Food-induced anaphylaxis in early childhood and factors associated with

Abstract

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 (inter quartile 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.

C1 [Aydogan, Metin; Simsek, Isil Eser; Cogurlu, Mujde Tugba] Kocaeli Univ, Pediat Allergy & Immunol Dept, Fac Med, Kocaeli, Turkey.

[Topal, Erdem; Kaplan, Fatih] Inonu Univ, Pediat Allergy & Immunol Dept, Fac Med, Malatya, Turkey.

[Yakici, Nalan; Orhan, Fazil] Karadeniz Teknik Univ, Pediat Allergy & Immunol Dept, Fac Med, Trabzon, Turkey.

[Acar, Hazal Cansu; Erdogan, Mehmet Sarper] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Publ Hlth, Istanbul, Turkey.

[Aydemir, Sezin; Kiykim, Ayca; Cokugras, Haluk] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Arga, Mustafa; Tamay, Zeynep; Suleyman, Ayse; Yucel, Esra; Guler, Nermin; Ozdemir, Cevdet] Istanbul Univ, Pediat Allergy & Immunol Dept, Fac Med, Istanbul, Turkey.

[Hancioglu, Gonca; Sancak, Recep] Ondokuz Mayis Univ, Pediat Allergy & Immunol Dept, Fac Med, Samsun, Turkey.

[Uysal, Pinar] Adnan Menderes Univ, Pediat Allergy & Immunol Dept, Fac Med, Aydin, Turkey.

[Akkelle, Emre] Sancaktepe Training & Res Hosp, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Arga, Mustafa; Cavkaytar, Ozlem] Medeniyet Univ, Pediat Allergy & Immunol Dept, Fac Med, Istanbul, Turkey.

[Cekic, Sukru; Sapan, Nihat] Uluda g Univ, Pediat Allergy & Immunol Dept, Fac Med, Bursa, Turkey.

[Tuncel, Tuba] Katip Celebi Univ, Pediat Allergy & Immunol Dept, Fac Med, Izmir, Turkey.

[Nacaroglu, Hikmet Tekin] Medipol Univ, Pediat Allergy & Immunol Dept, Fac Med, Istanbul, Turkey.

[Yasar, Adem; Yuksel, Hasan] Celal Bayar Univ, Pediat Allergy & Immunol Dept, Fac Med, Manisa, Turkey.

[Aydogmus, Cigdem] Kanuni Sultan Suleyman Training & Res Hosp, Pediat Allergy & Immunol Dept, Istanbul, Turkey.

[Ozdemir, Oner] Sakarya Univ, Pediat Allergy & Immunol Dept, Fac Med, Sakarya, Turkey.