Evaluation of "A Popular Guide on Indication for Intramuscular Injection of Adrenalin by EPIPEN^®" decided and released by The Anaphylaxis Exploratory Working Group of Japanese Society of Pediatric allergy and Clinical Immunology

Abstract

【Purpose】The Anaphylaxis Exploratory Working Group of Japanese Society of Pediatric Allergy and Clinical Immunology lately released a decision entitled "A Popular Guide on Indication for Intramuscular Injection of adrenalin by EPIPEN^®". The purpose of this study was to examine and evaluate validity of an intramuscular injection of adrenalin (adrenalin injection) to treat the symptoms described in that decision (WG symptoms) based on the result of the oral food challenge test (OFC). 【Method】OFCs by double blind method were performed for older than 5 years children to asses indication for treatment of oral immunotherapy. We examined retrospectively the result of 391 OFC positive cases in the OFC: 151 cases about chicken egg, 163 cases about cow's milk, 50 cases about wheat, 27 cases about peanuts. 【Result】In 106 of total 391 cases, some sorts of WG symptoms were present. Regarding those 106 cases, adrenalin injections were used in 90 (84.9%) cases. On the other hand, in 287 cases in which WG symptoms were not present, adrenalin injections did not be used. Although there were much respiratory symptom (p<0.001), neurological symptoms (p<0.001), and circulatory organ symptoms (p<0.001) intentionally in 90 children with adrenaline compared with 301 children without adrenalin intramuscular injection, a difference was not seen in skin symptom. 【Conclusion】According to the consideration on the result of OFC in severe cases, WG symptoms was thought to be useful criteria for figuring out indication for adrenalin injection.