First national study of anaphylaxis triggers in a large tertiary care hospital in Qatar

Abstract

Background: Anaphylaxis is a serious allergic disease that may lead to death if not immediately recognized and treated. Triggers of anaphylaxis including food, drugs, and insect stings can vary widely. The incidence of anaphylaxis seem to be affected by sex, socioeconomic factors, atopy, and geographic location. Although the incidence of anaphylaxis is high in Qatar, its triggers have not been thoroughly studied. This study aims to examine the most common triggers of anaphylaxis in Qatar. Method: All patients admitted to Hamad Medical Corporation in Qatar were audited using electronic medical records (November, 2012 ‐ December, 2016). A total of 1068 patients were identified to manifest with anaphylaxis from the medical coding system of anaphylaxis (n = 446) and from the epinephrine auto‐injectors dispense list of pharmacy (n = 622) after removing the duplicates. Results: Out of 1068 subjects, 574 (53.5%) patients had definite diagnosis of anaphylaxis; male to female ratio was 1.2 and 300 (77.9%) were less than 10 years old. The most common triggers of anaphylaxis were food (n = 316, 55%), insect stings (n = 161, 28%), and drugs (n = 103, 17.9%). Food was common trigger mainly in children less than 10 years (223, 74.3%). However, insect stings (n = 59, 43.0%) and drugs (n = 44, 32.0%) were dominant in adults (20‐ 55 years). Out of 574 anaphylactic cases, the most common food triggers were nuts (n = 173, 30.1%), eggs (n = 89, 15.5%), and seafood (n = 72, 12.5%). Antibiotics (n = 49, 8.5%) and nonsteroidal anti‐inflammatory (n = 30, 5.2%) agents were the most to induce anaphylaxis. Interestingly, 135 anaphylactic patients (23.5%) were due to black ant stings. Out of 44 (7.6%) patients who had idiopathic anaphylaxis, 29 (65.9%) patients were males. Conclusion: This is the first national study highlighting triggers and distribution of anaphylaxis among different age groups in Qatar. Some triggers of anaphylaxis are different in our study population compared to other countries in the region and other parts of the world. For instance, insect stings represents the second most common culprit of anaphylaxis in Qatar.