Causes of anaphylaxis by age in children

Objective: Anaphylaxis is a serious rapidly occurring systemic allergic reaction, causing death, and its incidence is increasing worldwide. There are many risk factors that affect the incidence, severity, clinical presentation and recognition of anaphylaxis. Diagnosis in anaphylaxis is made with history and clinical findings. The most common cause of anaphylaxis during childhood is food allergies. However, its incidence varies according to age distribution. In this study, we aimed to retrospectively examine the symptoms and etiology of the patients diagnosed with anaphylaxis who applied to the Cukurova Unıversity Faculty of Medicine Pediatric Allergy and Immunology clinic, and to determine the causes of anaphylaxis by age. Material and Method: In this study, 120 patients who were diagnosed with anaphylaxis between 2009-2019 in the Cukurova Unıversity Faculty of Medicine Pediatric Allergy Immunology Outpatient Clinic were retrospectively analyzed. The archives of the patients were accessed by taking the names of patients prepared from the Child Allergy Policlinic database and adrenaline autoinjector report. The information of the patients included in the study was recorded by finding them from the files and automation system. Ethical committee approval was obtained. Results: A total of 120 patients, 80 (66.7%) boys and 40 (33.3%) girls, were included in our study. The mean age of diagnosis was 78.43 ± 59.758 (5-210) months. Food allergy was present in 55 (45.8%) patients and drug allergy in 22 (18.3%) patients. A family history of allergic disease was present in 57.5% of patients. Clinical manifestations of anaphylaxis were most common in the skin and mucosa, at 95.8%. The most common triggering factor for anaphylaxis was food items (48.3%). Food-related anaphylaxis was most common in patients between the ages of 0-2 (46.6%). It was observed that anaphylaxis developed most frequently against cow's milk (34.5%). Other anaphylaxis inducing factors were medication (28.3%) and venom (19.2%). Drug-induced anaphylaxis was most common between the ages of 6-12 (41.2%). Venom-induced anaphylaxis was also most common between the ages of 6-12 (60.9%). Drug-induced anaphylaxis was most frequently linked to beta-lactam antibiotics (73.5%). Complete blood count, total IgE, specific IgE and skin prick tests were not examined in any of our patients. In laboratory examinations, which are examined during the anaphylaxis period or subsequent follow-up of patients, 103 patients (85.8%) had white blood cell count, 92 patients (76.6%) had total IgE, and 54 (45%) patients had specific IgE results. Prick test was performed in 51 patients (42.5%). Epinephrine autoinjector use was present in 63 patients (52.5%). Autoinjector was not used in 56 patients (46.7%). Autoinjector usage information could not be reached in 1 patient (0.8%). Conclusion: In conclusion, in our study, anaphylaxis was more common in males in the pediatric age group. It was observed that the frequency increased in girls with increasing age. Anaphylaxis due to foods was the most common etiological reason. It was observed that there was more anaphylaxis due to food and venom in adolescents versus mostly due to foods in infants and children, and the underlying atopy history increased the frequency of anaphylaxis. In our study, we found findings similar to the literature in terms of anaphylaxis etiology and clinical findings. However, we had some different results. It was thought that this was due to some limitations in our study. Keywords: Anaphylaxis, anaphylaxis risk factors, anaphylaxis etiological factors, anaphylaxis clinical findings