Anaphylaxis in Israel: Experience with 92 hospitalized children
Anaphylaxis in Israel: Experience with 92 hospitalized children
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DOI：
10.1111/j.1399-3038.2010.00990.x
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发表时间：
2011-03-01
影响因子：
4.4
通讯作者：
Garty, B. Z.
中科院分区：
文献类型：
--
作者：
Hoffer, V.;Scheuerman, O.;Garty, B. Z.
关于美国和欧洲以外儿童过敏反应的病程、原因和临床特征知之甚少。我们的目的是评价12年来以色列施耐德儿童医疗中心（一家主要的三级医疗机构）儿童的过敏反应事件。在研究期间，92名患有过敏反应的儿童（50名男孩，42名女孩）住院，年龄为14天至18岁（平均7.4岁）。52名儿童（56%）的事件发生在家中，24名（26%）发生在医疗机构，13名（15%）发生在户外，2名（2%）发生在学校，1名（1%）发生在未指明的地点。主要原因是食物（43%），主要是牛奶和坚果，药物（22%），和Hyattera毒液（11%）;在5名儿童中，过敏反应发生在全身麻醉期间，在5名，病原体无法确定。食物引起的过敏反应往往发生在年幼的儿童。48名儿童（52%）有过敏史（主要是哮喘）。住院治疗包括皮质类固醇（85%）、抗组胺药（75%）、肾上腺素（72%）和β 2受体激动剂（42%）。7名患者被送入重症监护室。无人死亡。在16例发生一次以上过敏反应的患者中，只有1例使用了EpiPen，这表明需要改进EpiPen应用方面的患者和家长教育。
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 beta 2 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.