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Infantile Anaphylaxis in Korea: a Multicenter Retrospective Case Study

Authors
 You Hoon Jeon  ;  Sooyoung Lee  ;  Kangmo Ahn  ;  So-Yeon Lee  ;  Kyung Won Kim  ;  Hyun Hee Kim  ;  Jeong Hee Kim  ;  Hye Yung Yum  ;  Woo Kyung Kim  ;  Yong Mean Park  ;  Tae Won Song  ;  Jihyun Kim  ;  Yong Ju Lee  ;  Gwang Cheon Jang  ;  Kyunguk Jeong  ;  Yoon Hee Kim  ;  Taek Ki Min  ;  Bok Yang Pyun 
Citation
 Journal of Korean Medical Science, Vol.34(13) : e106, 2019 
Journal Title
 Journal of Korean Medical Science 
ISSN
 1011-8934 
Issue Date
2019
Keywords
Anaphylaxis ; Epinephrine ; Food ; Infant
Abstract
BACKGROUND: Anaphylaxis is increasing in young children. The aim of the present study was to analyze the clinical characteristics of anaphylaxis in Korean infants, with a focus on food triggers. METHODS: The study analyzed the medical records of infants aged 0 to 2 years old who had been diagnosed with anaphylaxis in 23 secondary or tertiary hospitals in Korea. RESULTS: We identified 363 cases of infantile anaphylaxis (66.9% male). Cutaneous symptoms were most prevalent (98.6%), followed by respiratory (83.2%), gastrointestinal (29.8%), and neurologic (11.6%) symptoms. Cardiovascular symptoms were noted in 7.7% of the cases. Most of the cases of anaphylaxis (338; 93.1%) were induced by foods. The most common trigger food was cow's milk and cow's milk products (43.8%), followed by hen's eggs (21.9%), walnuts (8.3%), wheat (7.7%), peanuts (4.8%), other nuts (3.0%), and fish (2.1%). In cow's milk-induced anaphylaxis cases, more than half the cases had cow's milk specific immunoglobulin E (sIgE) levels that were lower than the diagnostic decision points (DDPs), which is 5 kUA/L for those under the age of 1 and 15 kUA/L for those over the age of 1. In anaphylaxis induced by hen's egg, most of the cases (91.8%) had hen's egg sIgE levels that were higher than the DDP, which is 2 kUA/L for those under the age of 2 and 7 kUA/L for those over the age of 2. Of the infantile anaphylaxis cases, 46.8% had been treated with epinephrine, and 25.1% had been prescribed an epinephrine auto-injector. CONCLUSION: Cow's milk is the most frequent trigger food of anaphylaxis in Korean infants. However, we found no significant correlation between the sIgE level and clinical severity. Education is required regarding the importance of epinephrine as the first line therapy for anaphylaxis and on properly prescribing epinephrine for infants with a history of anaphylaxis.
DOI
10.3346/jkms.2019.34.e106
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170934
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