Document Detail

Multicenter study of repeat epinephrine treatments for food-related anaphylaxis.
MedLine Citation:
PMID:  20308215     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We sought to establish the frequency of receiving >1 dose of epinephrine in children who present to the emergency department (ED) with food-related anaphylaxis.
PATIENTS AND METHODS: We performed a medical chart review at Boston hospitals of all children presenting to the ED for food-related acute allergic reactions between January 1, 2001, and December 31, 2006. We focused on causative foods, clinical presentations, and emergency treatments.
RESULTS: Through random sampling and appropriate weighting, the 605 reviewed cases represented a study cohort of 1255 patients. These patients had a median age of 5.8 years (95% confidence interval [CI]: 5.3-6.3), and the cohort was 62% male. A variety of foods provoked the allergic reactions, including peanuts (23%), tree nuts (18%), and milk (15%). Approximately half (52% [95% CI: 48-57]) of the children met diagnostic criteria for food-related anaphylaxis. Among those with anaphylaxis, 31% received 1 dose and 3% received >1 dose of epinephrine before their arrival to the ED. In the ED, patients with anaphylaxis received antihistamines (59%), corticosteroids (57%), epinephrine (20%). Over the course of their reaction, 44% of patients with food-related anaphylaxis received epinephrine, and among this subset of patients, 12% (95% CI: 9-14) received >1 dose. Risk factors for repeat epinephrine use included older age and transfer from an outside hospital. Most patients (88%) were discharged from the hospital. On ED discharge, 43% were prescribed self-injectable epinephrine, and only 22% were referred to an allergist.
CONCLUSIONS: Among children with food-related anaphylaxis who received epinephrine, 12% received a second dose. Results of this study support the recommendation that children at risk for food-related anaphylaxis carry 2 doses of epinephrine.
Susan A Rudders; Aleena Banerji; Blanka Corel; Sunday Clark; Carlos A Camargo
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-03-22
Journal Detail:
Title:  Pediatrics     Volume:  125     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-04-27     Revised Date:  2013-03-08    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e711-8     Citation Subset:  AIM; IM    
Division of Allergy and Immunology, Children's Hospital Boston, Boston, Massachusetts, USA.
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MeSH Terms
Anaphylaxis / drug therapy*,  etiology
Child, Preschool
Cohort Studies
Epinephrine / administration & dosage*
Food Hypersensitivity / complications,  drug therapy*
Pilot Projects
Retrospective Studies
Grant Support
Reg. No./Substance:
Comment In:
Curr Allergy Asthma Rep. 2011 Aug;11(4):271-2   [PMID:  21484311 ]
J Pediatr. 2010 Nov;157(5):861   [PMID:  20955858 ]

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