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Food-induced anaphylaxis in infants and children

Waheeda Samady1, Jennifer Trainor1, Bridget Smith2

  • 1Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois; Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|June 4, 2018
PubMed

Insights

Infant food-induced anaphylaxis (FIA) commonly presents with gastrointestinal and skin symptoms, with egg being the most frequent trigger. Most infants experiencing FIA do not have a history of eczema or prior food allergies.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pediatrics
  • Emergency Medicine

Background:

  • Recent guidelines recommend early introduction of peanut products to infants for allergy prevention.
  • This necessitates a thorough understanding of infant anaphylaxis presentation.
  • Current data on food-induced anaphylaxis (FIA) in infants is limited compared to older children.

Purpose of the Study:

  • To describe the clinical symptomatology of food-induced anaphylaxis (FIA) in infants under 12 months.
  • To compare infant FIA symptoms with those in older pediatric age groups.
  • To identify common food triggers and associated conditions in infant FIA.

Main Methods:

  • Retrospective review of 357 food-induced anaphylaxis (FIA) cases.
  • Data collected from June 2015 to June 2017 at a major urban children's hospital emergency department.
  • Cases categorized into infants (<12 months), toddlers (12-24 months), young children (2-6 years), and school-aged children (>6 years).

Main Results:

  • Infants (47 cases) showed significantly higher rates of gastrointestinal (89%) and skin (94%) involvement compared to older children.
  • Respiratory symptoms were more prevalent in older pediatric cohorts (44-54%) versus infants (17%).
  • Egg (38%) and cow's milk (17%) were the most common triggers in infants, unlike in school-aged children. Only 21% of infants had eczema, and 36% had a prior food allergy history.

Conclusions:

  • Infants with food-induced anaphylaxis (FIA) predominantly exhibit gastrointestinal and skin manifestations.
  • Egg is the primary food allergen triggering FIA in the infant population.
  • A significant proportion of infants with FIA lack a history of eczema or other food allergies, challenging typical risk factor assumptions.
Abstract

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