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Factors predicting anaphylaxis in children with tree nut allergies
Allergy and Asthma Proceedings
|April 26, 2019
Summary
Female gender, asthma, egg allergy, and higher serum basal tryptase (sBT) levels predict tree nut (TN) anaphylaxis in children. Elevated sBT levels are a significant risk factor for severe allergic reactions to tree nuts.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Food Allergy Research
Background:
- Tree nut (TN) allergies are a leading cause of fatal anaphylaxis.
- These allergies are typically lifelong conditions.
- Understanding predictors of severe reactions is crucial for management.
Purpose of the Study:
- To identify factors predicting anaphylaxis in children with tree nut allergies.
- To evaluate the role of specific clinical and laboratory markers in TN anaphylaxis.
Main Methods:
- Multivariate logistic regression analysis was used.
- Children with TN allergy were categorized into anaphylactic and nonanaphylactic groups.
- Predictors such as gender, comorbidities, and serum basal tryptase (sBT) were assessed.
Main Results:
- Female gender, concomitant asthma, egg white allergy, and higher sBT levels were significant risk factors for TN anaphylaxis.
- The optimal sBT cutoff for predicting anaphylaxis was 2.06 ng/mL (sensitivity 85.9%, specificity 69%).
- sBT levels of 1.94 ng/mL and 5.30 ng/mL predicted 50% and 95% probabilities of clinical reactivity, respectively.
Conclusions:
- Anaphylactic reactions to tree nuts in children are associated with gender, increased mast cell activity (indicated by sBT), and a stronger atopic background.
- Coexisting conditions like egg allergy and asthma increase the risk of severe TN reactions.
- Serum basal tryptase levels show promise as a biomarker for predicting the severity of tree nut allergic reactions in children.
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