Changing pattern of pediatric anaphylaxis in Hong Kong, 2010–2019

Abstract

Background Anaphylaxis is a significant health burden in most Western countries, but there are little published data on the incidence and pattern of anaphylaxis in Asia. We aim to determine the incidence rate and pattern of anaphylaxis over the past decade among the pediatric population in Hong Kong. Methods Medical records of patients presenting with allergy‐related symptoms during the period 2010 to 2019 were examined. Pediatric patients aged below 18 years who fulfilled the diagnostic criteria for anaphylaxis laid out by the NIAID/FAAN were analyzed. Incidence rates were calculated using population statistics as the denominator. All information pertaining to the anaphylaxis events and patients’ characteristics was retrieved using standardized data collection forms. Results The overall 10‐year estimated incidence of anaphylaxis was 9.76 per 100,000 person‐years, with a rising trend of anaphylaxis incidence across time. Food‐induced anaphylaxis accounted for the majority of hospital presentations, of which peanut and shellfish were the top food triggers in our population. Majority of anaphylaxis episodes were of Grade 4 severity, and young age was a significant predictor of severe allergic reactions. Half of the anaphylaxis episodes were misdiagnosed and adrenaline was only utilized in 42.2% of cases, of which 9.4% were administered adrenaline prior to hospital arrival. Conclusions An increasing trend of anaphylaxis incidence over the past decade is evident in Hong Kong children, with a discrepantly low accuracy in diagnosis and suboptimal management of anaphylaxis. There is a pressing need to heighten public and physicians’ awareness of the distinctive features of anaphylaxis in the pediatric age‐group.

Validation of the food allergy quality of life questionnaire series in Chinese families with food‐allergic children

“…Since Hong Kong is a westernized city, we believed the same situation is happening here 4,28–30 . This finding is comparable to recent research on pediatric anaphylaxis patterns, that food triggers such as milk and eggs are predominantly seen in the age group from birth to 4 years, while shellfish is the highest allergen trigger, usually at a later age factor 6 …”

“…4,[28][29][30] This finding is comparable to recent research on pediatric anaphylaxis patterns, that food triggers such as milk and eggs are predominantly seen in the age group from birth to 4 years, while shellfish is the highest allergen trigger, usually at a later age factor. 6 Furthermore, CFA helps to make sure that the components are measuring what they are supposed to but the goodness-of-fit statistics of CFA in this study showed a poor fit for the domains of all questionnaires. Therefore, exploratory factor analysis was done and the categories of items entered different domains.…”

“…Food allergy negatively affects patients' health‐related quality of life (HRQoL), and food avoidance and post‐exposure medication remain as the main effective management strategy for this problem 5 . However, food allergies can be fatal for some patients, 6 so patients and their parents or caregivers often need to vigilantly monitor patients' diets, which can affect their emotional, physical, and social status, thereby reducing their quality of life (QoL) 7 . Generic questionnaires for HRQoL are useful, but less sensitive to corporate questions directly related to detect changes in the patient status 8 .…”

Emerging approaches in the diagnosis and therapy in shellfish allergy

“…Although shellfish allergy is more common in adults, it affects also 1.3% of children in the US as compared to the estimated prevalence of peanut allergy ranging from 1.2–2.2% [1 ▪ ,2 ▪ ]. Shellfish is also the predominant food eliciting anaphylactic reactions affecting 43.8% of the pediatric population between 15 and 17 years old [3 ▪ ]. Patients suffering from shellfish allergy can develop mouth and throat itching, lip swelling and skin reactions such as urticaria, periorbital angioedema and skin redness.…”

Comparative Analysis of Asian Carps Parvalbumin Reveals the Evolutionary Divergence Pattern of a Major Fish Allergen

“…Our territory-wide survey revealed that fish was a main cause of adverse food reactions in Hong Kong pre-school children 3 . Collectively, fish was also a major food triggers of pediatric anaphylaxis, which affected a wide range of children from infants to school-age children in Hong Kong 4 . It is therefore important to identify the spectrum of fish allergen in order to design optimal diagnostic approach and design immunotherapeutic strategies.…”