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Anaphylaxis in Chinese Children: Different Clinical Profile Between Children with and without a History of
Nannan Jiang1,2,3, Wei Xu1,2,3, Huijie Huang1,2,3
1Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
Insights
Children with asthma or recurrent wheezing (RW) have distinct anaphylaxis profiles, including higher rates of buckwheat triggers and oropharyngeal symptoms. Severity was similar to those without a history of asthma or RW.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
Background:
- Asthma and recurrent wheezing (RW) are known risk factors for anaphylaxis.
- Limited data exists on anaphylaxis characteristics in Chinese children with a history of asthma/RW.
Purpose of the Study:
- To investigate the clinical characteristics of anaphylaxis in Chinese children with a history of asthma or recurrent wheezing (RW).
Main Methods:
- Retrospective, observational chart review of children diagnosed with anaphylaxis between 2014-2021.
- Data collected included demographics, symptoms, triggers, and history of asthma/RW.
- Analysis of 399 anaphylactic reactions in 264 patients.
Main Results:
- 45.1% of patients had a history of asthma/RW.
- Food was the most common trigger (85.5%).
- Buckwheat-induced anaphylaxis was significantly more common in the asthma/RW group (9.4% vs 0.5%).
- Higher rates of oropharyngeal symptoms (17.3% vs 8.6%) and wheezing (34.5% vs 15.9%) were observed in the asthma/RW group.
- No significant difference in severe anaphylaxis rates between groups.
- Children with asthma/RW were more likely to receive inhaled beta-agonists.
Conclusions:
- Children with a history of asthma/RW exhibit different anaphylaxis clinical profiles compared to those without.
- Wheezing and oropharyngeal symptoms are more prevalent in the asthma/RW group.
- Buckwheat is a more frequent trigger in children with asthma/RW.
Purpose:
Asthma and recurrent wheezing (RW) have been identified as risk factors for anaphylaxis; however, little is known about the characteristics of anaphylaxis in children with a history of asthma or RW in Chinese children.
Patients And Methods:
This was a retrospective, observational chart review of children who were diagnosed with anaphylaxis in a tertiary children's hospital between 2014 and 2021. Patients' demographics, symptoms, triggers and presence of physician-diagnosed asthma/RW history were collected from medical charts.
Results:
A total of 399 anaphylactic reactions in 264 patients were analyzed; 119 patients (45.1%) had a history of asthma/RW. Food was the most common cause (85.5%, 341/399). Compared with patients without a history of asthma/RW, buckwheat-induced anaphylaxis was significantly more common in the asthma/RW group (9.4% vs 0.5%, p < 0.001), patients with a history of asthma/RW had higher rates of oropharyngeal symptoms (17.3% vs 8.6%, p = 0.011) and wheezing (34.5% vs 15.9%, p < 0.001). Ninety-one reactions (22.8%, 91/399) presented as severe anaphylaxis, but no difference existed between asthma/RW and non-asthma/RW groups. Children with a history of asthma/RW were more likely to receive inhaled β agonists than children without a history of asthma/RW (11.8% vs 2.5%, p = 0.003). A larger proportion of children without asthma/RW history were treated with epinephrine (11.7%) than children with asthma/RW history (6.9%).
Conclusion:
Our finding revealed that different clinical profiles of anaphylaxis in children with and without a history of asthma/RW. Our study did not find that children with a history of asthma/RW have more severe anaphylactic reactions compared with children without asthma/RW. Buckwheat-induced anaphylaxis was more common in the asthma/RW group, wheezing and oropharyngeal symptoms affected a higher proportion of the asthma/RW group.
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