Anaphylaxis in Children: Experience of an Egyptian Center

Abstract

Abstract Introduction Anaphylaxis is a potentially life threatening allergic reaction that is rapid in onset and multisystemic in nature. Distribution of anaphylaxis tends to fluctuate based on age, gender, race, geographical residence and socioeconomic status of the involved subjects. Diagnosis of anaphylaxis in children is generally underestimated particularly in developing countries, and when diagnosed, proper management is occasionally lacking. Aim of the study to evaluate the frequency and pattern of anaphylaxis and mistakes in diagnosis and treatment among a group of Egyptian children and adolescents. Subjects and methods This observational study was conducted over 12 months duration, from 1st of March 2019 to the end of February 2020, in Children’s hospital, Ain Shams University, Cairo, Egypt, on children presenting to emergency department (ED). Anaphylaxis frequency, clinical presentation, triggers, diagnosis, management and long term follow up were assessed. Results frequency rate of anaphylaxis among children and adolescents was 0.43% (80/18816) over a year. Sixty percent of patients were infants. Biphasic reactions were reported in 11.3% of patients. The commonest trigger was food (22.5%) followed by medications (8.8%). Appropriate diagnosis of anaphylaxis by junior pediatricians was reported in all patients, with epinephrine given in most occasions in proper dosage and method (78.7%). Education of children and their caregivers, providing written plan, ready-to-use epinephrine and follow up appointment were deficient. In conclusion Anaphylaxis in children was relatively high particularly in infants, with food being the most common trigger. Diagnosis and early management of anaphylaxis in our University hospital was satisfactory, however, long term management and follow up were defective.