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Published on: June 4, 2017
Anaphylaxis in Chinese Children with Pollen Sensitization: Triggers, Clinical Presentation, and Acute Management
Nannan Jiang1, Wei Xu1, Huijie Huang1
1Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health; Key Laboratory of Major Diseases in Children, Ministry of Education; National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.
Insights
Anaphylaxis in children with pollen sensitization is often triggered by fruits and vegetables. Epinephrine use was low, indicating a need for better education on anaphylaxis management in pediatric allergy patients.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Food Allergy Research
Background:
- Pollen sensitization is increasingly prevalent in pediatric populations.
- Limited data exists on the specific characteristics of anaphylaxis in children with pollen sensitization.
Purpose of the Study:
- To investigate the clinical characteristics and triggers of anaphylaxis in children diagnosed with pollen sensitization.
- To identify common allergens and comorbidities associated with anaphylaxis in this cohort.
Main Methods:
- A retrospective study was conducted on 108 pediatric patients with anaphylaxis and pollen sensitization.
- Data collected from 2014 to 2021 included demographics, pollen types, food triggers, comorbidities, reaction severity, and management.
- Analysis focused on 157 anaphylaxis events to determine patterns and associations.
Main Results:
- The most common sensitizing pollens were mugwort, ragweed, and birch, with high rates of polysensitization.
- Fruits/vegetables were the most frequent food triggers, followed by wheat and milk.
- Skin and respiratory symptoms predominated; only 7.4% of patients received epinephrine treatment.
- Severe anaphylaxis was associated with a history of recurrent urticaria.
Conclusions:
- Anaphylaxis in children with pollen sensitization frequently involves fruit/vegetable allergens and presents with significant skin and respiratory symptoms.
- The low rate of epinephrine administration underscores a critical gap in acute anaphylaxis management, necessitating targeted educational interventions.
Purpose:
Pollen sensitization is increasing in children. However, there is little evidence regarding the characteristics of anaphylaxis in individuals with pollen sensitization.
Patients And Methods:
We conducted a retrospective study of patients with anaphylaxis combined with pollen sensitization who attended an allergy department in a tertiary children's hospital from 2014 to 2021.
Results:
A total of 157 anaphylaxis events in 108 patients were analyzed; the mean age at the reaction was 5.8 ± 4.17 years. A total of 99.1% (107/108) of the patients came from northern China. The most common sensitizing pollen was mugwort (93.5%,101/108), followed by ragweed (68.5%, 74/108) and birch (40.7%, 44/108). A total of 76.9% (83/108) of the patients showed polysensitization to pollen. Allergic rhinitis/conjunctivitis was the most common comorbidity (87.0%, 94/108). Children with severe anaphylaxis were more likely to have a history of recurrent urticaria (16.1% vs 3.9%, p = 0.028). The most frequently implicated foods were fruits/vegetables (22.3%, 35/157), followed by wheat (8.9%, 14/157) and milk (8.3%, 13/157), and the most common fruit allergen was peach (n = 7). Of 14% (22/157) exercise-induced reactions, 63.6% (14/22) occurred in pollen season. Skin symptoms were the most frequent (86.0%, 135/157) symptoms, followed by respiratory (73.9%, 116/157) and gastrointestinal (21%, 33/157) symptoms. Regarding acute management, only 7.4% of the patients were treated with epinephrine.
Conclusion:
Our findings revealed the characteristics of anaphylaxis in children with pollen sensitization. Fruits/vegetables accounted for a substantial percentage of anaphylaxis triggers. The suboptimal use of epinephrine highlights the need for educational programs promoting the use of epinephrine.
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