Fearful Dream Anaphylaxis: One Center Experience

Yıl 2021, Cilt: 21 Sayı: 1, 42 - 47, 17.05.2021

Pınar Yılmazbaş Deniz Özçeker Onur Adıgüzel Özlem Terzi

Öz

Objective: Anaphylaxis is a systemic reaction that can be fatal if not treated quickly and correctly. The aim of our study is to share the demographic characteristics, clinical course and triggering factors of the cases diagnosed with anaphylaxis in the pediatric allergy outpatient clinic. Material and Method: The files of the cases with a diagnosis of anaphylaxis who were examined in the pediatric allergy outpatient clinic between the years 2017-2020, were evaluated retrospectively. Results: The average age of the 57 anaphylaxis cases included in our study was 7.8±4.5 years, 56.1% were male. Of the cases, 68.4% were atopic, 49.1% had elevated serum IgE levels and 36.8% were accompanied by eosinophilia. Triggering allergens were foods (40.4%), drugs (35.1%) and venom (5.3%) respectively. Mild anaphylaxis was observed in 64.9% of cases. It was observed that accompanying allergic diseases, asthma and presence of atopy increased the severity of anaphylaxis. Two or more anaphylaxis attacks were observed in nine cases. None of the cases, who were prescribed adrenaline auto-injector, used the adrenaline autoinjector during the attack. Conclusion: Anaphylaxis cases are more common in boys. The most common triggering factor is food. Asthma, concomitant allergic diseases and the presence of atopy are factors that increase the severity of attacks. Adrenaline auto-injector is not used in cases where it has been prescribed.

Anahtar Kelimeler

Anaphylaxis, child, food allergy, adrenaline auto-injector

Korkulu Rüya Anafilaksi: Tek Merkez Deneyimi

Öz

Amaç: Anafilaksi hızlı ve doğru müdahale edilmediğinde ölümcül olabilen sistemik bir reaksiyondur. Çalışmamızın amacı çocuk alerji polikliniğine anafilaksi nedeni ile başvurmuş olan hastaların demografik özellikleri, klinik seyri ve tetikleyici etkenlerini paylaşmaktır. Gereç ve Yöntem: 2017-2020 yılları arasında anafilaksi tanısı ile çocuk alerji polikliniğinde tetkik edilmiş olan hastaların dosyaları geriye dönük olarak değerlendirildi. Bulgular: Çalışmamıza dahil edilen 57 anafilaksi hastasının yaş ortalaması 7,8±4,5 yıl idi, %56,1’i erkekti. Hastaların %68,4’ü atopik idi, %49,1’inde serum IgE yüksekliği, %36,8’inde eozinofili eşlik etmekteydi. Tetikleyici olduğu belirlenen alerjenler sırasıyla besinler (%40,4), ilaçlar (%35,1) ve venom (%5,3) idi. Hastaların %64,9’unda hafif şiddette anafilaksi gözlendi. Eşlik eden ek alerjik hastalık, astım ve atopi varlığının anafilaksi şiddetini arttırdığı görüldü. Dokuz hastada 2 veya daha fazla anafilaksi atağı gözlenmiş idi. Adrenalin oto-enjektörü reçete edilmiş olan hiçbir hastada atak esnasında oto-enjektör kullanılmamıştı. Sonuç: Anafilaksi erkek çocuklarda daha sık görülmektedir. En sık tetikleyici etken besinlerdir. Astım, eşlik eden alerjik hastalık ve atopi varlığı atak şiddetini arttıran etmenlerdir. Adrenalin oto-enjektörü reçete edilmiş olan hastalarda da kullanılmamaktadır.

Anahtar Kelimeler

anafilaksi, çocuk, besin alerjisi

Kaynakça

• 1. Anagnostu K. Anaphylaxis in children: epidemiology, risk factors and management. Curr Pediatr Rev 2018;14(3):180-186. doi: 10. 2174/1573396314666180507115115
• 2. Lee S, Hess EP, Lohse C, Gilani W, Chamberlain AM, Campbell RL. Trends, characteristics, and incidence of anaphylaxis in 2001-2010: A population-based study. J Allergy Clin Immunol 2017;139(1):182- 8. doi: 10.1016/j.jaci.2016.04.029
• 3. Rudders SA, Arias SA, Camargo CA Jr. Trends in hospitalizations for food-induced anaphylaxis in US children, 2000-2009. J Allergy Clin Immunol 2014;134(4):960-2. doi: 10.1016/j.jaci.2014.06.018
• 4. Tejedor-Alanso MA, Moro Moro M, Mugica Garcia MV. Epidemiology of anaphylaxis: contributions from the last 10 years. Clin Exp Allergy 2015;45(6):1027-39. doi: 10.1111/cea.12418
• 5. Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Rivas FM, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014;69(8):1026-45. doi: 10.1111/ all.12437
• 6. Grabenhenrich LB, Dölle S, Moneret-Vautin A, Köhli A, Lange L, Sprinder T, et al. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. J Allergy Clin Immunol 2016;137(4):1128-37. doi: 10.1016/j.jaci.2015.11.015
• 7. Dogru M, Bostancı I, Ozmen S, Ginis T, Şenol H.D. The features of anaphylaxis cases followed in the pediatric allergy clinic. J Curr Pediatr 2017;15:12-8. doi:10.4274/jcp.58070
• 8. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, 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. J Allergy Clin Immunol 2006;47(4):373-80. doi: 10.1016/j.jaci.2005.12.1303
• 9. Orhan F, Civelek E, Şahiner ÜM, Arga M, Can D, Çalıkaner AZ, et al. Anaphylaxis: Turkish National Guideline 2018. Asthma Allergy Immunology 2018;16. doi:10.21911/aai.2018.1
• 10. 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. doi: 10.1007/s00431-007-0661-2
• 11. Vezir E, Erkoçoğlu M, Kaya A, Toyran M, Özcan C, Akan A, et al. Characteristics of anaphylaxis in children referred to a tertiarty care center. Allergy Asthma Proc 2013;34:239-46. doi: 10.2500/ aap.2013.34.3654
• 12. Huang F, Chawla K, Jarvinen KM, et al. Anaphylaxis in a New York City pediatric emergency department: triggers, treatments, and outcomes. J Allergy Clin Immunol 2012;129(1):162-8, e1-3. doi: 10.1016/j.jaci.2011.09.018
• 13. Astier C, Morisset M, Roitel. Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy. J Allergy Clin Immunol 2006;118(1):250-6. doi: 10.1016/j.jaci.2006.04.053
• 14. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol 2001;107(1):191-3. doi: 10.1067/mai.2001.112031
• 15. Commins SP. Outpatient Emergencies: Anaphylaxis. Med Clin North Am 2017;101(3):521-36. doi: 10.1016/j.mcna.2016.12.003
• 16. 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.
• 17. Hoffer V, Scheuerman O, Marcus N, Levy Y, Segal N, Lagovsky I, et al. Anaphylaxis in Israel: experience with 92 hospitalized children. Pediatr Allergy Immunol 2010;22:172-7. doi: 10.1111/j.1399- 3038.2010.00990
• 18. Alves B, Sheikh A. Age-spesific aetiology of anaphylaxis. Arch Dis Child 2001;85:349. doi: 10.1136/adc.85.4.348b
• 19. Simons FER. Anaphylaxis. J Allergy Clin Immunol 2010;125:S161-81. doi:10.1016/j.jaci.2009.12.981
• 20. Shreffler WG, Beyer K, Chu T-HT, Burks AW, Sampson HA. Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes. J Allergy Clin Immunol 2004;113(4):776-82. doi: 10.1016/j.jaci.2003.12.588