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[Food-induced anaphylaxis. A new French multicenter study]
1Service de Médecine D, Centre Hospitalier Universitaire de Nancy, Hôpital Central.
Bulletin De L'Academie Nationale De Medecine
|January 1, 1995
Summary
Food-induced anaphylactic shocks (FIAS) are increasingly prevalent, with over a third of cases being recurrent. A thorough allergologic investigation is crucial for diagnosing these events, especially when allergens are hidden.
Area of Science:
- Allergy and Immunology
- Clinical Medicine
- Epidemiology
Context:
- Food-induced anaphylactic shocks (FIAS) represent a significant clinical challenge, accounting for 10.2% of emergency department visits.
- A substantial proportion (33.3%) of FIAS cases are recurrent, underscoring the need for effective diagnosis and management.
- Previously identified food allergies were present in 23.4% of patients, with hidden or inadvertently consumed allergens contributing to 30.8% of FIAS.
Purpose:
- To investigate the frequency and characteristics of food-induced anaphylactic shocks (FIAS) across multiple hospital departments.
- To identify common allergens, predisposing factors, and the diagnostic efficiency of allergy units in managing FIAS.
- To highlight the increasing prevalence of FIAS and recurrent anaphylaxis, suggesting a potential role for masked food allergens.
Summary:
- A survey of 794 anaphylactic shock (A.S.) cases revealed that FIAS constitute 10.2% of etiologies, with a notable increase in prevalence compared to previous studies.
- Common allergens include egg, fish, crustaceans, and milk, though the allergen remained unidentified in 25% of cases, raising suspicion of masked food allergens.
- Enhancing factors like alcohol, exercise, and aspirin, along with cross-reactivities and mastocytosis, were identified in a significant percentage of patients. Diagnostic efficiency in allergy units reached 94%.
Impact:
- The findings emphasize the critical need for comprehensive allergologic investigations in all cases of anaphylactic shock (A.S.) to accurately diagnose FIAS.
- The study supports the recommendation for informative food labeling to help patients avoid allergens, particularly hidden ones.
- The high incidence of idiopathic anaphylaxis (10.2%) further strengthens the argument for investigating potential allergies to masked food allergens.