Nabavi Mohammad, Lavavpour Mehrnoosh, Arshi Saba, Bemanian Mohammad Hasan, Esmaeilzadeh Hossein, Molatefi Rasool, Rekabi Mahsa, Ahmadian Javad, Eslami Narges, Shokri Sima, Darabi Kian, Sedighi Gholam Reza, Fallahpour Morteza
Department of Allergy, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Pediatric Department, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2017 Dec;16(6):480-487.
Despite the increasing prevalence of anaphylaxis, there is little information about the characteristics and practice of healthcare providers in treating anaphylaxis, so this study was conducted to record the characteristics and therapeutic approaches of anaphylaxis from May 2012 until April 2015, the data of all patients diagnosed with anaphylaxis in the Allergy department of three referral university hospitals in Tehran, Iran were recorded. Thereafter, the demographics, clinical features, triggers and therapeutic approach were evaluated. This study investigated 136 individuals, 64 males (47%) between 6 months and 68 years old, as well as 72 others (52.94%) under 18 years of age (pediatric). The following were the most common organs involved: Skin 86.02% (pediatric 91.66% vs adult 79.68%), respiratory tract 51.47% (pediatric 43.05% vs adult 60.93%), cardiovascular 50.73% (pediatric 54.16% vs adult 46.87%), gastrointestinal 20.58% (pediatric 27.7% vs adult 12.5% ) and neurologic system 5.88% (only in adults). The following were the most identified causing foods 69 (50.37%)[42 pediatric (children) and 27 adults], drugs 34( 25%)[14 pediatric and 20 adults], idiopathic 16( 11.77%)[3 pediatric and 13 adults], insect sting 7( 5.15%)[3 pediatric and 4 adults] , exercise 6( 4.42%) [1 pediatric and 5 adults]. Milk, egg and wheat were the most common causative foods in pediatric cases but sesame, as well as egg and milk were the most common causes in adults. Epinephrine injection, auto injector epinephrine prescription as a discharging plan and referral to an allergist were: 10.78, 1.96 and 7.8 %, respectively. In this case series we found that, cutaneous, respiratory, cardiovascular and gastrointestinal complains were the most common manifestations and food, drug and idiopathic were the most common causes.In this study, the diagnosis of anaphylaxis, epinephrine subscription and referral to an allergist were significantly lower in comparison to other studies.
尽管过敏反应的患病率不断上升，但关于医疗服务提供者治疗过敏反应的特点和实践的信息却很少，因此开展了本研究，以记录2012年5月至2015年4月期间过敏反应的特点和治疗方法，记录了伊朗德黑兰三家转诊大学医院过敏科所有诊断为过敏反应的患者的数据。此后，对人口统计学、临床特征、诱发因素和治疗方法进行了评估。本研究调查了136名个体，其中64名男性（47%），年龄在6个月至68岁之间，另外72名（52.94%）为18岁以下的儿童。以下是最常受累的器官：皮肤86.02%（儿童91.66%，成人79.68%），呼吸道51.47%（儿童43.05%，成人60.93%），心血管系统50.73%（儿童54.16%，成人46.87%），胃肠道20.58%（儿童27.7%，成人12.5%），神经系统5.88%（仅见于成人）。以下是最常见的诱发食物69种（50.37%）[42名儿童和27名成人]，药物34种（25%）[14名儿童和20名成人]，特发性16种（11.77%）[3名儿童和13名成人]，昆虫叮咬7种（5.15%）[3名儿童和4名成人]，运动6种（4.42%）[1名儿童和5名成人]。牛奶、鸡蛋和小麦是儿童病例中最常见的致病食物，但芝麻以及鸡蛋和牛奶是成人中最常见的病因。肾上腺素注射、开具自动注射器肾上腺素作为出院计划以及转诊至过敏症专科医生的比例分别为10.78%、1.96%和7.8%。在这个病例系列中，我们发现皮肤、呼吸道、心血管和胃肠道症状是最常见的表现，食物、药物和特发性是最常见的病因。在本研究中，过敏反应的诊断、肾上腺素的开具以及转诊至过敏症专科医生的比例与其他研究相比显著较低。
