title: Anaphylaxis in Turkish children: a multi-centre, retrospective, case study.
abstract: BACKGROUND
  Anaphylaxis is a serious and potentially lethal systemic reaction affecting more than one organ or system.
  
  
  OBJECTIVE
  We aimed to describe the demographic characteristics, clinical features, causes, settings, and administered therapy in Turkish children.
  
  
  METHODS
  This retrospective, case note study included all children referred to the outpatient clinics of the Pediatric Allergy Departments of the participating study centres from 1 July 1999 to 30 June 2009 for investigation of anaphylaxis or who were seen by us at the moment of the reaction during the same period and who met the clinical criteria of anaphylaxis.
  
  
  RESULTS
  Two hundred and twenty-four cases of anaphylaxis were reported in 137 children (88 boys, P = 0.0001). The mean ± SD age at the referral was 7.7 ± 4.2 years (range: 4 months-17 years). Ninety-eight episodes (43.8%) occurred at home. The symptoms were cutaneous in 222 (99.1%) episodes, respiratory in 217 (96.9%), neuro-psychiatric in 118 (52.7%), cardiovascular in 92 (41.1%), and gastrointestinal in 88 (39.3%). Biphasic reaction was reported in seven episodes (3.1%, 95% CI: 1.5-6.3). Death occurred in one case (0.4%, 95% CI: 0.08-2.4). Treatment was available in 158 episodes (70.5%). Of them, 148 (93.7%) received antihistamines, 132 (83.5%) corticosteroids, 51 (32.3%) epinephrine, and 17 (10.8%) beta-2-mimetics. The causative agents were foods in 86 (38.4%) episodes, hymenoptera venom in 84 (37.5%), drugs and medications in 47 (21.0%), and latex in 5 (2.2%). In two episodes (0.9%), the causative agent was unidentified. Allergy to the trigger was known prior to anaphylaxis in 116 (51.8%) episodes. An epinephrine auto-injector had been prescribed for 70 children (51.1%).
  
  
  CONCLUSIONS
  Anaphylaxis was seen significantly more in boys. Most of the reactions occurred at home. Foods were the most frequent cause. Epinephrine, the first-line treatment of anaphylaxis, was administered in only a third of the children.
authors.affiliation: Department of Pediatric Allergy, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey. fazilorhan@yahoo.com
authors.forename: F
authors.initials: F
authors.lastname: Orhan
authors.forename: Y
authors.initials: Y
authors.lastname: Canitez
authors.forename: A
authors.initials: A
authors.lastname: Bakirtas
authors.forename: O
authors.initials: O
authors.lastname: Yilmaz
authors.forename: A B
authors.initials: AB
authors.lastname: Boz
authors.forename: D
authors.initials: D
authors.lastname: Can
authors.forename: S
authors.initials: S
authors.lastname: Kuyucu
authors.forename: K
authors.initials: K
authors.lastname: Harmanci
authors.forename: F
authors.initials: F
authors.lastname: Tahan
authors.forename: I
authors.initials: I
authors.lastname: Reisli
authors.forename: T
authors.initials: T
authors.lastname: Karakas
authors.forename: A
authors.initials: A
authors.lastname: Baki
authors.forename: H
authors.initials: H
authors.lastname: Cokugras
authors.forename: M
authors.initials: M
authors.lastname: Cakir
authors.forename: H
authors.initials: H
authors.lastname: Yuksel
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology