Fatih ÇİÇEK, Ugur ALTAS, Zeynep Meva ALTAŞ, Ayşen ÇETEMEN, Mehmet Yaşar ÖZKARS

Çocuklarda Anafilaktik Reaksiyonların Özellikleri: Çocuk Alerji Kliniği Bulguları

ÖZET Amaç: Anafilaksi, hızla gelişen çoklu sistem tutulumu ile karakterize, şiddetli ve potansiyel olarak yaşamı tehdit edici bir aşırı duyarlılık reaksiyonudur. Anafilaksi öyküsü olan hastaların klinik özellikleri sistematik olarak değerlendirilerek, çocuklarda yaşamı tehdit eden bu durumun epidemiyolojisi ve klinik spektrumu hakkında değerli bilgiler edinebiliriz. Gereç ve Yöntemler: Ocak 2016- Aralık 2022 tarihleri arasında Çocuk Alerji Polikliniği' ne ‘anafilaktik şok, tanımlanmamış’ tanısı ile başvuran 0-18 yaş arası hastalar ile ilgili veriler geriye yönelik taranmış, anafilaksi öyküsü olan 186 hasta çalışmaya dahil edilmiştir. Hastaların tanı yaşı, cinsiyeti, alerji öyküsü, anafilaksiyi tetikleyen muhtemel alerjen öyküsü, anafilakside görülen klinik bulgular çalışma kapsamında değerlendirilmiştir. Bulgular: Hastaların %55,4'ü erkek, medyan yaş 5,0/yıl idi. Anafilaksi tetikleyicisi muhtemel alerjenler hastaların %41,9’unda besin, %40,3’ünde ilaç, %7,5’inde arı venomu, %10,2’sinde idiopatikti. Besinlerin içerisinde en sık kuruyemiş (%35,9), ilaçların içerisinde en sık antibiyotikler muhtemel alerjenlerdi. Hastaların %24,7’ sinde öncesinde bilinen alerji öyküleri vardı. Hastaların %85,5’inde solunum sistemi, %82,3’ünde deri-mukoza, %50’sinde gastrointestinal sistem ve %4,3’ünde kardiyovasküler sistem tutulumu gözlendi. Sonuçlar: Anafilaksi hastalarının klinik özelliklerinin değerlendirilmesi, çocuklarda bu karmaşık aşırı duyarlılık reaksiyonuna yönelik anlayışımızı ve klinik yaklaşımımızı geliştirmede büyük önem taşımaktadır. Bu sayede anafilaktik reaksiyonların tanısını, doğru yönetimini ve önlenmesini optimize etmeyi ve sonuçta çocuklar için daha iyi sağlık sonuçları ve daha iyi yaşam kalitesi hedeflenebilir.

Anahtar Kelimeler:

Anafilaksi, ilaç alerjisi, adrenalin, gıda kaynaklı anafilaksi

Characteristics of Anaphylactic Reactions in Children: Findings from a Pediatric Allergy Clinic

Abstract Background/Aims: Anaphylaxis is a severe and potentially life-threatening hypersensitivity reaction characterized by rapidly developing multisystem involvement. By systematically evaluating the clinical features of anaphylaxis patients, we can obtain valuable information about the epidemiology and clinical spectrum of this life-threatening condition in children. Materials and Methods: Between January 2016 and December 2022, data regarding patients aged 0-18 years who presented to the Pediatric Allergy Clinic with the diagnosis of 'unspecified anaphylactic shock' were retrospectively screened, and a total of 186 patients with a history of anaphylaxis were included in the study. The patients' age at diagnosis, gender, allergy history, the potential allergen-causing anaphylaxis, and clinical manifestations during anaphylactic episodes were evaluated as part of the study. Results: Of the patients, 55.4% were male, and the median age was 5.0 years. The probable allergen triggering anaphylaxis was food in 41.9% of patients, drugs in 40.3%, bee venom in 7.5%, and idiopathic in 10.2%. Among food triggers, tree nuts were the most common (35.9%), while antibiotics were the most common probable allergens among drugs. 24.7% of the patients had a known allergy history. Respiratory system involvement was observed in 85.5% of the patients, skin-mucosa involvement was observed in 82.3%, gastrointestinal system involvement was observed in 50%, and cardiovascular system involvement was observed in 4.3%. Conclusion: Evaluating the clinical characteristics of anaphylaxis patients is of great importance in enhancing our understanding and clinical approach to this complex hypersensitivity reaction in children. This approach aims to optimize the diagnosis, proper management, and prevention of anaphylactic reactions, ultimately leading to better health outcomes and improved quality of life for children.

Keywords:

Anaphylaxis, drug allergy, adrenalin, food-induced anaphylaxis,

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