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Original Article

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
The Ewha Medical Journal 2015;38(1):14-21. Published online: March 26, 2015

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: July 30, 2014   • Accepted: October 8, 2014

Copyright © 2015, The Ewha Medical Journal

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.

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  • 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
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Fig. 1

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

emj-38-14-g001.jpg
Fig. 2

The proportion of clinical manifestations of patients with anaphylaxis.

emj-38-14-g002.jpg
Table 1

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

Values are presented as number (%).

*P<0.05.

emj-38-14-i001.jpg
Table 2

Vital signs and blood pressure of anaphylaxis and angioedema

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).

emj-38-14-i002.jpg
Table 3

Treatment of anaphylaxis and angioedema

Values are presented as number (%).

*P<0.05.

emj-38-14-i003.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Pediatric anaphylaxis at a university hospital including the rate of prescribing epinephrine auto-injectors
      Jun Seak Gang, Hye-Sun Kim, Hyun Ho Bang, Tae Ho Kim, Hyun Jung Lee, Young Hwangbo, Joon Soo Park
      Allergy, Asthma & Respiratory Disease.2017; 5(3): 135.     CrossRef

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    Comparison of Anaphylaxis and Angioedema with Oral Mucosal Involvement in a Single Pediatric Emergency Department
    Ewha Med J. 2015;38(1):14-21.   Published online March 26, 2015
    DOI: https://doi.org/10.12771/emj.2015.38.1.14
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    Comparison of Anaphylaxis and Angioedema with Oral Mucosal Involvement in a Single Pediatric Emergency Department
    Ewha Med J. 2015;38(1):14-21.   Published online March 26, 2015
    DOI: https://doi.org/10.12771/emj.2015.38.1.14
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    Figure

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    • 1
    Comparison of Anaphylaxis and Angioedema with Oral Mucosal Involvement in a Single Pediatric Emergency Department
    Image Image
    Fig. 1 The proportion of patients for suspected foods of anaphylaxis and angioedema.
    Fig. 2 The proportion of clinical manifestations of patients with anaphylaxis.

    Fig. 1

    Fig. 2

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

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

    Values are presented as number (%).

    *P<0.05.

    Vital signs and blood pressure of anaphylaxis and angioedema

    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).

    Treatment of anaphylaxis and angioedema

    Values are presented as number (%).

    *P<0.05.
    Table 1 Baseline characteristics of patients, onset time and place of anaphylaxis and angioedema

    Values are presented as number (%).

    *P<0.05.

    Table 2 Vital signs and blood pressure of anaphylaxis and angioedema

    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

    Values are presented as number (%).

    *P<0.05.

    Table 1

    Table 2

    Table 3

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