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Changing Pattern of Paediatric Anaphylaxis in Hong Kong, 2010-2019
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  • Agnes Sze Yin Leung,
  • Rebecca Ming Yan Li,
  • Ann Wing Shan Au,
  • Jaime Sou da Rosa Duque,
  • Po Ki Ho,
  • Gilbert Chua,
  • Chi Hang Wong,
  • David Chi Kong Luk,
  • Mike Yat Wah Kwan,
  • Yat Sun Yau,
  • Gary Wong (N/A),
  • Ting Fan Leung
Agnes Sze Yin Leung
The Chinese University of Hong Kong
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Rebecca Ming Yan Li
The Chinese University of Hong Kong Faculty of Medicine
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Ann Wing Shan Au
The Chinese University of Hong Kong Faculty of Medicine
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Jaime Sou da Rosa Duque
University of Hong Kong Li Ka Shing Faculty of Medicine Department of Paediatrics and Adolescent Medicine
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Po Ki Ho
Hospital Authority Kowloon Central Cluster
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Gilbert Chua
University of Hong Kong Li Ka Shing Faculty of Medicine
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Chi Hang Wong
Hospital Authority
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David Chi Kong Luk
Hospital Authority
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Mike Yat Wah Kwan
Hospital Authority Kowloon West Cluster
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Yat Sun Yau
Hospital Authority Kowloon Central Cluster
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Gary Wong (N/A)
The Chinese University of Hong Kong
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Ting Fan Leung
The Chinese University of Hong Kong
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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.

Peer review status:IN REVISION

24 Jun 2021Submitted to Pediatric Allergy and Immunology
01 Jul 2021Reviewer(s) Assigned
07 Jul 2021Review(s) Completed, Editorial Evaluation Pending
12 Jul 2021Editorial Decision: Revise Major