Conclusions:  In  our  pediatric  popula/on,  the  main  triggering  agent  of  anaphylaxis  is  IgE-­‐mediated  food  allergy.  Epinephrine  is  clearly  

underused,  as  has  been  reported  by  others.  O=en,  children  have  several  episodes  before  being  assessed  by  an  allergist.    

We   stress   the   importance   of   systema/c   no/fica/on   of   anaphylaxis   and   improvement   of   educa/onal   programmes   in   order   to  

achieve  a  beAer  preven/ve  and  therapeu/c  management  of  this  life-­‐threatening  en/ty.  

Natacha  Santos,  Ângela  Gaspar,  Susana  Piedade,  Cris/na  Santa-­‐Marta,  Graça  Pires,  Graça  Sampaio,  Luís  Miguel  Borrego,  Cris/na  Arêde,  Mário  Morais-­‐Almeida  Immunoallergy  Department,  CUF  Descobertas  Hospital,  Lisbon,  Portugal  

Aim:   To   determine   the   prevalence   of   anaphylaxis   in   an   Immunoallergy   outpa/ent   clinic,   and   to   iden/fy   its   main   clinical  

manifesta/ons  and  triggers,  in  children  and  adolescents.    

Methods:  From  3646  pa/ents  aged  17  years  or   younger  observed   in  our   Immunoallergy  department   from   January   to  December  

2011,  those  with  reac/ons  fullfiling  the  diagnosis  criteria  for  anaphylaxis1  were  included.  A  ques/onnaire  describing  demographical  

and  clinical  data  was  used  and  e/ological  inves/ga/on  was  performed  by  the  assistant  allergist.  

In  rela/on  to  this  presenta/on,  we  declare  that  there  are  no  conflicts  of  interest.  

One-year survey in an Immunoallergy department

1  2  

4  

1  

3  

1  

3  

2  4  

2  

1  4  

1  

1  

6  12  

7  

2  1  

<2  years-­‐old   2  to  4  years-­‐old   5  to  9  years-­‐old   ≥  10  years-­‐old  

Milk  (n=22)  Egg  (n=7)  Peanut  (n=6)  Tree  nuts  (n=6)  Fresh  fruits  (n=6)  Crustaceans  (n=4)  Fish  (n=4)  Wheat  (n=2)  Soybean  (n=1)  

64  children  with  reported  anaphylac/c  reac/ons  

1.76%  Prevalence  

55*

Food  allergy  

Mean  age  8.1±5.5  years,  39  (61%)  male  

91%  had  personal  history  of  allergic  disease,  and  44%  had  asthma    

Median  age  of  the  first  anaphylac/c  episode:  3  years  (1  month  -­‐  17  years  old)  

Symptoms:  cutaneous  (94%),  respiratory  (84%),  gastrointes/nal  (42%)  and  cardiovascular  (25%)  

   

5

Drug  allergy  NSAID  (n=4)  amoxicillin  (n=1)  

3

Cold-­‐induced  anaphylaxis  

1 Latex-­‐fruit  syndrome  

1 Insect  s;ng  

86%  reac/ons  began  in  the  first  30  minutes  

73%  were  admiAed  to  emergency  department  

Only  33%  were  treated  with  epinephrine  

Recurrence  of  anaphylaxis  occurred  in  25  

pa/ents  (3  or  more  episodes  in  14  children)  

Fig.  1  –  Number  of  children  with  a  given  food  allergy  according  to  age  of  the  first  anaphylac/c  episode  

1Sampson  HA,  Muñoz-­‐Furlong  A,  Campbell  RL,  Adkinson  NF  Jr,  Bock  SA,  Branum  A,  et  al.  Second  symposium  on  the  defini/on  and  management  of  anaphylaxis:  summary  report  -­‐  Second  Na/onal  Ins/tute  of  Allergy  and  Infec/ous  Disease/Food  Allergy  and  Anaphylaxis  Network  symposium.  J  Allergy  Clin  Immunol  2006;117:391-­‐7  

73%  had  no  previous  diagnosis  of  the  e>ologic  factor  

*  1  child  had  anaphylaxis  to  shrimp  and  NSAID  

3  children  had  anaphylaxis  to  two  different  food  groups