, anafilaksi, adrenalin

Etik Beyan

Çalışma için Mersin Üniversitesi Klinik Araştırmalar Etik Kurulu’ndan 2023/513 karar numarası ile onay alındı.

Destekleyen Kurum

Bu çalışmayı maddi olarak destekleyen bir kuruluş bulunmamaktadır

Kaynakça

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