D2.328 - Pediatric Anaphylaxis in Turkey: Clinical Characteristics, Triggers, and Severity in a Nation-wide Registry

Anaphylaxis is a potentially life-threatening systemic allergic reaction that may present differently in children compared with adults. Pediatric data from large-scale registries are limited, particularly regarding symptom patterns, triggers, and disease severity across childhood. This study aimed to describe the clinical characteristics, triggers, and severity of anaphylaxis in children using data from a nationwide registry.

Children aged 0–17 years recorded in the Turkish Online Anaphylaxis Registry were analyzed. Demographic features, clinical manifestations, diagnostic criteria, triggers, severity grading according to the World Allergy Organization (WAO) grading system, biphasic reactions, and outcomes were evaluated. 

A total of 1,252 pediatric patients constituted 63.3% of the overall registry population. The mean age was 8.6 ± 4.5 years, and 60.5% were male. The mean age at the time of anaphylaxis was 7.0 ± 4.3 years. Cutaneous and mucosal symptoms were the most frequent manifestations (91.7%), followed by respiratory (77.5%), gastrointestinal (40.6%), cardiovascular (21.8%), neurological symptoms (14.4%) and other symptoms (1.8%). Food (53.2%) was the most frequently reported trigger in children. Other triggers are drugs (26.6%), insect venom (9.3%), vaccines (2%), immunotherapy (1%), latex (0.2%), exercise (0.4%), cold exposure (0.5%) and other (1.7%). A history of anaphylaxis was present in 19.5% of cases.Triptase levels during anaphylaxis were 11.4 ± 14.7 (0.79-120). According to the WAO grading system, most pediatric reactions were classified as moderate to severe (Grade 3–4: 52.2%, 18.1%, respectively). Biphasic reactions occurred in 1.8% of children. No fatal anaphylactic reactions were recorded in the pediatric age group.

Pediatric anaphylaxis is characterized by a high frequency of cutaneous and respiratory involvement, food as the predominant trigger, and a substantial proportion of moderate-to-severe reactions. Despite this, fatal outcomes are rare. These findings underscore the importance of early recognition, trigger identification, and appropriate management strategies in children with anaphylaxis.