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Çocuk Alerji Kliniği’nde İzlenen Anafilaksili Olguların Özellikleri

Year 2017, Volume: 15 Issue: 1, 12 - 18, 01.04.2017
https://doi.org/10.4274/jcp.58070

Abstract

Giriş: Anafilaksi hayatı tehdit edebilen, ciddi bir hipersensitivite reaksiyonudur. Anafilaksi sıklığı toplumlara göre değişmektedir. Bu çalışmada çocuk alerji kliniğimizde anafilaksi tanısı konulan hastaların demografik özellikleri, klinik seyirleri, tetikleyici ajanlar ve tedavi yaklaşımları değerlendirilmiştir.Gereç ve Yöntem: 2010-2012 yılları arasında anafilaksi tanısı konulan çocukların tıbbi kayıtları retrospektif olarak değerlendirildi. Bulgular: Polikliniğimize 2010-2012 yılları arasında 39,371 hasta başvurdu. Yaş ortalaması 8,9±5,3 yıl olan 66 çocuk 49 erkek, 17 kız anafilaksi olarak değerlendirildi. Olguların 37’sinde anafilaksi ev ortamında gerçekleşmişti. Dermatolojik semptomlar en sık başvuru şikayetleriydi. Beş hasta dışındaki tüm hastalarda %92,4 olası anafilaksi nedeni tanımlandı. Besinler olguların 25’inde anafilaksi nedeniydi. Bunu takiben, olguların 22’sinde arı sokması, 14’ünde ilaçlar anafilaksi nedeniydi. Yaşlara göre en sık anafilaksi nedenleri besinler, arı sokması ve ilaçlardı sırasıyla 0-3 yaş, 4-14 yaş ve 14 yaş üstü . Tüm hastalara antihistaminik uygulanmıştı. Uygulanan diğer ilaçlar kortikosteroid, oksijen, intravenöz sıvı, adrenalin 21/66 ve nebülize salbutamol idi. Sonuç: Çocuklardaki anafilaksinin sık nedeni besin alerjenleridir. Fakat bu sıklık yaşla azalmaktadır ve diğer nedenler besinlerden daha sıktır. Ülkemizde anafilaksi tedavisinde adrenalin kullanımı düşüktür.

References

  • 1. Simons FE, Ardusso LR, Bilò MB, Dimov V, Ebisawa M, El￾Gamal YM, et al; World Allergy Organization. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol 2012;12:389-99.
  • 2. Lieberman P, Camargo CA Jr, Bohlke K, Lieberman P, Camargo CA Jr, 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;97:596-602.
  • 3. Decker WW, Campbell RL, Manivannan V, Luke A, St Sauver JL, Weaver A, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008;122:1161-5.
  • 4. Shen Y, Li L, Grant J, Rubio A, Zhao Z, Zhang X, et al. Anaphylactic deaths in Maryland (US) and Shanghai: a review of forensic autopsy cases from 2004 to 2006. Forensic Sci Int 2009;186:1-5.
  • 5. Orhan F, Canitez Y, Bakirtas A, Yilmaz O, Boz AB, Can D, et al. Anaphylaxis in Turkish children: a multi-centre, retrospective, case study. Clin Exp Allergy 2011;41:1767-76.
  • 6. Serbes M, Can D, Atlihan F, Günay I, Asilsoy S, Altinöz S. Common features of anaphylaxis in children. Allergol Immunopathol (Madr) 2013;41:255-60.
  • 7. Vezir E, Erkoçoğlu M, Kaya A, Toyran M, Özcan C, Akan A, et al. Characteristics of anaphylaxis in children referred to a tertiary care center. Allergy Asthma Proc 2013;34:239-46.
  • 8. Topal E, Bakirtas A, Yilmaz O, Ertoy Karagol IH, Arga M, Demirsoy MS, et al. Anaphylaxis in infancy compared with older children. Allergy Asthma Proc 2013;34:233-8.
  • 9. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, 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. Ann Emerg Med 2006;47:373-80.
  • 10. Simons FER, Peterson S, Black C. Epinephrine dispensing for out-of-hospital treatment of anaphylaxis in infants and children: a population-based study. Ann Allergy Asthma Immunol 2001;86:622-6.
  • 11. De Swert LF, Bullens D, Raes M, Dermaux AM. Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach. Eur J Pediatr 2008;167:1251- 61.
  • 12. Sheehan WJ, Graham D, Ma L, Baxi S, Phipatanakul W. Higher incidence of pediatric anaphylaxis in northern areas of the United States. J Allergy Clin Immunol 2009;124:850-2.
  • 13. Simons FE. Anaphylaxis. J Allergy Clin Immunol 2010;125 (Suppl 2):161-81.
  • 14. Harduar-Morano L, Simon MR, Watkins S, Blackmore C. Algorithm for the diagnosis of anaphylaxis and its validation using population-based data on emergency department visits for anaphylaxis in Florida. J Allergy Clin Immunol 2010;126:98- 104.
  • 15. Yocum MW, Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD. Epidemiology of anaphylaxis in Olmsted County: a population-based study. J Allergy Clin Immunol 1999;104:452-6.
  • 16. Mehl A, Wahn U, Niggeman B. Anaphylactic reactions in children-a questionnaire-based survey in Germany. Allergy 2005;60:1440-5.
  • 17. Novembre E, Cianferoni A, Bernardini R, Mugnaini L, Caffarelli C, Cavagni G, et al. Anaphylaxis in children: clinical and allergologic features. Pediatrics 1998;101:E8.
  • 18. Thong BY, Cheng YK, Leong KP, Tang CY, Chng HH. Anaphylaxis in adults referred to a clinical immunology/allergy centre in Singapore. Singapore Med J 2005;46:529-34.
  • 19. Ben-Shoshan M, Clarke AE. Anaphylaxis: past, present and future. Allergy 2011;66:1-14.
  • 20. Pastorello EA, Rivolta F, Bianchi M, Mauro M, Pravettoni V. Incidence of anaphylaxis in the emergency department of a general hospital in Milan. J Chromatogr B Biomed Sci Appl 2001;756:11-7.
  • 21. Lieberman PL. Anaphylaxis. In: Adkinson NF Jr, Bochner BS, Busse WW, Holgate ST, Lemanske RF Jr, Simons FER, editors. Middleton’s allergy: principles and practice. 7th ed. China, Elsevier; 2009. p.1027-49.
  • 22. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. J Clin Pathol 2000;53:273-6.
  • 23. Cianferoni A, Novembre E, Mugnaini L, Lombardi E, Bernardini R, Pucci N, et al. Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985-1996). Ann Allergy Asthma Immunol 2001;87:27-32.
  • 24. Lieberman P. Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol 2005;95:217-26.

