Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 West Arbor Drive #8676, San Diego, CA, 92103, USA.
Department of Medical Toxicology, Northwell Health at North Shore University, 300 Community Drive, Manhasset, NY, 11030, USA.
J Med Toxicol. 2021 Jan;17(1):48-50. doi: 10.1007/s13181-020-00798-0. Epub 2020 Jul 24.
Studies of acute hypersensitivity reactions in pediatric populations receiving Crotalidae Polyvalent Immune Fab (CPIF) are complicated by small size, wide age ranges, and diverse definitions of such reactions.
This is a retrospective chart review of patients aged 13 years or younger treated with CPIF for Crotalid envenomation from November 2006 to 2016. The primary outcome was the presence of an acute hypersensitivity reaction to CPIF and was defined as the development of any of the following symptoms within 3 hours of initiation of CPIF infusion: urticaria, wheezing or respiratory distress, angioedema, hypotension, nausea, and/or vomiting. Demographics, CPIF dose to control and total dose, bite location, level of care, and length of stay were also recorded.
Thirty-four patients were ultimately treated with CPIF. Ages ranged from 10 months to 13 years. Twenty-one patients (60%) were male, 24 (70.6%) were admitted to the ICU, and the median length of stay was 2 days with a range of 1-11 days. Zero patients developed an acute hypersensitivity reaction to CPIF.
Acute hypersensitivity reactions to CPIF did not occur in this cohort. Such reactions are rare with the use of CPIF in pediatric patients.
研究儿科人群接受响尾蛇多价免疫 Fab（CPIF）后发生的急性过敏反应，因患儿体型小、年龄范围广且对这类反应的定义多样化而变得复杂。
这是一项对 2006 年 11 月至 2016 年间接受 CPIF 治疗响尾蛇咬伤的 13 岁及以下患者进行的回顾性图表审查。主要结局是 CPIF 是否出现急性过敏反应，定义为在 CPIF 输注开始后 3 小时内出现以下任何症状：荨麻疹、喘息或呼吸窘迫、血管性水肿、低血压、恶心和/或呕吐。还记录了患者的人口统计学资料、CPIF 控制剂量和总剂量、咬伤部位、护理级别和住院时间。
最终有 34 例患者接受 CPIF 治疗。年龄从 10 个月至 13 岁。21 例（60%）为男性，24 例（70.6%）入住 ICU，中位住院时间为 2 天，范围为 1-11 天。没有患者对 CPIF 发生急性过敏反应。
在本队列中，CPIF 未引起急性过敏反应。在儿科患者中，CPIF 的使用很少出现此类反应。
