Abstract

Background: Anaphylaxis is an allergic disease that requires special handling due to its potential fatality. Recent epidemiological data indicate that the incidence of anaphylaxis is rising. However, actual data on the prevalence or causes of anaphylaxis in Korea are limited. Methods: The emergency room attendees diagnosed with anaphylaxis between 2011 and 2015 in five university hospitals were included. Medical records were reviewed retrospectively. Results: During the 5 years, a total of 505 subjects were diagnosed with anaphylaxis. Respiratory presentations were more common in children than in adults, while adults presented more frequently with cardiovascular symptoms. Intraoral angioedema was more often observed in the countryside than in the city. Insect stings/bites were more common in the countryside than in the city. Drugs were much more common in adults than in children. In the countryside, the frequency of anaphylaxis was higher in summer and autumn than in spring and winter. The use of corticosteroids was less common in children than in adults, while children more frequently got treatment with inhaled beta 2 agonist. Conclusions: The principal causes of anaphylaxis in Korean patients were food, drugs, and stings/bites. The cause, clinical features and management of anaphylaxis were significantly different depending on age and region. These real-world data on anaphylaxis could be helpful to deepen that understanding of this condition for physicians and patients.

Highlights

  • Anaphylactic reactions include systemic allergic reactions such as urticaria, dyspnea, hypotension, and loss of consciousness

  • We examined the clinical characteristics of anaphylaxis in target patients visiting five university hospitals in Seoul, Anyang, Dongtan (Gyeonggi-do) and Chuncheon (Gangwon-do) over five years

  • We found that manifestations of atopic dermatitis, allergic rhinitis, and asthma were higher in children with anaphylaxis than in adults with anaphylaxis

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Summary

Introduction

Anaphylactic reactions include systemic allergic reactions such as urticaria, dyspnea, hypotension, and loss of consciousness. These are explained by an IgE-mediated reaction that activates mast cells or basophils that secrete chemical media [1,2,3]. Six years of data on 138 anaphylaxis patients from a university hospital in Seoul showed that the causes of anaphylaxis were drugs (34.8%), food (21.0%), unknown (13.0%), exercise (13.0%), and insect bites (11.6%) [6]. At a university hospital in Suwon, 11 years of data on 158 patients reported the causes of anaphylaxis as drugs (51.2%), insect bites (25.3%), food (10.8%), and exercise (6.3%) [7]. There are numerous causes of anaphylaxis, and there are variable clinical responses, even with the same cause [5]. Respiratory presentations were more common in children than in adults, while adults presented more frequently with cardiovascular symptoms

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