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Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry
Ioana Maris1, Sabine Dölle-Bierke2, Jean-Marie Renaudin3
1Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland.
Insights
Peanut allergy is a significant cause of severe anaphylaxis in European children, often associated with asthma and biphasic reactions. Adrenaline use needs improvement to manage these life-threatening allergic reactions effectively.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Epidemiology of Allergic Diseases
Background:
- Peanut allergy prevalence is increasing in high-income nations, impacting 0.5%-1.4% of children.
- Anaphylaxis, a severe allergic reaction, requires detailed understanding, especially in pediatric populations.
- Comparative analysis of food-induced anaphylaxis is crucial for effective management strategies.
Purpose of the Study:
- To compare peanut anaphylaxis with anaphylaxis from other food triggers in European children and adolescents.
- To identify specific characteristics and risk factors associated with peanut anaphylaxis.
- To evaluate treatment and outcome differences in pediatric anaphylaxis cases.
Main Methods:
- Utilized data from the European Anaphylaxis Registry, collected via online questionnaires.
- Reviewed cases of food-induced anaphylaxis from a tertiary pediatric allergy center.
- Analyzed 3514 cases of food anaphylaxis reported between July 2007 and March 2018.
Main Results:
- Peanut anaphylaxis occurred in 459 children and adolescents, representing 85% of all peanut anaphylaxis cases.
- Peanut anaphylaxis showed higher rates of previous reactions, asthma comorbidity, cofactors, and biphasic reactions compared to other food anaphylaxis.
- Severe anaphylaxis (Ring&Messmer grade III/IV) was common; hospitalization rates were higher for peanut anaphylaxis, while self-administration of intramuscular adrenaline was low.
Conclusions:
- Peanut is a major cause of severe, life-threatening allergic reactions in European children, characterized by asthma comorbidity and biphasic reactions.
- Low usage of intramuscular adrenaline as a first-line treatment for anaphylaxis highlights a need for improvement.
- The European Anaphylaxis Registry serves as a vital resource for ongoing assessment of anaphylaxis trends and management.
Background:
Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents.
Methods:
Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre.
Results:
3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004).
Conclusions:
The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.
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