Idiopathic anaphylaxis: What you do not know may hurt you

Chan, Suzanne; John, Rita Marie

doi:10.1097/jxx.0000000000000221

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…Also, in the French study, in contrast to our study (6.1%), more children (17%) developed IA where a trigger factor could not be identified [ 19 ]. French data were consistent with American studies, which in 2017 determined IA occurrence to be 17%, almost doubling from 10% recorded at the end of the 20 th century [ 23 ]. IA was always a mark of system imperfection and limitation of diagnostic possibilities.…”

Section: Discussionsupporting

confidence: 85%

Is the clinical manifestation of anaphylaxis in children influenced by the trigger of reaction?

Tarczoń¹,

Jedynak-Wąsowicz

Lis

et al. 2021

pdia

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Introduction The number of anaphylaxis diagnoses in children is rising, being still based on the clinical picture. Aim To determine whether triggers of anaphylaxis influence its clinical characteristics in children and adolescents. Material and methods The study group included 114 children (5 months–17 years, mean age: 8.0 ±4.8 years), (66%: boys) with the episode of anaphylaxis up to 1 year back. Medical data were entered to the NORA Registry by means of a validated structured on-line questionnaire. Results Three most frequent triggers of anaphylaxis were: insect venom (47.4%), food (35.1%), drugs (5.3%), with a predominance of food (egg white, cow’s milk, nuts and peanuts) in the 0–6 years age group, while insect venom (bee predominance) in the 7–17 years age group ( p = 0.016). Clinical manifestations differed between food vs. venom allergic reactions and presented as gastro-intestinal (GI) (61.4%) ( p = 0.004), respiratory (RS) (93.9%) ( p = 0.036), and cardiovascular (CVS) (74.6%) ( p = 0.022) symptoms. Among objective symptoms, vomiting was the most common symptom in the 0–2 years age group (47.1%) ( p = 0.006), while hypotension in those aged 7–12 years (40%) ( p = 0.010). Severity of symptoms evaluated as Mueller’s grade (IV – 74.5%) and as Ring and Messmer’s grade (III – 65.8%), depended on the trigger ( p = 0.028, p = 0.029, respectively). Life-threatening symptoms occurred in 26 children (fall of the blood pressure – 22%, loss of consciousness – 4.4%). Conclusions The clinical manifestation of anaphylaxis in children is both trigger and age dependent, irrespective of the gender. A typical patient with food anaphylaxis was younger, presenting predominantly GI symptoms, while a typical patient with venom anaphylaxis was older, with mostly cardiovascular symptoms.

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Section: Discussionsupporting

confidence: 85%