Food-Induced Anaphylaxis among Children Weighing <15 kg: A Single-Center Case Series of the Pediatric Emergency Department

2021 ◽  
pp. 1-10
Author(s):  
Kenshiro Tabata ◽  
Tatsuki Fukuie ◽  
Masami Narita ◽  
Shinichiro Inagaki ◽  
Shima Ohnishi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Series ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Age Related ◽  
Desensitization Therapy ◽  
History Of ◽  
Health And Development ◽  
Grade 3 ◽  
Epinephrine Dose

<b><i>Introduction:</i></b> Food-induced anaphylaxis among infants shows an increasing prevalence; however, the prescription of epinephrine auto-injectors (EAIs) for children weighing &#x3c;15 kg is associated with issues of the needle length and the epinephrine dose. Several studies have shown age-related differences in food-induced anaphylaxis, although little is known about the weight-related differences in food-induced anaphylaxis. This study aimed to reveal the incidence, clinical characteristics, and management of food-induced anaphylaxis in children weighing &#x3c;15 kg. <b><i>Methods:</i></b> This chart review included children who visited the pediatric emergency department (ED) of the National Center for Child Health and Development (Tokyo, Japan) from January 2014 to December 2016 and were diagnosed with food-induced anaphylaxis. The severity of anaphylaxis was evaluated using the Sampson Grading Scale. <b><i>Results:</i></b> Of 89,232 ED visits, 444 visits included patients with food-induced anaphylaxis, after excluding cases of food-induced anaphylaxis related to oral desensitization therapy. The incidence was 4.98 per 1,000 visits. More than half of the children (<i>n</i> = 247/444, 55.6%) weighed &#x3c;15 kg. The proportion of grade 3 and higher severity anaphylactic symptoms was 74.5% (184/247) in children weighing &#x3c;15 kg and 79.2% (156/197) in children weighing 15 kg or more. The recurrence rate of food-induced anaphylaxis was 22.3% (55/247) in children weighing &#x3c;15 kg and 48.7% (96/197) in children weighing 15 kg or more. Among the children weighing &#x3c;15 kg, the proportion of those with recurrent food-induced anaphylaxis was 4 times higher in children weighing 10–15 kg than in those weighing &#x3c;10 kg (32.2% [47/146] vs. 7.9% [8/101]). The proportion of patients who were prescribed EAIs before each visit was 25.5% (14/55) in children weighing &#x3c;15 kg with a history of food-induced anaphylaxis. <b><i>Conclusion:</i></b> Food-induced anaphylaxis among children weighing &#x3c;15 kg occurred as frequently and was as severe as that among children weighing 15 kg or more. However, the proportion of patients prescribed EAIs was very low in children weighing &#x3c;15 kg with food-induced anaphylaxis. The potential need for EAIs is suggested among children weighing &#x3c;15 kg, especially among children weighing 10 kg or more but &#x3c;15 kg.

scholarly journals Screening for Coronavirus Disease 2019 (COVID-19) at the Pediatric Emergency Department During Different Pandemic Phases

2021 ◽  
Vol 9 ◽  
Author(s):  
Indrė Stacevičienė ◽  
Sigita Burokienė ◽  
Aušra Steponavičienė ◽  
Daiva Vaičiūnienė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Emergency Department ◽  
Phase I ◽  
Phase Ii ◽  
Wide Spectrum ◽  
Age Groups ◽  
Pediatric Emergency ◽  
Phase Iii ◽  
Pediatric Emergency Department ◽  
Test Results ◽  
History Of

