时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
We hypothesized that adrenaline would be underused in pediatric anaphylaxis and that treatment patterns would vary according to reaction trigger and severity.Materials and MethodsStudy Design and SettingThis study was designed as a single-center, retrospective cohort analysis.；Patients were included irrespective of whether adrenaline was administered during the acute reaction; thus, the cohort comprised both adrenaline-treated and untreated cases.
方法
Although cutaneous manifestations are the most frequent presenting features, they may be absent in a proportion of patients, making the diagnosis particularly challenging.；Furthermore, a proportion of patients experience biphasic or protracted reactions despite apparent initial clinical improvement.；In contrast, antihistamines, corticosteroids, bronchodilators, and supplemental oxygen are considered adjunctive therapies and should never delay adrenaline administration.3,4 Despite these recommendations, numerous real-world studies have demonstrated that adrenaline remains substantially underused, especially in pediatric patients and food-induced reactions, where early clinical manifestations may be subtle and diagnostic uncertainty is common.
核心结论
In contrast, antihistamines, corticosteroids, bronchodilators, and supplemental oxygen are considered adjunctive therapies and should never delay adrenaline administration.3,4 Despite these recommendations, numerous real-world studies have demonstrated that adrenaline remains substantially underused, especially in pediatric patients and food-induced reactions, where early clinical manifestations may be subtle and diagnostic uncertainty is common.；These findings are broadly consistent with international guidance on anaphylaxis recognition and management.1,3,4The predominance of food as a trigger in younger children and the emergence of venom-induced anaphylaxis at older ages mirrors the well-described epidemiological transition in pediatric anaphylaxis, in which food allergens dominate in infancy and early childhood while environmental exposures such as outdoor activity and venom sensitization accumulate with age.；Taken together, these findings suggest that the observed age-related difference in cardiovascular involvement is largely explained by differences in trigger distribution rather than by chronological age itself.
局限
However, clinically indistinguishable reactions may also occur through non-IgE-mediated pathways, notably in association with certain medications and physical triggers, highlighting the heterogeneity of the underlying mechanisms.4The clinical course of anaphylaxis is highly unpredictable.；However, total IgE is a non-specific marker that correlates poorly with clinical reactivity and severity; children with food allergy may have low total IgE yet experience significant reactions, whereas high levels are common in atopic dermatitis without corresponding clinical allergy.；Serum tryptase was not systematically measured, and no patient was evaluated for mast cell activation syndrome (MCAS) or clonal mast cell disorders; the possible contribution of mast cell–intrinsic processes to idiopathic reactions therefore warrants evaluation in future prospective studies.Cardiovascular involvement was significantly more frequent in older children (p=0.016).
对本项目的价值
中等价值：属「代谢 / 内分泌 / 肝肾老化」方向；代谢 / 内分泌 / 肝肾老化的界面栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.6/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 42,730 字符，题名指纹 0.75，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：儿童严重过敏反应肌注肾上腺素使用不足：回顾性队列研究
- 英文标题：Underuse of Intramuscular Adrenaline in Pediatric Anaphylaxis: A Retrospective Cohort Study.
- 期刊与标识：Journal of asthma and allergy · PMID 42968958 · DOI 10.2147/JAA.S648252 · PMC PMC13724069