Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;8(4):353-61.
doi: 10.4168/aair.2016.8.4.353.

Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes

Nannan Jiang  1 , Jia Yin  2 , Liping Wen  1 , Hong Li  1
Affiliations

Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes

Nannan Jiang et al. Allergy Asthma Immunol Res. 2016 Jul.

Abstract

Purpose: Comprehensive evaluation of anaphylaxis in China is currently lacking. In this study, we characterized the clinical profiles, anaphylactic triggers, and emergency treatment in pediatric and adult patients.

Methods: Outpatients diagnosed with "anaphylaxis" or "severe allergic reactions" in the Department of Allergy, Peking Union Medical College Hospital from January 1, 2000 to June 30, 2014 were analyzed retrospectively.

Results: A total of 1,952 episodes of anaphylaxis in 907 patients were analyzed (78% were adults and 22% were children). Foods are the most common cause (77%), followed by idiopathic etiologies (15%), medications (7%) and insects (0.6%). In food-induced anaphylaxis, 62% (13/21) of anaphylaxis in infants and young children (0-3 years of age) were triggered by milk, 59% (36/61) of anaphylaxis in children (4-9 years of age) were triggered by fruits/vegetables, while wheat was the cause of anaphylaxis in 20% (56/282) of teenagers (10-17 years of age) and 42% (429/1,016) in adults (18-50 years of age). Mugwort pollen sensitization was common in patients with anaphylaxis induced by spices, fruits/vegetables, legume/peanuts, and tree nuts/seeds, with the prevalence rates of 75%, 67%, 61%, and 51%, respectively. Thirty-six percent of drug-induced anaphylaxis was attributed to traditional Chinese Medicine. For patients receiving emergency care, only 25% of patients received epinephrine.

Conclusions: The present study showed that anaphylaxis appeared to occur more often in adults than in infants and children, which were in contrast to those found in other countries. In particular, wheat allergens played a prominent role in triggering food-induced anaphylaxis, followed by fruits/vegetables. Traditional Chinese medicine was a cause of drug-induced anaphylaxis. Furthermore, exercise was the most common factor aggravating anaphylaxis. Education regarding the more aggressive use of epinephrine in the emergency setting is clearly needed.

Keywords: Anaphylaxis; China; epinephrine; traditional Chinese medicine; wheat allergy.

PubMed Disclaimer

Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1. Age-related food trigger patterns. Five age groups based on the onset age.
Fig. 2
Fig. 2. Pollen sensitization profile in food-induced anaphylaxis patients.
See this image and copyright information in PMC

References

    1. Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010;125(Suppl 2):S161–S181. - PubMed
    1. Sheikh A, Hippisley-Cox J, Newton J, Fenty J. Trends in national incidence, lifetime prevalence and adrenaline prescribing for anaphylaxis in England. J R Soc Med. 2008;101:139–143. - PMC - PubMed
    1. Huang F, Chawla K, Järvinen KM, Nowak-Węgrzyn A. Anaphylaxis in a New York City pediatric emergency department: triggers, treatments, and outcomes. J Allergy Clin Immunol. 2012;129:162–168.e1. - PMC - PubMed
    1. Ben-Shoshan M, La Vieille S, Eisman H, Alizadehfar R, Mill C, Perkins E, et al. Anaphylaxis treated in a Canadian pediatric hospital: Incidence, clinical characteristics, triggers, and management. J Allergy Clin Immunol. 2013;132:739–741.e3. - PubMed
    1. Banerji A, Rudders SA, Corel B, Garth AM, Clark S, Camargo CA., Jr Repeat epinephrine treatments for food-related allergic reactions that present to the emergency department. Allergy Asthma Proc. 2010;31:308–316. - PubMed