The wide spectrum of COVID-19 symptoms complicates the selection of target groups for screening. We aimed to compare data of children screened for COVID-19 at the pediatric emergency department in Vilnius between different phases throughout 1 year (Phase I: March–May, 2020; Phase II: June–September, 2020; and Phase III: October, 2020–February, 2021) and to evaluate the possible predictors of the disease. SARS-CoV-2 PCR tests were positive for 2.7% of tested children (248/9,238), significantly higher during the Phase III (5.5%) compared with the Phase I (0.6%, p = 0.000) and Phase II (0.3%, p = 0.000). Infants and teenagers (12–17 years) accounted for a larger proportion of COVID-19 patients (24.6 and 26.2%, respectively) compared to other age groups: 1–2 years (18.9%), 3–6 years (14.9%), and 7–11 years (15.3%). There were more COVID-19 cases among children with a known SARS-CoV-2 exposure compared to those who did not declare any contact (18.2 vs. 1.1%, p = 0000). When symptoms were adjusted for age, gender and known exposure to SARS-CoV-2, we found that fever (OR 2.66; 95% CI 1.89–3.81), pharyngitis (OR 1.35; 95% CI 1.01–1.80), headache (OR 1.81; 95% CI 1.09–2.90), and anosmia/ageusia (OR 6.47; 95% CI 1.61–22.47) were the most significant predictors.Conclusion: Although high numbers of testing were maintained throughout the year, the positive test results were significantly higher during the Phase III. Age (&lt;1 year, 12–17 years), a history of exposure to SARS-CoV-2 and some symptoms, such as fever, pharyngitis, headache and anosmia/ageusia could aid in targeting groups for screening for COVID-19 in children.

A Multi-institutional Case Series With Review of Point-of-Care Ultrasound to Diagnose Malrotation and Midgut Volvulus in the Pediatric Emergency Department

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Angélica Marie Garcia ◽  
Imran Asad ◽  
Mark O. Tessaro ◽  
Adam Sivitz ◽  
Katharine Osborn ◽  
...  
Keyword(s):  
Emergency Department ◽  
Point Of Care ◽  
Case Series ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Midgut Volvulus

Pediatric emergency department thoracotomy: A large case series and systematic review

2015 ◽  
Vol 50 (1) ◽  
pp. 177-181 ◽  
Author(s):  
Casey J. Allen ◽  
Evan J. Valle ◽  
Chad M. Thorson ◽  
Anthony R. Hogan ◽  
Eduardo A. Perez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Case Series ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Emergency Department Thoracotomy ◽  
Large Case Series ◽  
Large Case

Acquired methemoglobinemia presenting to the pediatric emergency department: a clinical challenge

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 673-677 ◽  
Author(s):  
Nir Friedman ◽  
Dennis Scolnik ◽  
Lindsey McMurray ◽  
Jennifer Bryan
Keyword(s):  
Emergency Department ◽  
Hemolytic Anemia ◽  
Case Series ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Packed Red Blood Cells ◽  
Diagnosis And Management ◽  
Hypoxia Exposure ◽  
Clinical Challenge ◽  
Uncommon Presentation

ABSTRACTObjectivesAcquired methemoglobinemia (MetHb) is an uncommon presentation of cyanosis in the pediatric emergency department (ED), making its diagnosis and management a clinical challenge. Through this case series we hope to improve clinician ability to recognize the potential for MetHb in pediatric ED patients and to avoid overlooking this important cause of cyanosis.MethodsThis was a case series using a health records review, investigating patients diagnosed with MetHb at our pediatric ED during 2007–2018. We included only cases with methemoglobin saturation ≥5%.ResultsTen patients were diagnosed with MetHb in our pediatric ED during the study period. Five had an underlying hematologic disease who received a pharmacologic trigger known to induce MetHb as well (four dapsone, one rasburicase). The other five patients were previously healthy, who presented with a clinical picture of hemolytic anemia, all of whom were diagnosed with previously unknown glucose-6-phosphate dehydrogenase (G6PD) deficiency. Two of the patients received methylene blue, and five patients needed packed red blood cells. All of the patients survived the acute MetHb episode.ConclusionAcquired MetHb in the pediatric ED is a rare but important cause of cyanosis. Diagnosis and management of acute, acquired MetHb in the ED requires a high level of suspicion, and a background knowledge of the common precipitants and underlying conditions associated with this condition. We hope this case series will help ED physicians to consider MetHb in pediatric patients presenting with cyanosis and persistent hypoxia. Exposure to known precipitants (e.g., medications and foods), particularly in the setting of active treatment for malignancy or with symptoms of hemolytic anemia should further increase suspicion.

scholarly journals Nebulized ketamine for managing acute pain in the pediatric emergency department: A case series

2021 ◽  
Vol 21 (2) ◽  
pp. 75
Author(s):  
Jessica Zerzan ◽  
AdamJames Rhodes ◽  
MicheleJoy Fagan ◽  
SergeyM Motov
Keyword(s):  
Emergency Department ◽  
Acute Pain ◽  
Case Series ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department
Sign in / Sign up

Export Citation Format

Share Document