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Food-induced anaphylaxis in children less than 2 years of age

Liliana Klim1, Maria Michalik1, Natalia Figura2

  • 1SSG at Children's Diseases Clinic, Children's University Hospital, Jagiellonian University Medical College, Krakow, Poland.

Postepy Dermatologii I Alergologii
|September 26, 2025
PubMed

Insights

Severe allergic reactions (anaphylaxis) in young children are common, often triggered by food. Epinephrine, the recommended treatment, was underutilized in this study, highlighting a critical gap in pediatric anaphylaxis management.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pediatrics
  • Emergency Medicine

Background:

  • Anaphylaxis is a severe, life-threatening hypersensitivity reaction, frequently triggered by food allergens in young children.
  • The prevalence of pediatric anaphylaxis is increasing, necessitating a thorough understanding of its characteristics and management.
  • Epinephrine is the first-line treatment for anaphylaxis, but its administration in clinical practice requires further investigation.

Purpose of the Study:

  • To characterize severe allergic reactions in children aged 0-2 years.
  • To identify common allergens, symptoms, and treatments used in pediatric anaphylaxis.
  • To evaluate the utilization of epinephrine in managing anaphylaxis in infants.

Main Methods:

  • A retrospective study was conducted using hospital database records.
  • Reviewed cases of anaphylaxis in children under 2 years of age admitted to a pediatric allergy department between 2014 and 2023.
  • Data collected included patient demographics, allergens, symptoms, and treatments administered.

Main Results:

  • 87 patients (54 boys, mean age 12.3 months) experienced anaphylaxis, with cow's milk and hen's egg as primary triggers.
  • Mucocutaneous symptoms (93.1%) were common, often accompanied by respiratory issues. Asthma and hen's egg allergy were risk factors for severity.
  • Despite 43% experiencing Grade 4 anaphylaxis, only 10.5% of medicated patients received epinephrine; glucocorticosteroids were more frequently used.

Conclusions:

  • Anaphylaxis in infants presents diagnostic challenges and is a significant clinical concern.
  • The study highlights a concerning underuse of epinephrine in managing severe allergic reactions in this vulnerable pediatric population.
  • Improved adherence to anaphylaxis treatment guidelines, particularly epinephrine administration, is crucial for better patient outcomes.
Abstract

Keywords:
anaphylaxisfood allergyinfants

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