Objective: Anaphylaxis is an acute and potentially fatal allergic reaction. To the best of the author’s knowledge, no studies have yet been conducted to evaluate the spectrum of anaphylactic reactions among Omani patients. As such, this study aimed to describe the clinical features, causes, investigation, and management of anaphylaxis among patients presenting to a tertiary care center in Oman. Methods: This retrospective study took place between August 2005 and June 2020 at the allergy and immunology clinic of the Sultan Qaboos University Hospital, Muscat, Oman. All patients diagnosed with anaphylaxis during the study period were included. Data were collected from electronic medical records. Results: A total of 100 patients were diagnosed with anaphylaxis during the study period. Of these, 52% were male. The mean age was 15.9 16.2 years, with 70% being <18 years old. The eosinophil count ranged from 0–16.9 ×109 /L, with a mean of 0.8 2.2 ×109 /L and a median 2 of 0.30 (IQR: 0.15-0.65) ×109 /L. Total IgE levels ranged from 25–8,706 kIU/L, with a mean of 935.1 1369.5 kIU/L and a median of 500.4 (IQR: 186.0-972.5) kIU/L. Overall, the majority of patients had a family history of allergies (72%), other concomitant allergic condition (66%) and were all prescribed epinephrine (100%). The most common cause of anaphylaxis was food (65%), the second most frequent trigger was insect venom (32%). The majority of patients had one category cause (81%) however two or more causes were present in 19% of the patients. Clinical symptoms manifested most frequently as cutaneous (92%), and respiratory (85%). The majority of patients (87%) demonstrated involvement of more than one bodily system. Total IgE levels were significantly higher in patients with concomitant presence of other allergic conditions 1193.8 kIU/L compared to patients without another concomitant allergic disease mean 503.6 kIU/L (p=0.03). In addition, concomitant other allergic disease is significantly higher in patients <18 years of age 75.4% compared to patients >18 years of age 45.2% (p= 0.01). Conclusions: Due to its life-threatening nature, knowledge of the epidemiology and clinical features of anaphylaxis in different populations is necessary in order to deliver rapid treatment. This study found that the clinical features of anaphylactic patients in Oman were similar to those reported elsewhere. Further research is needed to determine the true incidence of anaphylaxis in Oman in order to minimize associated morbidity and mortality.
Rhino-orbital mucormycosis: Our experiences with clinical features and management in a tertiary care center
