Food-induced anaphylaxis in infants and children

Samady, Waheeda; Trainor, Jennifer L.; Smith, Bridget; Gupta, Ruchi S.

doi:10.1016/j.anai.2018.05.025

Cited by 87 publications

(57 citation statements)

References 26 publications

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“…Although the definitive diagnosis of asthma is difficult in infants, we expected a relatively small proportion of infants with that comorbidity compared to that reported in preschool children (23%). Similarly to our data, Samady et al reported data of food‐related anaphylaxis cases in infants (<12 months) and compared the characteristics of 47 infants with 43 toddlers (12‐24 months), 96 preschool children (2‐6 years) and 171 school children (>6 years) . Infants were more likely to have mucocutaneous (particularly hives) and gastrointestinal symptoms than school‐aged children ( P < .001) but had fewer respiratory symptoms than preschool or school‐aged children ( P < .001) …”

Section: Discussionsupporting

confidence: 86%

“…Similarly to previous studies, we confirm that cow's milk and hen's egg were the most common anaphylaxis triggers. These two food allergens are involved in 55‐83% of the food‐related reactions in infancy . We also found that anaphylaxis occurred in around half of cases (46%) of all the anaphylaxis cases with the first intake of cow's milk after breastfeeding discontinuation.…”

Section: Discussionmentioning

confidence: 65%

“…However, this rate is higher than reported in other studies. In the cohort of 47 infants (<12 months) with anaphylactic reactions reported by Samady et al, 2% had a cardiovascular involvement, and this rate was of 8% in another cohort of 363 children aged 0‐2 years who had been diagnosed with anaphylaxis . Cardiovascular involvement may be underdiagnosed because blood pressure is not systematically measured and also because anaphylaxis is a dynamic phenomenon .…”

Section: Discussionmentioning

confidence: 88%

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Food‐induced anaphylaxis in infancy compared to preschool age: A retrospective analysis

Pouessel

Jean-Bart

Deschildre

et al. 2019

Clin Experimental Allergy

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Objective: Little is known regarding food anaphylaxis in infancy. We aimed to describe specificities of food anaphylaxis in infants (≤12 months) as compared to preschool children (1-6 years). Methods:We conducted a retrospective study of all food anaphylaxis cases recorded by the Allergy Vigilance Network from 2002 to 2018, in preschool children focusing on infants.Results: Of 1951 food anaphylaxis reactions, 61 (3%) occurred in infants and 386 (20%) in preschool children. Two infants had two anaphylaxis reactions; thus, we analyzed data among 59 infants (male: 51%; mean age: 6 months [SD: 2.9]); 31% had a history of atopic dermatitis, 11% of previous food allergy. The main food allergens were cow's milk (59%), hen's egg (20%), wheat (7%) and peanut (3%) in infants as compared with peanut (27%) and cashew (23%) in preschool children. Anaphylaxis occurred in 28/61 (46%) cases at the first cow's milk intake after breastfeeding discontinuation. Clinical manifestations were mainly mucocutaneous (79%), gastrointestinal (49%), respiratory (48%) and cardiovascular (21%); 25% of infants received adrenaline. Hives, hypotension and neurologic symptoms were more likely to be reported in infants than in preschool children (P = .02; P = .004; P = .002, respectively).Antihistamines and corticosteroids were more often prescribed in preschool children than in infants (P = .005; P = .025, respectively). Conclusion:Our study found that in infants presenting with their first food allergy, in a setting with a high rate of infant formula use, the most predominant trigger was cow's milk. As compared to older preschool children, hives, hypotonia and hypotension were more likely to be reported in infants. We believe that this represents a distinct food anaphylaxis phenotype that can further support developing the clinical anaphylaxis criteria in infants. | 75POUESSEL Et aL.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 88%

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Food‐induced anaphylaxis in infancy compared to preschool age: A retrospective analysis

