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Prescribing adrenaline auto-injectors in Slovenian children
© Vesel et al; licensee BioMed Central Ltd. 2015
Published: 30 March 2015
Little is known about the reasons for prescribing adrenalin auto-injectors in Slovenian children. Our objective was to evaluate prescription of adrenaline auto-injectors in children in our department in year 2013 and also to evaluate management of anaphylaxis of those children.
We retrospectively collected data on interventions of anaphylaxis and allergic-clinic follow-up of 258 children which had adrenaline auto-injectors prescribed in year 2013.
Adrenaline auto-injector was prescribed in 258 children (66% boys and 34% girls). In 120 of them adrenaline auto-injector was prescribed de novo. 2% of them were babies, 31% 1 to 5 years old, 52% 6 to 14 years old and 15% 15 to 18 years old. In 66% adrenaline auto-injector was prescribed because of anaphylaxis, in 27% because of urticaria or/and angioedema and in 7% because of other reasons such as food allergy and bronchial asthma or/and recombinant based IgE testing results.
In 174 children (67%) adrenaline auto-injector was prescribed because of food allergy, most frequently because of allergy to peanuts (81 children), egg (35 children), tree nuts (19 children) and cow milk (14 children). 77% of peanut allergic children had IgE antibodies to rArah h 2. Among food allergic children 44% had multiple food allergies, 40% asthma and 11% suffered more than one immediate reaction. In 60 children (23%) adrenaline auto-injector was prescribed because of insect sting (49 had anaphylaxis and eleven urticaria or/and angioedema). Allergy to wasp or hornet venom was more frequently confirmed (in 34 children) than allergy to honeybee venom (23 children). 3 children had negative testing results after anaphylaxis due to a sting. In four children parents refused starting specific immunotherapy with Hymenoptera venom after anaphylaxis. In 12 children (5%) the cause of immediate reaction was unknown. Other confirmed reasons for prescribing adrenaline auto-injector were rare (such as cold, inhalant allergens, latex).
30% of anaphylaxis was treated with adrenaline (auto-injector was used in eight children). 23% of children were not admitted to hospital after anaphylaxis. No child was admitted to intensive care unit.
Our data showed that allergy to peanuts was most frequent cause of prescribing adrenaline auto-injector to children during last year. There is need to increase education of management of anaphylaxis in children in Slovenia.
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