The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic

Year 2017, Volume: 15 Issue: 1, 12 - 18, 01.04.2017
https://doi.org/10.4274/jcp.58070

Abstract

Introduction: Anaphylaxis is a severe hypersensitivity reaction that can be lifethreatening. The frequency of anaphylaxis varies among the societies. In this study, the demographic characteristics, clinical course, triggering agents and treatment approaches of the patients who were diagnosed with anaphylaxis in our pediatric allergy clinic were evaluated.Materials and Methods: The medical records of children who received a diagnosis of anaphylaxis between 2010 and 2012 were retrospectively evaluated. Results: Between 2010 and 2012, 39.371 patients were admitted to our outpatient clinic. Sixty-six patients 49 male, 17 female with a mean age of 8.9±5.3 years were evaluated as anaphylaxis. In 37 of the cases, anaphylactic attack occurred at home. Dermatological symptoms were the most frequent complaints. A probable cause of anaphylaxis was identified in all the patients except for five of them 92.4% . Food was the cause of anaphylaxis in 25 of the cases, followed by hymenoptera sting in 22 patients and drugs in 14 patients. The most common causes of anaphylaxis according to age groups were food, hymenoptera sting and drugs 0-3 years, 4-14 years and over the age of 14, respectively . Antihistamines were applied to all patients. The other medications that were applied were corticosteroid, oxygen, intravenous fluids, adrenaline 21/66 , and salbutamol.Conclusions: The common cause of anaphylaxis in children is food allergens. However, the frequency decreases by age and other causes are more common than food. In our country, usage of adrenaline for the treatment of anaphylaxis is low

