title: Clinical diagnosis and management of anaphylaxis in infancy.
abstract: BACKGROUND
  Anaphylaxis is increasingly reported in infancy. Diagnosis and management of anaphylaxis is difficult, and data are limited in infants. The aim of the present study was to determine the clinical course and management strategies used for anaphylaxis in infancy.
  
  
  METHODS
  Patients attending to our clinic and who had anaphylaxis under 2 years old were evaluated. Sixty-three patients were enrolled for the study. The mean ± standard deviation age was 10.6 ± 6.1 months (median, 11 months).
  
  
  RESULTS
  Anaphylaxis occurred at home in 48 infants (76.2%). Food was the most common causative agent (n = 52 [82.5%]), with cow's milk (n = 21 [40.4%]) and egg white (n = 13 [25%]) being the most frequent. Medication was the other causative agent (n = 9 [14.3%]), with antibiotics being the most frequent (n = 6 [66.7%]). The clinical manifestations were cutaneous (95.2%) and respiratory symptoms (79.4%). The median time lapse between contact and onset of symptoms was 10 minutes (5-15 minutes) (median, interquartile range [IQR] 25-75%). The total duration of symptoms was 2 hours (0.5-3 hours) (median, IQR 25-75%). Six patients had mild (9.5%), 40 moderate (63.5%), and 17 severe (27%) symptoms. A biphasic course was noticed in two infants (3.2%), with a symptom-free interval between a minimum of 30 minutes and a maximum of 4 hours. Forty-three (68.3%) received H1 antihistamines, 31 received corticosteroids (49.2%), and 23 received adrenaline (36.5%). Only one patient needed intensive care.
  
  
  CONCLUSIONS
  This study provided detailed clinical information in the diagnosis of anaphylaxis in infants. Diagnosing and managing anaphylaxis are difficult in infancy. Arrangements for definition of symptoms should be made in the new anaphylaxis guidelines.
authors.forename: Emine
authors.initials: E
authors.lastname: Dibek Misirlioglu
authors.forename: Emine
authors.initials: E
authors.lastname: Vezir
authors.forename: Müge
authors.initials: M
authors.lastname: Toyran
authors.forename: Murat
authors.initials: M
authors.lastname: Capanoglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Guvenir
authors.forename: Ersoy
authors.initials: E
authors.lastname: Civelek
authors.forename: Can Naci
authors.initials: CN
authors.lastname: Kocabas
mesh_terms: D000707:Anaphylaxis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019468:Disease Management; D005260:Female; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D010641:Phenotype; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D001993:Bronchodilator Agents; D006633:Histamine Antagonists; D007073:Immunoglobulin E