A multicenter anaphylaxis registry in Korea: Clinical characteristics and acute treatment details from infants to older adults

Kyunguk Jeong; Young-Min Ye; Sang-Ha Kim; Kyung Won Kim; Jeong Hee Kim; Ji-Won Kwon; Song-I Yang; So-Yeon Lee; Eun Hee Chung; Mi-Ae Kim; Yoon Hee Kim; Hye-Young Kim; Gwang Cheon Jang; Joo-Hee Kim; Eunjoo Lee; Jihyun Kim; Kangmo Ahn; Yoon-Seok Chang; Gyu-Young Hur; Jeongmin Lee; Taek Ki Min; Bok-Yang Pyun; Kyung Hee Park; Jaechun Lee; Tae Won Song; Hye Mi Jee; Yoo Seob Shin; Dankyu Yoon; Jeom-Kyu Lee; Sooyoung Lee

doi:10.1016/j.waojou.2020.100449

A multicenter anaphylaxis registry in Korea: Clinical characteristics and acute treatment details from infants to older adults

World Allergy Organ J. 2020 Aug 11;13(8):100449. doi: 10.1016/j.waojou.2020.100449. eCollection 2020 Aug.

Authors

Kyunguk Jeong¹, Young-Min Ye², Sang-Ha Kim³, Kyung Won Kim⁴, Jeong Hee Kim⁵, Ji-Won Kwon⁶, Song-I Yang⁷, So-Yeon Lee⁷, Eun Hee Chung⁸, Mi-Ae Kim⁹, Yoon Hee Kim⁴, Hye-Young Kim¹⁰, Gwang Cheon Jang¹¹, Joo-Hee Kim¹², Eunjoo Lee¹, Jihyun Kim¹³, Kangmo Ahn¹³, Yoon-Seok Chang¹⁴, Gyu-Young Hur¹⁵, Jeongmin Lee¹⁶, Taek Ki Min¹⁷, Bok-Yang Pyun¹⁷, Kyung Hee Park¹⁸, Jaechun Lee¹⁹, Tae Won Song²⁰, Hye Mi Jee²¹, Yoo Seob Shin², Dankyu Yoon²², Jeom-Kyu Lee²², Sooyoung Lee¹

Affiliations

¹ Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea.
² Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea.
³ Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
⁴ Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, South Korea.
⁵ Department of Pediatrics, Inha University Hospital, Incheon, South Korea.
⁶ Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
⁷ Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
⁸ Department of Pediatrics, Chungnam University College of Medicine, Daejeon, South Korea.
⁹ Department of Pulmonary, Allergy, and Critical Care Medicine, CHA University School of Medicine, Seongnam, South Korea.
¹⁰ Department of Pediatrics, Pusan National Hospital, Pusan University College of Medicine, Busan, South Korea.
¹¹ Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, South Korea.
¹² Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University College of Medicine, Anyang, South Korea.
¹³ Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
¹⁴ Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
¹⁵ Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
¹⁶ Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, South Korea.
¹⁷ Department of Pediatrics, Soonchunhyang University Hospital, Seoul, South Korea.
¹⁸ Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
¹⁹ Department of Internal Medicine, Jeju National University School of Medicine, Jeju, South Korea.
²⁰ Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
²¹ Department of Pediatrics, CHA University School of Medicine, Seongnam, South Korea.
²² Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, South Korea.

Abstract

Background: Although the prevalence of anaphylaxis is increasing worldwide, the large-scale studies in Asia evaluating anaphylaxis in all age groups are limited. We aimed to collect more precise and standardized data on anaphylaxis in Korea using the first multicenter web-based registry.

Methods: Twenty-two departments from 16 hospitals participated from November 2016 to December 2018. A web-based case report form, designed by allergy specialists, was used to collect anaphylaxis data.

Results: Within the 2-year period, 558 anaphylaxis cases were registered. The age of registered patients ranged from 2 months to 84 years, and 60% were aged <18 years. In children and adolescents, foods (84.8%) were the most common cause of anaphylaxis, followed by drugs (7.2%); in adults, drugs (58.3%) were the most common cause, followed by foods (28.3%) and insect venom (8.1%). The onset time was ≤10 min in 37.6% of patients. Among the 351 cases registered via the emergency department (ED) of participating hospitals, epinephrine was administered to 63.8% of patients. Among those receiving epinephrine in the ED, 13.8% required 2 or more epinephrine shots. Severe anaphylaxis accounted for 23.5% cases (38.1% in adults; 13.7% in children); patients with drug and insect venom-induced anaphylaxis had higher rates of severe anaphylaxis.

Conclusion: This multicenter registry provides data on anaphylaxis for all age groups for the first time in Asia. The major causes and severity of anaphylaxis were remarkably different according to age group, and the acute treatment features of anaphylaxis in the EDs were examined in detail.

Keywords: Anaphylaxis; CRF, case report form; ED, emergency department; Epinephrine; FDEIA, food-dependent exercise-induced anaphylaxis; OPD, outpatient department; Registry; Severity; Trigger.