An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period

Christopher D. Wright, Mindy Longjohn, Phillip L. Lieberman, Jay Lieberman

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few. Objective To describe confirmed cases of pediatric anaphylaxis in patients presenting to a pediatric hospital emergency department (ED). Methods We identified all ED visits with the International Classification of Diseases, Ninth Revision (ICD-9) codes 995.XX (allergic reactions) and 989.5 (sting or venom reaction) for 1 calendar year (January 1, 2014, through December 31, 2014). Cases were reviewed by an allergist and an emergency medicine physician to identify true anaphylaxis cases using National Institute of Health/National Institute of Allergy and Infectious Diseases criteria. Any questionable or debatable cases were evaluated and adjudicated by a second allergist. Results We identified 927 unique ED visits. Of these visits, 40 were determined to definitively meet anaphylaxis criteria. Median age of the patients was 6.5 years. A total of 70% of patients were male, and 80% were African American. Causes included foods (65%), venom or insect sting (12.5%), and medications (5%), and 17.5% were idiopathic. All patients had multiorgan involvement, with 98% having skin involvement, 78% having lower respiratory tract symptoms, and 40% having gastrointestinal symptoms. There were no deaths. Only 33% of patients received epinephrine at some point in their care. Only 12 patients were referred to an allergist, and only 4 of these were actually seen by an allergist. Conclusion At our center, foods are the most common trigger for pediatric anaphylaxis. Patients continue to be undertreated, and referral to an allergist from the ED is rare.

Original languageEnglish (US)
Pages (from-to)461-464
Number of pages4
JournalAnnals of Allergy, Asthma and Immunology
Volume118
Issue number4
DOIs
StatePublished - Apr 1 2017

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Anaphylaxis
Hospital Emergency Service
Pediatrics
International Classification of Diseases
Venoms
National Institute of Allergy and Infectious Diseases (U.S.)
Insect Bites and Stings
Food
Pediatric Hospitals
Emergency Medicine
Hospital Departments
National Institutes of Health (U.S.)
Bites and Stings
African Americans
Respiratory System
Epinephrine
Hypersensitivity
Referral and Consultation
Allergists
Physicians

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period. / Wright, Christopher D.; Longjohn, Mindy; Lieberman, Phillip L.; Lieberman, Jay.

In: Annals of Allergy, Asthma and Immunology, Vol. 118, No. 4, 01.04.2017, p. 461-464.

Research output: Contribution to journalArticle

Wright, Christopher D. ; Longjohn, Mindy ; Lieberman, Phillip L. ; Lieberman, Jay. / An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period. In: Annals of Allergy, Asthma and Immunology. 2017 ; Vol. 118, No. 4. pp. 461-464.
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