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Ann Allergy Asthma Immunol. 2018 Sep;121(3):360-365. doi: 10.1016/j.anai.2018.05.025. Epub 2018 Jun 1.

Food-induced anaphylaxis in infants and children.

Author information

1
Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois; Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: wsmady@luriechildrens.org.
2
Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois; Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
3
Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois.

Abstract

BACKGROUND:

Recent recommendations to introduce peanut products to infants for peanut allergy prevention requires a focused assessment of infant anaphylaxis.

OBJECTIVE:

This study describes the symptomatology of food-induced anaphylaxis (FIA) in infants (<12 months) compared with older pediatric cohorts.

METHODS:

Retrospective review between June 2015 and June 2017 of children presenting with FIA at a large urban children's hospital emergency department (ED).

RESULTS:

A total of 357 cases of FIA were evaluated: 47 in infants (<12 months), 43 in toddlers (12-24 months), 96 in young children (2-6 years), and 171 in school-aged children (>6 years). Infants presented with gastrointestinal (GI) involvement more frequently than any other age group (89% vs 63% [P = .003], 60% [P < .001], and 58% [P < .001]). Additionally, infants and young children presented with skin involvement more frequently than school-aged children (94% and 91% vs 62% [P < .001]). Respiratory symptoms were more common in older cohorts (17% in infants vs 44% in young children [P < .001] and 54% in school-aged children [P < .001]). Egg and cow's milk were more common causes of FIA in infants compared with school-aged children (egg, 38% vs 1% [P < .001]; milk, 17% vs 7% [P = .03]). Only 21% of infants with FIA had eczema, and 36% had a history of food allergy.

CONCLUSION:

Infants with FIA primarily presented with GI and skin manifestations. Egg was the most common food trigger in infants. Most infants with FIA did not have eczema or a history of food allergy.

PMID:
29860051
DOI:
10.1016/j.anai.2018.05.025
[Indexed for MEDLINE]

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