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.

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.

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.

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.

The etiology for Kawasaki disease (KD) remains unknown, but several studies have suggested the involvement of immune dysregulation and genetic factors. The purpose of this study is to compare gene expressions before and after an infusion of intravenous immunoglobulin (IVIG) in KD patients.

Blood was obtained from both acute and sub-acute phases of 4 patients with KD and febrile control children. Blood was collected in PAXgene blood RNA tubes and RNA was extracted using a PAXgene blood RNA isolation kit. Labeled RNAs were analyzed using Roche NimbleGen human whole genome 12-plex array.

KD patients prior to IVIG injection showed more than a two-fold increase in the expression of 88 genes and more than a two-fold decrease in the expression of 98 genes compared to the control group. They also showed more than two-fold increase in the expression of 226 genes and more than a two-fold decrease in 117 genes in KD patients after IVIG treatment compared to the patients before IVIG injection. Through microarray evaluation, the expressions of genes involved in proliferation, translation, inflammatory response, immune response, cell adhesion, cell migration, cell differentiation, apoptosis, cell growth, transport, cell cycle, transcription, signal transduction and metastasis were observed.

Changes in gene expressions in pediatric patients with KD before and after IVIG were observed via microarray evaluation.