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Home / Allergy and Asthma Proceedings, Volume 42, Number 5

Food-induced anaphylaxis in early childhood and factors associated with its severity

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Background:

Several factors that increase the risk of severe food-induced anaphylaxis have been identified.

Objective:

We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis.

Methods:

We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey.

Results:

The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6‐18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension.

Conclusion:

Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

Keywords: anaphylaxis; angioedema; childhood; cow's milk; epinephrine; food allergy; hen's egg; hoarseness; risk factors; severity

Document Type: Research Article

Affiliations: 1: From the Pediatric Allergy and Immunology Department, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey 2: Pediatric Allergy and Immunology Department, Faculty of Medicine, Inonu University, Malatya, Turkey 3: Pediatric Allergy and Immunology Department, Faculty of Medicine, Karadeniz Teknik University, Trabzon, Turkey 4: Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey 5: Pediatric Allergy and Immunology Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey 6: Pediatric Allergy and Immunology Department, Faculty of Medicine, Medeniyet University, Istanbul, Turkey 7: Pediatric Allergy and Immunology Department, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey 8: Pediatric Allergy and Immunology Department, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey 9: Pediatric Allergy and Immunology Department, Faculty of Medicine, Uludağ University, Bursa, Turkey 10: Pediatric Allergy and Immunology Department, Sancaktepe Training and Research Hospital, Istanbul, Turkey 11: Pediatric Allergy and Immunology Department, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey 12: Pediatric Allergy and Immunology Department, Faculty of Medicine, Celal Bayar University, Manisa, Turkey 13: Pediatric Allergy and Immunology Department, Faculty of Medicine, Katip Çelebi University, Izmir, Turkey 14: Pediatric Allergy and Immunology Department, Faculty of Medicine, Medipol University, Istanbul, Turkey 15: Pediatric Allergy and Immunology Department, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey, and 16: Pediatric Allergy and Immunology Department, Faculty of Medicine, Sakarya University, Sakarya, Turkey

Publication date: 01 September 2021

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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