Pouessel

Jean-Bart

Deschildre

et al. 2019

Clin Experimental Allergy

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“…The common food commodities accounting for FA in children are cow's milk, egg, peanut, tree nuts, and fish, 4 while the first three foods are the leading causes for pediatric anaphylaxis in Western countries. 5 In Asia, the prevalence of pediatric FA seems to vary between 1.11% and 7.65%, 6 and the patterns of FA showed marked difference from other parts of the world. 1 Recent studies among 2-to 7-year-old children from Singapore, Thailand, the Philippines, and Hong Kong demonstrated that shellfish allergy was dominant, but not milk, egg, or peanut.…”

Section: Introductionmentioning

confidence: 99%

A cross‐sectional, population‐based study on the prevalence of food allergies among children in two different socio‐economic regions of Vietnam

Nguyen

et al. 2019

Pediatric Allergy Immunology

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Background There is a paucity of data on the prevalence of food allergy (FA) in Vietnam. A cross‐sectional, population‐based study was conducted to evaluate the current prevalence of FA among 2‐ to 6‐year‐old children in two different regions in Vietnam. Method A structured, anonymous questionnaire, modified from published FA epidemiologic studies and based on EAACI guidelines, was distributed to parents/guardians of participating children in Hue City (urban area) and Tien Giang Province (rural area). Data collected from the survey were statistically analyzed to generate the prevalence of self‐reported and doctor‐diagnosed FA and overarching pattern of food allergens. Results A total of 8620 responses were collected (response rate 81.5%). Children in Tien Giang reported more than twice the food‐induced adverse reactions seen in children in Hue (47.8% vs. 20.5%). In contrast, children in Hue showed higher self‐reported FA (9.8%) and doctor‐diagnosed FA rates (8.4%) than children in Tien Giang (7.9% and 5.0%, respectively). Crustacean was the predominant allergy‐inducing food in both areas (330 of 580 cases, 56.9%), followed by fish, mollusk, beef, milk, and egg. However, substantial variations of FA patterns were seen between the study sites. Geographic location and co‐morbidities of other allergic diseases were key risk factors for FA (P < 0.001). Conclusions The prevalence of FA in Vietnamese children seems to be higher than previously reported from other Asian countries. Crustacean is the predominant allergy‐inducing food among participating preschool children in Vietnam. The variation of reported food allergen sources across different socio‐economic locations could imply different eating habits or the participation of indoor and outdoor allergen exposure.

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“…Available data clearly show this to be unlikely, however, because foodrelated severe anaphylaxis in infancy is extremely rare and no fatalities have been reported. [32][33][34] Because the LEAP study did not evaluate alternative peanut ingestion schedules or durations, it is unknown whether shorter, less frequent, or smaller amounts of peanut are equally efficacious for prevention of peanut allergy. 35 Emerging Treatments: Immunotherapies…”

Section: Unmet Needsmentioning

confidence: 99%

Unmet needs of children with peanut allergy

Chan

Dinakar

Gonzales-Reyes

et al. 2020

Annals of Allergy, Asthma & Immunology

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Background: Peanut allergy is a potentially severe and lifelong allergy, with few effective treatments or preventive measures. Objective: To convene an expert panel of allergists, pediatricians, and advocates to discuss and highlight unmet needs in the prevention and management of peanut allergies. Methods: Literature searches of PubMed were performed. The panel evaluated published data on the prevention of peanut allergy, treatment of existing peanut allergy, and management of reactions after unintentional peanut exposures. Results: The following key unmet needs in the prevention and management of peanut allergy were identified: (1) enhancing and optimizing implementation of early peanut introduction as a means of preventing

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Food-induced anaphylaxis in infants and children

Cited by 87 publications

References 26 publications

Food‐induced anaphylaxis in infancy compared to preschool age: A retrospective analysis

Food‐induced anaphylaxis in infancy compared to preschool age: A retrospective analysis

A cross‐sectional, population‐based study on the prevalence of food allergies among children in two different socio‐economic regions of Vietnam

Unmet needs of children with peanut allergy

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