title: One-year survey of paediatric anaphylaxis in an allergy department.
abstract: OBJECTIVE
  To determine the frequency of anaphylaxis in an allergy outpatient department, allowing a better understanding regarding aetiology, clinical manifestations and management, in children and adolescents.
  
  
  METHODS
  From among 3646 patients up to 18 years old observed during one-year period, we included those with history of anaphylaxis reported by allergists.
  
  
  RESULTS
  Sixty-four children had history of anaphylaxis (prevalence of 1.8%), with mean age 8.1±5.5 years, 61% being male. Median age of the first anaphylactic episode was 3 years (1 month-17 years). The majority of patients had food-induced anaphylaxis (84%): milk 22, egg 7, peanut 6, tree nuts 6, fresh fruits 6, crustaceans 4, fish 4 and wheat 2. Food-associated exercise-induced anaphylaxis was reported in 2 adolescents. Drug-induced anaphylaxis occurred in 8%: 4 non-steroidal anti-inflammatory drugs and 1 amoxicillin. Three children had cold-induced anaphylaxis, one adolescent had anaphylaxis to latex and one child had anaphylaxis to insect sting. The majority (73%) had no previous diagnosis of the etiologic factor. Symptoms reported were mainly mucocutaneous (94%) and respiratory (84%), followed by gastrointestinal (42%) and cardiovascular (25%). Fifty-one patients were admitted to the emergency department, although only 33% were treated with epinephrine. Recurrence of anaphylaxis occurred in 26 patients (3 or more episodes in 14).
  
  
  CONCLUSIONS
  In our paediatric population, the main triggering agent of anaphylaxis was IgE-mediated food allergy. Epinephrine is underused, as reported by others. Often, children have several episodes before being assessed by an allergist. We stress the importance of systematic notification and improvement of educational programmes in order to achieve a better preventive and therapeutic management of this life-threatening entity.
authors.affiliation: Immunoallergy Department CUF Descobertas Hospital 1998-018 Lisbon, Portugal. E-mail: angela.gaspar@sapo.pt.
authors.forename: Â
authors.initials: Â
authors.lastname: Gaspar
authors.affiliation: Immunoallergy Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: N
authors.initials: N
authors.lastname: Santos
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Piedade
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Santa-Marta
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Pires
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Sampaio
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Arêde
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal. CEDOC, NOVA Medical School, Lisbon, Portugal.
authors.forename: L M
authors.initials: LM
authors.lastname: Borrego
authors.affiliation: Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal. CINTESIS, Center for Research in Health Technologies and Information Systems, Porto, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Morais-Almeida
mesh_terms: D000293:Adolescent; D000486:Allergy and Immunology; D000707:Anaphylaxis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D019538:Health Care Surveys; D006748:Hospital Departments; D006801:Humans; D008297:Male; D010372:Pediatrics; D011174:Portugal / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D015995:Prevalence; D012008:Recurrence; D012017:Referral and Consultation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D004837:Epinephrine
keywords: Anaphylaxis; children; epidemiology; epinephrine; management; notification