ТЯЖЕЛАЯ АНАФИЛАКСИЯ У ДЕТЕЙ: КЛИНИЧЕСКИЕ ОСОБЕННОСТИ И ТРИГГЕРЫ

Abstract

Over a long period of time in Russia we had the lack of the anaphylaxis (AF) register problem as it sounds to be the most important tool for recording, analysis and monitoring of this group of patients. Then, starting 2022, the first “Moscow Pediatric Anaphylaxis Register” has been maintaining at the Morozov Children’s City Clinical Hospital (Moscow, Russia), which systematizes and analyzes all the patient data on the etiology, clinical picture, severity factors and risk of developing AF, which in its turn is undoubtedly extremely valuable for further management of this group of patients. The purpose of this research was to evaluate the severity of AF taking into account the age and gender factors, comorbidity, triggers and clinical symptoms among children among the Moscow agglomeration. Materials and methods used: within the framework of a single-center cohort prospective study, the questionnaire data of 69 pediatric patients aged 0 to 18 y/o, 28 girl/41 boys, who were included in the study in May 2022-Sept. 2023, were subjected to statistical analysis register for emergency hospitalization due to AF. Results: the proportion of patients with severe AF was 30%; two age-related peaks in its frequency were recorded in the groups of children 0 to 3 y/o and 13 to 18 y/o (44% and 35%, respectively). Food triggers were the most significant regardless of the severity of AF; severe food AF was induced by tree nuts in 31%, and cow's milk in 19%. The central nervous and cardiovascular systems in severe AF were involved statistically significantly more often in comparison with the mild/moderate AF groups (86% v 25% and 81% v 30%, respectively, p<0.001), in 63% of cases symptoms developed within 0 to 15 minutes. Statistically significant differences were revealed in the frequency of diagnosis of AF in severe and moderate AF (57% v 12%, p=0.001). Conclusion: severe anaphylactic reactions in children are most often induced by food triggers and are characterized by a high frequency of involvement of the cardiovascular and central nervous systems, rapid development of symptoms, which is extremely important to consider during emergency verification of the diagnosis and immediate administration of epinephrine.