References

  • 1. Simons FE, Ardusso LR, Bilò MB, Dimov V, Ebisawa M, El￾Gamal YM, et al; World Allergy Organization. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol 2012;12:389-99.
  • 2. Lieberman P, Camargo CA Jr, Bohlke K, Lieberman P, Camargo CA Jr, 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;97:596-602.
  • 3. Decker WW, Campbell RL, Manivannan V, Luke A, St Sauver JL, Weaver A, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008;122:1161-5.
  • 4. Shen Y, Li L, Grant J, Rubio A, Zhao Z, Zhang X, et al. Anaphylactic deaths in Maryland (US) and Shanghai: a review of forensic autopsy cases from 2004 to 2006. Forensic Sci Int 2009;186:1-5.
  • 5. Orhan F, Canitez Y, Bakirtas A, Yilmaz O, Boz AB, Can D, et al. Anaphylaxis in Turkish children: a multi-centre, retrospective, case study. Clin Exp Allergy 2011;41:1767-76.
  • 6. Serbes M, Can D, Atlihan F, Günay I, Asilsoy S, Altinöz S. Common features of anaphylaxis in children. Allergol Immunopathol (Madr) 2013;41:255-60.
  • 7. Vezir E, Erkoçoğlu M, Kaya A, Toyran M, Özcan C, Akan A, et al. Characteristics of anaphylaxis in children referred to a tertiary care center. Allergy Asthma Proc 2013;34:239-46.
  • 8. Topal E, Bakirtas A, Yilmaz O, Ertoy Karagol IH, Arga M, Demirsoy MS, et al. Anaphylaxis in infancy compared with older children. Allergy Asthma Proc 2013;34:233-8.
  • 9. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, 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. Ann Emerg Med 2006;47:373-80.
  • 10. Simons FER, Peterson S, Black C. Epinephrine dispensing for out-of-hospital treatment of anaphylaxis in infants and children: a population-based study. Ann Allergy Asthma Immunol 2001;86:622-6.
  • 11. De Swert LF, Bullens D, Raes M, Dermaux AM. Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach. Eur J Pediatr 2008;167:1251- 61.
  • 12. Sheehan WJ, Graham D, Ma L, Baxi S, Phipatanakul W. Higher incidence of pediatric anaphylaxis in northern areas of the United States. J Allergy Clin Immunol 2009;124:850-2.
  • 13. Simons FE. Anaphylaxis. J Allergy Clin Immunol 2010;125 (Suppl 2):161-81.
  • 14. Harduar-Morano L, Simon MR, Watkins S, Blackmore C. Algorithm for the diagnosis of anaphylaxis and its validation using population-based data on emergency department visits for anaphylaxis in Florida. J Allergy Clin Immunol 2010;126:98- 104.
  • 15. Yocum MW, Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD. Epidemiology of anaphylaxis in Olmsted County: a population-based study. J Allergy Clin Immunol 1999;104:452-6.
  • 16. Mehl A, Wahn U, Niggeman B. Anaphylactic reactions in children-a questionnaire-based survey in Germany. Allergy 2005;60:1440-5.
  • 17. Novembre E, Cianferoni A, Bernardini R, Mugnaini L, Caffarelli C, Cavagni G, et al. Anaphylaxis in children: clinical and allergologic features. Pediatrics 1998;101:E8.
  • 18. Thong BY, Cheng YK, Leong KP, Tang CY, Chng HH. Anaphylaxis in adults referred to a clinical immunology/allergy centre in Singapore. Singapore Med J 2005;46:529-34.
  • 19. Ben-Shoshan M, Clarke AE. Anaphylaxis: past, present and future. Allergy 2011;66:1-14.
  • 20. Pastorello EA, Rivolta F, Bianchi M, Mauro M, Pravettoni V. Incidence of anaphylaxis in the emergency department of a general hospital in Milan. J Chromatogr B Biomed Sci Appl 2001;756:11-7.
  • 21. Lieberman PL. Anaphylaxis. In: Adkinson NF Jr, Bochner BS, Busse WW, Holgate ST, Lemanske RF Jr, Simons FER, editors. Middleton’s allergy: principles and practice. 7th ed. China, Elsevier; 2009. p.1027-49.
  • 22. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. J Clin Pathol 2000;53:273-6.
  • 23. Cianferoni A, Novembre E, Mugnaini L, Lombardi E, Bernardini R, Pucci N, et al. Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985-1996). Ann Allergy Asthma Immunol 2001;87:27-32.
  • 24. Lieberman P. Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol 2005;95:217-26.
There are 24 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Mahmut Doğru

İlknur Bostancı This is me

Serap Özmen This is me

Tayfur Giniş This is me

Handan Duman Şenol This is me

Publication Date April 1, 2017
Published in Issue Year 2017 Volume: 15 Issue: 1

Cite

APA Doğru, M., Bostancı, İ., Özmen, S., Giniş, T., et al. (2017). The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic. Güncel Pediatri, 15(1), 12-18. https://doi.org/10.4274/jcp.58070
AMA Doğru M, Bostancı İ, Özmen S, Giniş T, Duman Şenol H. The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic. Güncel Pediatri. April 2017;15(1):12-18. doi:10.4274/jcp.58070
Chicago Doğru, Mahmut, İlknur Bostancı, Serap Özmen, Tayfur Giniş, and Handan Duman Şenol. “The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic”. Güncel Pediatri 15, no. 1 (April 2017): 12-18. https://doi.org/10.4274/jcp.58070.
EndNote Doğru M, Bostancı İ, Özmen S, Giniş T, Duman Şenol H (April 1, 2017) The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic. Güncel Pediatri 15 1 12–18.
IEEE M. Doğru, İ. Bostancı, S. Özmen, T. Giniş, and H. Duman Şenol, “The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic”, Güncel Pediatri, vol. 15, no. 1, pp. 12–18, 2017, doi: 10.4274/jcp.58070.
ISNAD Doğru, Mahmut et al. “The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic”. Güncel Pediatri 15/1 (April 2017), 12-18. https://doi.org/10.4274/jcp.58070.
JAMA Doğru M, Bostancı İ, Özmen S, Giniş T, Duman Şenol H. The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic. Güncel Pediatri. 2017;15:12–18.
MLA Doğru, Mahmut et al. “The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic”. Güncel Pediatri, vol. 15, no. 1, 2017, pp. 12-18, doi:10.4274/jcp.58070.
Vancouver Doğru M, Bostancı İ, Özmen S, Giniş T, Duman Şenol H. The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic. Güncel Pediatri. 2017;15(1):12-8.