Pediatric Anaphylaxis in Emergency Care: A Detailed Analysis of Demographic and Laboratory Findings
Nilay Caliskan1, Recep Okur2, Alper Kaçar3, Deniz Ozceker11Department of Pediatric Allergy and Immunology, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Türkiye2Department of Pediatrics, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Türkiye
3Department of Pediatric Emergency, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Türkiye
Objectives: Anaphylaxis, which has been increasing in frequency parallel to other allergic diseases in recent years, is a life-threatening, acute systemic reaction. Physicians working in pediatric emergency departments (PED) should recognize the signs and symptoms of anaphylaxis and administer initial treatment. This study aims to evaluate the demographic, clinical, and laboratory findings of patients diagnosed with anaphylaxis in the pediatric emergency unit of a tertiary care facility.
Methods: Patients diagnosed with anaphylaxis in our unit at the PED were retrospectively reviewed between 2016 and 2023.
Results: A total of 100 patients were diagnosed with anaphylaxis in our pediatric emergency department, including 39 girls and 61 boys. Of these patients, 3% were under 2 years of age, 25% were between 2–6 years, and 72% were over 6 years old. In 83% of the cases, anaphylaxis occurred at home, while 11% occurred during medication administration at a hospital. Triggers were identified in 81% of the patients, whereas 19% were diagnosed with idiopathic anaphylaxis. The most common triggers were medications. Food-related anaphylaxis was the second most common trigger, with cow’s milk being the most frequent at 8%. The most commonly affected system was the skin and mucosa in 97% of cases. When examining the relationship between age groups and triggers, food allergies were most frequent in children under 2 years old (p<0.001). The average tryptase level measured during anaphylaxis was 5.27 ug/L (1.43–33.6), with idiopathic cases showing a significantly higher average of 9.15 ug/L (6.29–33.6) (p=0.005).
Conclusion: Anaphylaxis is a systemic reaction that can be fatal if not treated quickly and accurately. Adrenaline is the single most effective treatment, and pediatric emergency physicians play a crucial role in this context. Our findings suggest that tryptase levels in pediatric patients are often below the widely accepted cut-off; however, larger studies are needed before reference ranges can be redefined.
Keywords: Allergy, anaphylaxis, children, emergency care
Manuscript Language: English