Allergy Asthma Immunol Res.  2016 Jul;8(4):353-361. 10.4168/aair.2016.8.4.353.

Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes

• Jiang N
• Yin J
• Wen L
• Li H

• KMID: 2165919
• DOI: http://doi.org/10.4168/aair.2016.8.4.353

Abstract

PURPOSE
Comprehensive evaluation of anaphylaxis in China is currently lacking. In this study, we characterized the clinical profiles, anaphylactic triggers, and emergency treatment in pediatric and adult patients.
METHODS
Outpatients diagnosed with "anaphylaxis" or "severe allergic reactions" in the Department of Allergy, Peking Union Medical College Hospital from January 1, 2000 to June 30, 2014 were analyzed retrospectively.
RESULTS
A total of 1,952 episodes of anaphylaxis in 907 patients were analyzed (78% were adults and 22% were children). Foods are the most common cause (77%), followed by idiopathic etiologies (15%), medications (7%) and insects (0.6%). In food-induced anaphylaxis, 62% (13/21) of anaphylaxis in infants and young children (0-3 years of age) were triggered by milk, 59% (36/61) of anaphylaxis in children (4-9 years of age) were triggered by fruits/vegetables, while wheat was the cause of anaphylaxis in 20% (56/282) of teenagers (10-17 years of age) and 42% (429/1,016) in adults (18-50 years of age). Mugwort pollen sensitization was common in patients with anaphylaxis induced by spices, fruits/vegetables, legume/peanuts, and tree nuts/seeds, with the prevalence rates of 75%, 67%, 61%, and 51%, respectively. Thirty-six percent of drug-induced anaphylaxis was attributed to traditional Chinese Medicine. For patients receiving emergency care, only 25% of patients received epinephrine.
CONCLUSIONS
The present study showed that anaphylaxis appeared to occur more often in adults than in infants and children, which were in contrast to those found in other countries. In particular, wheat allergens played a prominent role in triggering food-induced anaphylaxis, followed by fruits/vegetables. Traditional Chinese medicine was a cause of drug-induced anaphylaxis. Furthermore, exercise was the most common factor aggravating anaphylaxis. Education regarding the more aggressive use of epinephrine in the emergency setting is clearly needed.

Keyword

Anaphylaxis; epinephrine; wheat allergy; traditional Chinese medicine; China

MeSH Terms

Adolescent
Adult
Allergens
Anaphylaxis*
Artemisia
Asian Continental Ancestry Group*
Child
China
Education
Emergencies
Emergency Medical Services
Emergency Treatment
Epinephrine
Humans
Hypersensitivity*
Infant
Insects
Medicine, Chinese Traditional
Milk
Outpatients
Pollen
Prevalence
Retrospective Studies*
Spices
Trees
Triticum
Wheat Hypersensitivity
Allergens
Epinephrine

Figure

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  Fig. 1 Age-related food trigger patterns. Five age groups based on the onset age.

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  Fig. 2 Pollen sensitization profile in food-induced anaphylaxis patients.

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