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Clinical Characteristics and Severity of Pediatric Anaphylaxis in the Emergency Department: A Six-Year Study Based on

Nazli Ercan1, Aysun Tekeli2

  • 1Division of Pediatric Immunology and Allergy, Department of Pediatrics, University of Health Sciences Turkey, Gülhane Education and Research Hospital, Ankara, Turkey, drnazliercan@gmail.com.

International Archives of Allergy and Immunology
|June 15, 2026
PubMed

Insights

Severe pediatric anaphylaxis is often triggered by food, with cardiovascular issues indicating critical reactions. Updated World Allergy Organization (WAO) criteria help assess severity, guiding better management and discharge practices for children.

Area of Science:

  • Pediatric Allergy and Immunology
  • Emergency Medicine
  • Clinical Research

Background:

  • Anaphylaxis incidence is rising in children, necessitating standardized diagnostic and grading tools.
  • The World Allergy Organization (WAO) introduced new criteria for evaluating acute systemic allergic reactions.
  • Understanding pediatric anaphylaxis characteristics is crucial for effective management.

Purpose of the Study:

  • To assess clinical features, triggers, and severity of anaphylaxis in children using WAO criteria.
  • To identify risk factors associated with severe reactions in pediatric anaphylaxis cases.
  • To analyze etiological distribution and management patterns in pediatric anaphylaxis.

Main Methods:

  • Retrospective analysis of children (WAO Grade 2-4) with acute systemic allergic reactions.
  • Evaluation of clinical data, triggers, management, and outcomes from a tertiary pediatric emergency department.
  • Logistic regression used to determine independent risk factors for severe anaphylaxis.

Main Results:

  • 61% of children met WAO criteria for anaphylaxis; food was the most common trigger (49%).
  • Cardiovascular compromise (hypotension) was a key indicator of severe (Grade 4) anaphylaxis.
  • Food-induced anaphylaxis showed a higher likelihood of severe reactions compared to drug or other allergens.

Conclusions:

  • Cardiovascular compromise is the primary determinant of severe pediatric anaphylaxis under WAO criteria.
  • Severity-based assessment is essential for managing pediatric anaphylaxis effectively.
  • Discharge practices, including adrenaline autoinjector prescription, require optimization for high-risk cases.
Abstract

Keywords:
AnaphylaxisChildrenClinical featuresRisk factorsSevere anaphylaxis

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