Food-induced anaphylaxis in children – state of art

Abstract

Food-induced anaphylaxis is the most frequent type of anaphylaxis and the most common cause of fatal acute hypersensitivity reactions in children. It typically occurs after accidental food exposure, after inhalation of food allergen, cutaneous contact and controlled oral food challenge. There is no consensus on a universal clinical definition of anaphylaxis or a uniform symptoms severity score. Recent advances in molecular allergology allow, in many cases, the detailed identification of the allergenic molecule responsible for anaphylaxis. Along with the development of precision medicine, new phenotypes and endotypes of anaphylaxis are being defined. The anaphylaxis course is entirely unpredictable, and even initially mild symptoms may herald a potentially fatal reaction. At the same time, a significant proportion of immediate food hypersensitivity episodes are mild and known as systemic allergic reactions. The occurrence and severity of clinical course of food-induced anaphylaxis are influenced by factors related directly to the child, coexisting diseases, the type and the nature of the allergen, or the presence of cofactors. The unpredictable course of anaphylaxis justifies immediate treatment based on rapid intramuscular administration of adrenaline, regardless of severity. Delayed adrenaline administration is associated with higher incidence of severe course and death. Appropriate and prompt treatment of anaphylaxis is even more critical during the COVID-19 pandemic due to difficult access to medical facilities, hence current treatment plans for food-induced anaphylaxis emphasise the need to administer adrenaline immediately after the onset of the first, even mild, but rapidly progressive symptoms and recommend that the patient have at least two adrenaline autoinjectors.

Use of in vitro and in vivo tests in the diagnosis of food-induced anaphylaxis – a case study

“…It occurs with a frequency of 3-8% in the child population and 1-3% in the adult population. Food-induced anaphylaxis is the most prevalent form of anaphylaxis in children, accounting for 30-50% of all cases (2,3) . The primary triggers of food-induced anaphylaxis in the population of Polish children (0-18 years old) are allergens found in cow's milk, peanuts, chicken eggs, tree nuts, and grains (3) .…”

“…The primary triggers of food-induced anaphylaxis in the population of Polish children (0-18 years old) are allergens found in cow's milk, peanuts, chicken eggs, tree nuts, and grains (3) . The leading causes of fatal anaphylaxis include peanuts and tree nuts (2) . As of now, there is no universally agreed-upon definition of anaphylaxis.…”

Characteristics of clinical manifestations of allergy in correlation with cow’s milk-sIgE components in children – preliminary reports

“…A UK study has documented a steadily increasing number of hospitalisations and deaths due to food anaphylaxis over the past two decades. Cow's milk protein allergen was responsible for 26% of schoolaged children's deaths (26,27) .…”