Format

Send to

Choose Destination
Ann Allergy Asthma Immunol. 2017 Oct;119(4):339-348.e1. doi: 10.1016/j.anai.2017.07.028. Epub 2017 Sep 7.

Multicenter prevalence of anaphylaxis in clinic-based oral food challenges.

Author information

1
Immunology, Allergy, and Rheumatology Section, Texas Children's Hospital, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
2
Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas.
3
Departments of Internal Medicine and Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
4
Northwest Asthma & Allergy Center, University of Washington School of Medicine, Seattle, Washington.
5
Division of Immunology, Boston Children's Hospital Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
6
Section of Pediatric Pulmonology, Allergy, and Sleep Medicine Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana.
7
Immunology, Allergy, and Rheumatology Section, Texas Children's Hospital, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas. Electronic address: cmdavis@texaschildrens.org.

Abstract

BACKGROUND:

Although previous single-center studies report the rate of anaphylaxis for oral food challenges (OFCs) as 9% to 11%, little is known regarding the epidemiology of clinical OFCs across multiple centers in the United States.

OBJECTIVE:

To examine the epidemiology, symptoms, and treatment of clinical low-risk OFCs in the nonresearch setting.

METHODS:

Data were obtained from 2008 to 2013 through a physician survey in 5 food allergy centers geographically distributed across the United States. Allergic reaction rates and the association of reaction rates with year, hospital, and demographics were determined using a linear mixed model. Meta-analysis was used to pool the proportion of reactions and anaphylaxis with inverse-variance weights using a random-effects model with exact confidence intervals (CIs).

RESULTS:

A total of 6,377 OFCs were performed, and the pooled estimate of anaphylaxis was 2% (95% CI, 1%-3%). The rate of allergic reactions was 14% (95% CI, 13%-16%) and was consistent during the study period (P = .40). Reaction rates ranged from 13% to 33%. Males reacted 16% more frequently than females (95% CI, 4%-37.5%; P = .04). Foods challenged in 2013 varied geographically, with peanut as the most challenged food in the Northeast, Midwest, and West and egg as the most challenged in the South.

CONCLUSION:

As the largest national survey of allergic reactions of clinical open OFCs in a nonresearch setting in the United States, this study found that performing clinical nonresearch open low-risk OFCs results in few allergic reactions, with 86% of challenges resulting in no reactions and 98% without anaphylaxis.

PMID:
28890356
DOI:
10.1016/j.anai.2017.07.028
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center