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Anaphylaxis following immunisation
Anaphylaxis is a rare but serious complication of immunisation with only limited contemporaneous data on incidence. Erlewyn-Lajeunesse et al report on cases of suspected anaphylaxis as an adverse effect following immunisation reported through the British Paediatric Surveillance scheme. During the 13 month study period seven out of 15 children reported met the criteria for anaphylaxis, none following the routine infant and preschool immunisation programme despite 5.5 million primary schedule immunisations being given during this time period. This is an important and useful dataset further supporting the safety of childhood immunisation. This, and the importance of the BPSU data reporting system in getting such an impressive data set are discussed in the accompanying editorial. See pages 487 and 485.
Hypernatraemia in hospitalised patients
Hypernatraemic dehydration is well recognised in breastfed infants although rarely seen outside the neonatal period. Forman et al report their experience over 10 years of children either admitted with (n=45, 64 episodes, 1 in 2288 admissions) or who developed hypernatraemia during their inpatient stay (n = 177). Hypernatraemia is defined as plasma sodium ≥150 mmol/l. The commonest causes on admission were …