Characteristics of cases diagnosed with anaphylaxis presenting to the pediatric emergency department

Objective: Anaphylaxis is a life-threatening systemic hypersensitivity reaction with an increasing prevalence worldwide. Its incidence is progressively rising globally. This study aims to present new data concerning the demographic, clinical, and laboratory characteristics of children presenting to the pediatric emergency department with a diagnosis of anaphylaxis. The study seeks to evaluate the etiology of anaphylaxis, risk factors associated with it, severity of anaphylaxis and its influencing factors, triggers for recurrent anaphylaxis, the contribution of laboratory methods, and treatment approaches. Materials and Methods: The study included 52 patients aged between 0-18 years who presented with allergic symptoms to the pediatric emergency departments of the Akdeniz University Hospital and the Training and Research Hospital of the Ministry of Health, Antalya Provincial Health Directorate, between July 2021 and March 2023, meeting the diagnostic criteria for anaphylaxis. The demographic and clinical characteristics of the patients were prospectively evaluated. A questionnaire form was completed in collaboration between the patient's caregiver and the physician for patients diagnosed with anaphylaxis. Approval was received from Akdeniz University Faculty of Medicine Clinical Research Ethics Committee. Results: The average age of the 52 patients included in our study diagnosed with anaphylaxis was 7,5±4,89 years. Among the patients, 27 were male (51,9%), and 25 were female (48,1%). Of the 52 patients, 24 (46,2%) had additional systemic diseases. A history of atopy was found in 36,5% of the patients. The most commonly observed allergic disease among the patients was asthma, with a rate of 19,2%. The rate of patients with atopy in their family was calculated as 64,7%. The most common symptom observed at the time of admission to the emergency department was skin-related, accounting for 90,4%. It was observed that the time elapsed from exposure to the allergen to the onset of symptoms ranged from 15 minutes to 2 hours in 50% of the patients. The interval between symptom onset and the initiation of treatment was in the category of 15 minutes to 2 hours in 64,7% of cases. The primary location for initial treatment in patients was predominantly the hospital (80,4%). Adrenaline was administered as the initial treatment in 84,6% of the patients. Following adrenaline, 65,4% received antihistamines, 38,5% received methylprednisolone, and 30,8% received intravenous fluid therapy. Food allergy (50%) was the most common trigger. Drug etiology followed with 32,7%. The rate of recurrence of anaphylaxis was determined to be 26,9%. It was found that 75% of the 12 patients whose data was accessed had an auto-injector. Conclusion: Anaphylaxis is a serious allergic reaction where the body exhibits a systemic response, potentially resulting in severe and life-threatening consequences. Common triggers include foods, medications, and venoms. In children, symptoms of anaphylaxis can rapidly escalate and result in various systemic manifestations such as respiratory distress, facial swelling, skin rashes, gastrointestinal disturbances, cardiovascular issues, neurological complications, and hypotension. This condition necessitates immediate medical intervention and should be managed with accurate diagnosis and treatment. It is essential to enhance education for all healthcare personnel regarding at-risk patients and their family's concerning anaphylaxis. Increased awareness of risk factors associated with anaphylaxis in each community will contribute to its effective management.