Recurrent food anaphylaxis and risk factors in children

Abstract

Recurrent food anaphylaxis and risk factors in childrenTo The Editor, Data about anaphylaxis recurrence and medical follow-up after an anaphylaxis reaction are scarce. Identifying the phenotype of the patients who are the most at risk of anaphylaxis recurrences remains challenging.The aim of the study was to determine the incidence of food anaphylaxis recurrence in a cohort of children previously admitted to emergency care units (ECU) for food anaphylaxis and to determine the characteristics of these at-risk children, that is, with anaphylaxis recurrences.All children (<16 years) admitted for food anaphylaxis to one of the 18 pediatric ECU in the Nord-Pas-de-Calais region of France were prospectively included (2015)(2016)(2017). Anaphylaxis was defined according to the National Institute of Allergy and Infectious Diseases/FA and Anaphylaxis Network Symposium. 1 The cohort characteristics and the index anaphylaxis reactions have been previously reported. 2 In this second part, we conducted a telephone survey in families of these children to assess their allergy follow-up using a standardized questionnaire. The 5-grade Astier score was used to assess the anaphylaxis severity. 3 Methods and statistical analysis are described in Appendix S1.

Treatment‐requiring accidental ingestion and risk factors among nursery children with food allergy

“…4,9 In a study of anaphylaxis recurrence, one-fifth of children with a history of food anaphylaxis experienced at least one anaphylaxis recurrence episode at a mean interval of 12 months. 10 We confirmed similar results in younger and generalized populations. Indeed, one-fourth of the children with a history of anaphylaxis to wheat had accidental wheat ingestion within 1 year, and more than half of them were treated in the hospital or clinic for accidental ingestion (Figure S2).…”

“…The design of this study, a questionnaire survey, has the potential for bias, such as social desirability bias. We excluded many patients with multiple food allergens known as risk factors for recurrent anaphylaxis, 10 which may indicate selection bias. Indeed, 12.0% (399/3355) of wheatallergic patients with multiple food allergens experienced accidental ingestion within 1 year (Supporting information).…”

Cow's milk and hen's egg anaphylaxis: A comprehensive data analysis from the European Anaphylaxis Registry

“…Recurrent anaphylaxis in the CMA group presented in more than half of the patients, which is higher than the one third reported by the previous paediatric EAR study regarding children up to 12 years, 1 and 1.5 times higher in comparison to the HEA group from this study. Retrospective data from Portugal indicates a similar frequency of recurrent anaphylaxis (41%), 13 as opposed to data from a prospective French study, where the frequency was half as high (18%) 17 . Difference in the reported recurrency of anaphylaxis might be trigger‐ or patient‐dependent.…”

“…Retrospective data from Portugal indicates a similar frequency of recurrent anaphylaxis (41%), 13 as opposed to data from a prospective French study, where the frequency was half as high (18%). 17 Difference in the reported recurrency of anaphylaxis might be trigger‐ or patient‐dependent. The former refers to a high potency of allergen (e.g.…”

“…French study, where the frequency was half as high (18%). 17 Difference in the reported recurrency of anaphylaxis might be trigger-or patient-dependent. The former refers to a high potency of allergen (e.g.…”