Anaphylaxis in Israel: experience with 92 hospitalized children.
Little is known about the courses, causes, and clinical features of anaphylaxis in children outside the USA and Europe. Our objective was to evaluate the events of anaphylaxis in children admitted to the Schneider Children's Medical Center of Israel, a major tertiary facility, over a 12-year period. Ninety-two children with anaphylaxis (50 boys, 42 girls) aged 14 days to 18 yr (mean, 7.4 yr) were hospitalized during the study period. The event occurred at home in 52 children (56%), in a medical institution in 24 (26%), outdoors in 13 (15%), at school in 2 (2%), and in an unspecified location in 1 (1%). The main causes were foods (43%), mainly milk and nuts, medications (22%), and hymenoptera venom (11%); in five children, anaphylaxis occurred during general anesthesia, and in 5, the causative agent could not be determined. Food-induced anaphylaxis tended to occur in younger children. Forty-eight children (52%) had a history of atopy (mainly asthma). Hospital treatment consisted of corticosteroids (85%), antihistamines (75%), epinephrine (72%), and β2 agonists (42%). Seven patients were admitted to intensive care units. There were no fatalities. EpiPen was used by only one of the 16 patients with more than one episode of anaphylaxis, indicating that patient and parent education in the application of the EpiPen needs to be improved.
Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tikvah, Israel.
V
V
Hoffer
O
O
Scheuerman
N
N
Marcus
Y
Y
Levy
N
N
Segal
I
I
Lagovsky
Y
Y
Monselise
B Z
BZ
Garty
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000517:prevention & control; D000758:Anesthesia / Q000009:adverse effects; D001180:Arthropod Venoms / Q000009:adverse effects / Q000276:immunology; D001249:Asthma / Q000150:complications / Q000276:immunology; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000276:immunology; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001180:Arthropod Venoms; D006633:Histamine Antagonists; D004837:Epinephrine