Çocuk Alerji Kliniği’nde İzlenen Anafilaksili Olguların Özellikleri

Yıl 2017, , 12 - 18, 01.04.2017

Mahmut Doğru , İlknur Bostancı Serap Özmen Tayfur Giniş Handan Duman Şenol

https://doi.org/10.4274/jcp.58070

Öz

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.

Anahtar Kelimeler

Anafilaksi, çocuk, besinler, adrenalin, triptaz

The Features of Anaphylaxis Cases Followed in the Pediatric Allergy Clinic

Öz

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

Anahtar Kelimeler

Anaphylaxis, child, foods, adrenaline, tryptase

Kaynakça

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