J Korean Soc Emerg Med.  2001 Mar;12(1):84-90.

Anaphylactic Shock Patients Admitted in the Emergency Department of a Tertiary Hospital

• Park JS
• Park HS
• Lee SY
• Jung YS
• Cho JP

Abstract

BACKGROUND: Anaphylaxis is a systematic allergic reaction, which may be fatal. However, despite its seriousness, its low level of incidence has prevented in depth studies. Thus, we analyzed the causes of anaphylactic shock in patients admitted in a tertiary hospital, observed its clinical symptoms, and formed a basis for adequate emergency treatment, as well preventive methods.
METHODS
The patients who visited Ajou university hospitals from June 1994 to May 2000(7 years) and who met the 1974 JAMA definition were selected for this retrospective study. The analysis of causative agents was made on the basis of clinical symptoms and the patients' chief complaints at the time of admission. Patients diagnosed with anaphylactic shock included those showing at least two types of IgEmediated symptoms; and those with a simple rash or breathing difficulties were excluded from the study.
RESULTS
Of 36 patients, 22 were male and 14 female, Those below the age of 20 comprised 16.7% of the patients(6 patients), between 20 and 29 comprised 16.7%(6 patients), 30 and 39 comprised 25%(9 patients), 40 and 49 comprised 27.8%(10 patients), over 50 comprised 14%(5 patients). The overall percentage show 70% of the patients in active adult age group. Rash was the most common clinical symptoms(89%, 32 patients) and hypotension the second(75%, 27 patients), followed by respiratory distress, fainting, and arrhythmia. Causative agents were insect bites, including bee stings(15 patients), medication(12 patients), food(8 patients), and unknown(1 patients). Nine(9) of the 36 case, were diagnosed as having an atopic origin.
CONCLUSION
Bee sting was the single most common cause in the insect criteria while penicillin and NSAIDs accounted for most of medication-induced cases. Food showed a varied distribution. An atopic origin was not a basis for anaphylactic shock, but did show a two-fold increase of prevalence. This study is the first of its kind in addressing anaphylactic shock, a potentially severe illness, over a period of 7 years.

Keyword

Anaphylaxis; Clinical profile; Causative agent

MeSH Terms

Adult
Anaphylaxis*
Anti-Inflammatory Agents, Non-Steroidal
Arrhythmias, Cardiac
Bees
Bites and Stings
Emergencies*
Emergency Service, Hospital*
Emergency Treatment
Exanthema
Female
Hospitals, University
Humans
Hypersensitivity
Hypotension
Incidence
Insect Bites and Stings
Insects
Male
Penicillins
Prevalence
Respiration
Retrospective Studies
Syncope
Tertiary Care Centers*
Anti-Inflammatory Agents, Non-Steroidal
Penicillins