Abstract
Background: Anaphylaxis is a significant health burden in most
Western countries but there is little published data on the incidence
and pattern of anaphylaxis in Asia. We aim to determine the incidence
rate and pattern of anaphylaxis over the past decade among the
paediatric population in Hong Kong. Methods: Medical records of
patients presenting with allergy-related symptoms during the period 2010
to 2019 were examined. Paediatric patients aged below 18 years who
fulfilled the diagnostic criteria for anaphylaxis laid out by the
NIAID/FAAN were analysed. Incidence rates were calculated using
population statistics as the denominator. All information pertaining to
the anaphylaxis events and patients’ characteristics were retrieved
using standardized data collection forms. Results: The overall
10-year estimated incidence of anaphylaxis was 7.70 per 100,000
person-years, with a rising trend of anaphylaxis incidence across time.
Food-induced anaphylaxis accounted for the majority of hospital
presentation, of which peanut and shellfish were the top food triggers
in our population. Comorbid asthma and young age were risk factors
associated with wheeze at presentation. Misdiagnosis of anaphylaxis
occurred in up to half the anaphylaxis cases and adrenaline was only
utilised in 45% of cases. Conclusions: An increasing trend of
anaphylaxis incidence over the past decade is evident in Hong Kong
children, with a discrepantly low accuracy in diagnosis and suboptimal
management of anaphylaxis. There is a pressing need to heighten public
and physicians’ awareness of the distinctive features of anaphylaxis in
the paediatric age group.