Jiang Nannan, Xu Wei, Huang Huijie, Hou Xiaoling, Xiang Li
Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, People's Republic of China.
J Asthma Allergy. 2022 Aug 18;15:1093-1104. doi: 10.2147/JAA.S376495. eCollection 2022.
Asthma and recurrent wheezing (RW) have been identified as risk factors for anaphylaxis; however, little is known about the characteristics of anaphylaxis in children with a history of asthma or RW in Chinese children.
This was a retrospective, observational chart review of children who were diagnosed with anaphylaxis in a tertiary children's hospital between 2014 and 2021. Patients' demographics, symptoms, triggers and presence of physician-diagnosed asthma/RW history were collected from medical charts.
A total of 399 anaphylactic reactions in 264 patients were analyzed; 119 patients (45.1%) had a history of asthma/RW. Food was the most common cause (85.5%, 341/399). Compared with patients without a history of asthma/RW, buckwheat-induced anaphylaxis was significantly more common in the asthma/RW group (9.4% vs 0.5%, p < 0.001), patients with a history of asthma/RW had higher rates of oropharyngeal symptoms (17.3% vs 8.6%, p = 0.011) and wheezing (34.5% vs 15.9%, p < 0.001). Ninety-one reactions (22.8%, 91/399) presented as severe anaphylaxis, but no difference existed between asthma/RW and non-asthma/RW groups. Children with a history of asthma/RW were more likely to receive inhaled β agonists than children without a history of asthma/RW (11.8% vs 2.5%, p = 0.003). A larger proportion of children without asthma/RW history were treated with epinephrine (11.7%) than children with asthma/RW history (6.9%).
Our finding revealed that different clinical profiles of anaphylaxis in children with and without a history of asthma/RW. Our study did not find that children with a history of asthma/RW have more severe anaphylactic reactions compared with children without asthma/RW. Buckwheat-induced anaphylaxis was more common in the asthma/RW group, wheezing and oropharyngeal symptoms affected a higher proportion of the asthma/RW group.
哮喘和复发性喘息（RW）已被确定为过敏反应的危险因素；然而，在中国儿童中，对于有哮喘或RW病史的儿童发生过敏反应的特征知之甚少。
这是一项对2014年至2021年间在一家三级儿童医院被诊断为过敏反应的儿童进行的回顾性观察性病历审查。从病历中收集患者的人口统计学信息、症状、诱发因素以及医生诊断的哮喘/RW病史。
共分析了264例患者的399次过敏反应；119例患者（45.1%）有哮喘/RW病史。食物是最常见的诱因（85.5%，341/399）。与无哮喘/RW病史的患者相比，荞麦诱发的过敏反应在哮喘/RW组中明显更常见（9.4%对0.5%，p<0.001），有哮喘/RW病史的患者口咽症状发生率更高（17.3%对8.6%，p=0.011），喘息发生率更高（34.5%对15.9%，p<0.001）。91次反应（22.8%，91/399）表现为严重过敏反应，但哮喘/RW组与非哮喘/RW组之间无差异。有哮喘/RW病史的儿童比无哮喘/RW病史的儿童更有可能接受吸入性β受体激动剂治疗（11.8%对2.5%，p=0.003）。无哮喘/RW病史的儿童接受肾上腺素治疗的比例（11.7%）高于有哮喘/RW病史的儿童（6.9%）。
我们的研究结果显示，有和无哮喘/RW病史的儿童过敏反应的临床特征不同。我们的研究未发现有哮喘/RW病史的儿童与无哮喘/RW病史的儿童相比有更严重的过敏反应。荞麦诱发的过敏反应在哮喘/RW组中更常见，喘息和口咽症状在哮喘/RW组中的发生率更高。
