eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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SCImago Journal & Country Rank
5/2021
vol. 38
 
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abstract:
Original paper

Is the clinical manifestation of anaphylaxis in children influenced by the trigger of reaction?

Izabela Tarczoń
1
,
Urszula Jedynak-Wąsowicz
2
,
Grzegorz Lis
2
,
Tomasz Tomasik
2
,
Piotr Brzyski
3
,
Ewa Cichocka-Jarosz
2

1.
“Przyladek Zdrowia”, Krakow, Poland
2.
Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
3.
“Dziupla” Statistical Analysis, Krakow, Poland
Adv Dermatol Allergol 2021; XXXVIII (5): 788-797
Online publish date: 2020/06/26
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Introduction
The number of anaphylaxis diagnoses in children is rising, being still based on the clinical picture.

Aim
To determine whether triggers of anaphylaxis influence its clinical characteristics in children and adolescents.

Material and methods
The study group included 114 children (5 months–17 years, mean age: 8.0 ±4.8 years), (66%: boys) with the episode of anaphylaxis up to 1 year back. Medical data were entered to the NORA Registry by means of a validated structured on-line questionnaire.

Results
Three most frequent triggers of anaphylaxis were: insect venom (47.4%), food (35.1%), drugs (5.3%), with a predominance of food (egg white, cow’s milk, nuts and peanuts) in the 0–6 years age group, while insect venom (bee predominance) in the 7–17 years age group (p = 0.016). Clinical manifestations differed between food vs. venom allergic reactions and presented as gastro-intestinal (GI) (61.4%) (p = 0.004), respiratory (RS) (93.9%) (p = 0.036), and cardiovascular (CVS) (74.6%) (p = 0.022) symptoms. Among objective symptoms, vomiting was the most common symptom in the 0–2 years age group (47.1%) (p = 0.006), while hypotension in those aged 7 –12 years (40%) (p = 0.010). Severity of symptoms evaluated as Mueller’s grade (IV – 74.5%) and as Ring and Messmer’s grade (III – 65.8%), depended on the trigger (p = 0.028, p = 0.029, respectively). Life-threatening symptoms occurred in 26 children (fall of the blood pressure – 22%, loss of consciousness – 4.4%).

Conclusions
The clinical manifestation of anaphylaxis in children is both trigger and age dependent, irrespective of the gender. A typical patient with food anaphylaxis was younger, presenting predominantly GI symptoms, while a typical patient with venom anaphylaxis was older, with mostly cardiovascular symptoms.

keywords:

anaphylaxis, children, trigger of anaphylaxis, clinical manifestation

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