Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tikvah, Israel.
Pediatr Allergy Immunol. 2011 Mar;22(2):172-7. doi: 10.1111/j.1399-3038.2010.00990.x.
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 β2 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.
儿童过敏反应的病程、病因和临床特征在美国和欧洲以外的地区知之甚少。我们的目的是评估在以色列施耐德儿童医疗中心接受治疗的过敏反应患儿的发病情况，该中心是一家主要的三级医疗机构。在 12 年的研究期间，有 92 名过敏反应患儿（50 名男孩，42 名女孩）住院治疗，年龄为 14 天至 18 岁（平均年龄 7.4 岁）。发病事件发生在 52 名儿童（56%）家中、24 名儿童（26%）医疗机构中、13 名儿童（15%）户外、2 名儿童（2%）学校和 1 名儿童（1%）未知地点。主要病因是食物（43%），主要是牛奶和坚果、药物（22%）和蜂毒液（11%）；在 5 名儿童中，过敏反应发生在全身麻醉期间，5 名儿童的病因无法确定。食物诱发的过敏反应倾向于发生在年龄较小的儿童中。48 名儿童（52%）有特应性病史（主要是哮喘）。医院治疗包括皮质类固醇（85%）、抗组胺药（75%）、肾上腺素（72%）和β2 激动剂（42%）。7 名患者被收入重症监护病房。无死亡病例。在 16 名有多次过敏反应发作的患者中，只有 1 名使用了 EpiPen，这表明需要改进患者和家长对 EpiPen 使用的教育。
