Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
Allergy Asthma Proc. 2013 May-Jun;34(3):233-8. doi: 10.2500/aap.2013.34.3658.
Although there has been increasing data on pediatric anaphylaxis, information about anaphylaxis in the 1st year of life is scarce. This study provides detailed information on clinical signs and symptoms of anaphylaxis in the 1st year of life. A retrospective review was performed of our pediatric allergy database between 2007 and 2011. Children who met the diagnostic criteria of anaphylaxis were included. They were categorized as "infant" if they were ≤12 months of age at the time of anaphylactic reaction and "children" if >12 months. There were 104 patients (60 male and 44 female subjects) who met the diagnosis criteria of anaphylaxis. From the 104 cases of anaphylaxis, 23 (22.1%) were infants. Boys (p = 0.043), atopic eczema (p = 0.049), and history of food allergy (p < 0.001) were significantly higher in infants than in children with anaphylaxis. Severe anaphylaxis was less frequent in infants than in children (p = 0.04). There was no significant difference between infants and children considering cutaneous and respiratory symptoms (p > 0.05 for both) but persistent vomiting was (p = 0.023). Irritability, persistent crying, and somnolence are the signs which are difficult to interpret in infants with anaphylaxis. Within these signs, irritability, persistent crying, and somnolence were present in 69.6, 43.5, and 26.1% of infants, respectively. Blood pressure was measured in 5 infants (21.7%) compared with 44 children (54.3%; p = 0.005). Four children (4.9%) required more than one epinephrine treatment, but no infant did. Median observation periods were 4 hours in both groups (p = 0.087) and no biphasic reactions occurred in either. Food (p < 0.001) was significantly more and drugs (p = 0.015) were a less frequent cause of anaphylaxis in infants than in children. Anaphylaxis in infants is not rare but many signs of anaphylaxis are overlooked and still undertreated.
虽然有关儿科过敏反应的资料日益增多，但有关婴儿期过敏反应的资料却很少。本研究提供了婴儿期过敏反应的详细临床体征和症状信息。对我们儿科过敏症数据库中 2007 年至 2011 年的数据进行了回顾性分析。入选符合过敏反应诊断标准的患儿。如果在过敏反应发生时年龄≤12 个月，则归类为“婴儿”；如果>12 个月，则归类为“儿童”。共有 104 例（60 名男性和 44 名女性）符合过敏反应的诊断标准。在 104 例过敏反应中，23 例（22.1%）为婴儿。与儿童过敏相比，男婴（p=0.043）、特应性皮炎（p=0.049）和食物过敏史（p<0.001）的发生率明显更高。婴儿严重过敏反应的发生率低于儿童（p=0.04）。在皮肤和呼吸道症状方面，婴儿和儿童之间无显著差异（p>0.05），但持续性呕吐的差异有统计学意义（p=0.023）。在婴儿过敏中，烦躁、持续哭闹和嗜睡等体征较难解释。在这些体征中，烦躁、持续哭闹和嗜睡分别在 69.6%、43.5%和 26.1%的婴儿中出现。与 44 名儿童（54.3%）相比，5 名婴儿（21.7%）接受了血压测量（p=0.005）。4 名儿童（4.9%）需要接受多次肾上腺素治疗，但无婴儿需要。两组的中位观察时间均为 4 小时（p=0.087），且均未发生双相反应。食物（p<0.001）是婴儿过敏的更常见原因，而药物（p=0.015）则是儿童过敏的更常见原因。婴儿过敏并不少见，但许多过敏反应的体征被忽视，仍未得到充分治疗。
