Ahanchian Hamid, Behmanesh Fatemeh, Azad Farahzad Jabbari, Ansari Elham, Khoshkhui Maryam, Farid Reza, Hassanpur Yalda, Kouzegaran Samaneh
Child Health Research Centre, University of Queensland, Brisbane, Australia.
Department of Pediatric Allergy and Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Med Gas Res. 2019 Jan 9;8(4):129-134. doi: 10.4103/2045-9912.248262. eCollection 2018 Oct-Dec.
Identifying the causes of anaphylaxis which is an acute, potentially fatal systemic reaction is very important in every community. Treatment strategies and pitfalls should also be determined. We sought to determine the most common triggers of anaphylaxis, clinical manifestations and treatment strategies in Mashhad, northeast of Iran. An observational cross-sectional study was conducted to evaluate all patients with a history of anaphylactic reaction who were referred to University Allergy Clinics between 2006 and 2016 in Mashhad Iran. We used a combination of patient's clinical history and allergy diagnostic testing including radioallergosorbant test and skin prick test in order to determine the etiology of anaphylaxis. We identified 172 anaphylactic reactions in 70 patients. Median age was 15 years with a range from 6 months to 48 years. The triggers included: foods, 61.4%; drugs, 15.7%; hymenoptera venom, 8.6%; idiopathic, 5.7%; immunotherapy, 4.3% and other etiologies: 5.7%. Nuts and seeds were the most important triggers of food induced anaphylaxis, especially in school children, adolescents and young adults, followed by fruits. However, Cow's milk and hen's egg were the main triggers of anaphylaxis in children aged under 2 years. The most common symptoms were cutaneous and cardiovascular. Corticosteroids (94.3%) and/or antihistamines (85.7%) were used most frequently for treatment followed by intravenous fluids (54.3%), whereas epinephrine was only used in 17.1% of the cases. Food related anaphylaxis and other typical triggers of anaphylaxis are age dependent and the risks and triggers change with age. Epinephrine injection should be increased by improving the awareness of physician and medical teams. The study was approved by the Ethics Committee of the Faculty of Medicine of Mashhad University of Medical Sciences (approved number: IR.MUMS.REC.1393.960).
识别过敏反应（一种急性、可能致命的全身反应）的病因在每个社区都非常重要。还应确定治疗策略和陷阱。我们试图确定伊朗东北部马什哈德地区过敏反应最常见的诱因、临床表现和治疗策略。进行了一项观察性横断面研究，以评估2006年至2016年期间转诊至伊朗马什哈德大学过敏诊所的所有有过敏反应病史的患者。我们结合患者的临床病史和过敏诊断测试，包括放射变应原吸附试验和皮肤点刺试验，以确定过敏反应的病因。我们在70名患者中识别出172次过敏反应。中位年龄为15岁，范围从6个月至48岁。诱因包括：食物，61.4%；药物，15.7%；膜翅目毒液，8.6%；特发性，5.7%；免疫疗法，4.3%；其他病因：5.7%。坚果和种子是食物诱发过敏反应的最重要诱因，尤其是在学龄儿童、青少年和年轻人中，其次是水果。然而，牛奶和鸡蛋是2岁以下儿童过敏反应的主要诱因。最常见的症状是皮肤和心血管方面的。治疗最常使用皮质类固醇（94.3%）和/或抗组胺药（85.7%），其次是静脉输液（54.3%），而肾上腺素仅在17.1%的病例中使用。食物相关的过敏反应和其他典型的过敏反应诱因与年龄有关，风险和诱因随年龄变化。应通过提高医生和医疗团队的认识来增加肾上腺素注射的使用。该研究获得了马什哈德医科大学医学院伦理委员会的批准（批准号：IR.MUMS.REC.1393.960）。
