Abstract

MOTA, Andreia Filipa et al. Anaphylactic reactions in children admitted to a pediatric emergency department. Rev Port Imunoalergologia [online]. 2017, vol.25, n.1, pp.39-49. ISSN 0871-9721.

Anaphylaxis is a systemic acute hypersensitivity reaction, showing a large variation in clinical presentation and severity. It is a medical emergency requiring an immediate recognition and represents a challenge mainly in younger population. The aim of our study was to evaluate the incidence of anaphylaxis and characterize it in children admitted to a pediatric emergency department during a 5-year period. Revision of 38.978 files of patient with less than 18 years admitted to the pediatric emergency department between 01/01/2010 and 31/12/2014 was performed. From the analyzed data 27 anaphylactic reactions were identified; 24 children-54 % females, mean age 5,5 years were involved. For 10 of them this was a first episode. The incidence was 69.2/100 000 in 5 years. All children had cutaneous manifestations and 74 % had respiratory, 33 % gastrointestinal and 15 % cardiovascular involvement. In 63% of the reactions food was the eliciting factor, in 11 % hymenoptera stings and in 7 % skin care products. The treatment options were in 93 % a first generation antihistaminic, in 89 % corticosteroid, in 70% supplementary oxygen, in 59 % adrenaline, in 44 % inhaled salbutamol and in 27 % normal saline solution, in different combinations. Hospitalization was required in 10 episodes. Eleven children (46 %) were referred to an allergy consultation. There was no mortality. Anaphylaxis is a rare reason for admission in the emergency department. Food related reactions were the most common cause in our study group. Only in 59% of the episodes adrenaline was used, in spite of the guidelines recommend it as first line of treatment, for every anaphylactic reaction. Less than 50% of the children were referred to a specialty consultation, lacking the majority the access to both, a correct diagnostic workup and a personalized emergency and therapeutic plan

Keywords : Adrenaline; allergy; anaphylaxis; emergency department; pediatrics.

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