Clinical characteristics and adrenaline use in anaphylaxis in children: a cross-sectional study

This study aimed to analyze the clinical characteristics and adrenaline use in anaphylaxis in children, providing evidence to optimize the management strategies for anaphylaxis. A retrospective analysis was performed on 115 pediatric patients with anaphylaxis treated at Hangzhou Children’s Hospital from January 2021 to October 2024. The analysis included age, gender, suspected triggers, allergy history, clinical manifestations, treatments, adverse reactions, and outcomes. Data on adverse reactions were collected from 70 children who received intramuscular adrenaline for non-anaphylaxis. Among the 115 patients, 37 had a prior history of allergy. The primary suspected triggers were food allergens (52/115, 45.22%) and drug allergens (34/115, 29.57%). Skin and mucosal involvement were the most common clinical manifestations, observed in 108 of 115 patients (93.91%), and typically presented as urticaria or angioedema. Respiratory symptoms were the second most frequent, occurring in 104 patients (90.43%), with manifestations including cough, wheezing, dyspnea, and laryngeal edema. Intramuscular adrenaline was administered to 101 patients (87.83%), with 91 patients (79.13%) receiving it as the first-line treatment. No adverse reaction was observed in either the anaphylaxis or non-anaphylaxis groups following adrenaline administration. No significant adverse reaction was reported in any of the children treated with adrenaline. Pediatric anaphylaxis faces a dual challenge of delayed adrenaline administration and excessive prophylactic use. Given the diagnostic difficulty of anaphylaxis in children, early administration of adrenaline, when anaphylaxis is strongly suspected clinically, may help optimize clinical management.