Anaphylaxis in pediatric patients: Single-center study in a private hospital

Objective: To describe the profile of probable cases of anaphylaxis attended at a private pediatric hospital emergency service in São Paulo, encompassing triggering factors, the presence of cofactors, treatments performed, and the follow-up of these cases through interviews with the patients’ families. Methods: A single-center cross-sectional study that analyzed medical records of children and adolescents treated between 2016 and 2020. Cases with symptoms compatible with anaphylaxis were evaluated by allergist physicians to select probable cases, and the parents or legal guardians of these cases were interviewed to collect detailed information about the episodes. Results: 69 probable cases of anaphylaxis (PCA) were identified among 460,434 attendances. Of the 51 PCAs, the majority presented cutaneous and respiratory symptoms, with a male predominance (63%), and 27% were under 2 years old. Foods, especially nuts and peanuts, were the main triggers. Nearly a third of the patients did not undergo investigation after the episode, and intramuscular adrenaline (37%) and auto-injectable (AI) adrenaline (4%) were underutilized as treatments. Eight cases showed recurrence of symptoms after improvement, suggesting a possible biphasic reaction. Conclusion: This study revealed that the majority of PCAs occurred in male children. Nuts and peanuts were the main triggers. The approach to PCAs was not ideal, with underutilization of intramuscular adrenaline as first-line treatment and low prescription of AI adrenaline in follow-up. Awareness and education about anaphylaxis in children and the importance of proper treatment are crucial to reduce the risk of morbidity and mortality in this vulnerable population.