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Keum, Lee, Cho, Hong, and Kwon: Comparison of Anaphylaxis and Angioedema with Oral Mucosal Involvement in a Single Pediatric Emergency Department
Original Article

The Ewha Medical Journal 2015; 38(1): 14-21.

Published online: 26 March 2015

DOI: https://doi.org/10.12771/emj.2015.38.1.14

Comparison of Anaphylaxis and Angioedema with Oral Mucosal Involvement in a Single Pediatric Emergency Department

Hyun Sup Keum, Do Kyung Lee, Su Jin Cho, Young Mi Hong, Jung Hyun Kwon

Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Jung Hyun Kwon. Department of Pediatrics, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-5275, Fax: 82-2-2653-3718, pediangel@naver.com

Received 30 July 2014       Accepted 8 October 2014

Copyright © 2015, The Ewha Medical Journal

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

We aimed to compare and distinguish the characteristics of anaphylaxis and angioedema, especially with oral mucosal involvement and treatment of patients who visited the Pediatric Emergency Department.

Methods

We retrospectively analyzed patients under age 18-year-old who were diagnosed with anaphylaxis and angioedema with oral mucosal involvement and treated with epinephrine from May 2008 to May 2013 in a single Pediatric Emergency Department in Seoul, Korea. We evaluated their past history, possible triggering causes, symptoms, vital signs and treatment and discharge with education.

Results

During the study period the total cases of anaphylaxis were 79 and angioedema with oral mucosal involvement were 218. The age of patients with anaphylaxis was significantly higher (6.6±4.9 years vs. 4.1±3.3 years). The heart rate relative to age was significantly higher in the anaphylaxis group (49.4% vs. 36.2%). After discharge from the Emergency Center, 3.8% of anaphylaxis patients were prescribed an epinephrine injection. Education to avoid the triggering factor was provided in 32.9% of anaphylaxis group and 17.4% in the angioedema group.

Conclusion

Besides blood pressure, we should pay attention to the heart rate in pediatric patients with severe allergic reactions. More active follow-up of anaphylaxis and angioedema with oral mucosal involvement is needed to educate parents and prescribe emergency medication.

Keywords: Anaphylaxis, Angioedema, Child

Figures and Tables

Fig. 1

The proportion of patients for suspected foods of anaphylaxis and angioedema.

emj-38-14-g001
Fig. 2

The proportion of clinical manifestations of patients with anaphylaxis.

emj-38-14-g002
Table 1

Baseline characteristics of patients, onset time and place of anaphylaxis and angioedema

emj-38-14-i001

Values are presented as number (%).

*P<0.05.

Table 2

Vital signs and blood pressure of anaphylaxis and angioedema

emj-38-14-i002

Values are presented as number (%).

*P<0.05. †According to normal vital sign from Nelson Textbook of Pediatrics. ‡According to the Clinical Criteria for the Diagnosis of Anaphylaxis. §Total (n=122), anaphylaxis (n=46), angioedema (n=76).

Table 3

Treatment of anaphylaxis and angioedema

emj-38-14-i003

Values are presented as number (%).

*P<0.05.

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