title: First study of pattern of anaphylaxis in a large tertiary care hospital in Saudi Arabia.
abstract: BACKGROUND
  Anaphylaxis is a serious allergic reaction that may cause death. The signs and symptoms of anaphylaxis have not been examined in the Saudi population before.
  
  
  OBJECTIVE
  The present study examined the signs, symptoms, triggers, and demographic patterns of patients treated for anaphylaxis at a large tertiary care hospital in Riyadh, Saudi Arabia.
  
  
  METHODS
  All the patients who were prescribed new prescriptions of adrenaline auto-injectors (AAs) between February 1, 2010 and December 31, 2011 were included in this study. Information was collected using a standardized form.
  
  
  RESULTS
  There were 238 patients who were analyzed. The median age at the time of first AA prescription was 15.5 years. Female to male ratio was 52:48 and 54% of the subjects were more than 18 years of age. There were some differences in the presenting signs and symptoms observed in our study compared with similar studies from around the world. Urticaria and angioedema were the most common at about 70% across all ages, followed by shortness of breath at 28%. Some triggers were found to be more common in our region. Food was the commonest trigger for anaphylaxis including tree nuts, egg, and sesame. Drug allergy was also a common trigger, with penicillins and nonsteroidal anti-inflammatory drugs being the commonest. Regarding insect allergy, samsam ant was the commonest trigger in our study.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study on anaphylaxis in Saudi Arabia. Some of the manifestations of anaphylaxis are significantly different in our population study compared to previously published data from other parts of the world. While managing anaphylaxis, we should be mindful of these differences. This improved understanding should help reduce the morbidity and mortality associated with anaphylaxis in our region.
authors.affiliation: Section of Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Farrukh
authors.initials: F
authors.lastname: Sheikh
authors.affiliation: Medical and Critical Care Pharmacy, Department of Pharmaceutical Care, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Rashid
authors.initials: R
authors.lastname: Amin
authors.affiliation: Section of Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Agha M
authors.initials: AM
authors.lastname: Rehan Khaliq
authors.affiliation: Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Talal
authors.initials: T
authors.lastname: Al Otaibi
authors.affiliation: Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Samia
authors.initials: S
authors.lastname: Al Hashim
authors.affiliation: Section of Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh 3354, Saudi Arabia.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Al Gazlan
keywords: Adrenaline; Anaphylaxis; Saudi Arabia