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Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry |
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| Authors: | Ioana Maris Sabine Dölle-Bierke Jean-Marie Renaudin Lars Lange Alice Koehli Thomas Spindler Jonathan Hourihane Kathrin Scherer Katja Nemat C. Kemen Irena Neustädter Christian Vogelberg Thomas Reese Ismail Yildiz Zsolt Szepfalusi Hagen Ott Helen Straube Nikolaos G. Papadopoulos Susanne Hämmerling Ute Staden Michael Polz Tihomir Mustakov Ewa Cichocka-Jarosz Renata Cocco Alessandro Giovanni Fiocchi Montserrat Fernandez-Rivas Margitta Worm Network for Online Registration of Anaphylaxis (NORA) |
| Affiliation: | 1. Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland;2. Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany;3. Allergy Vigilance Network, Vandoeuvre les Nancy, France;4. Department of Paediatrics, St. Marien-Hospital, Bonn, Germany;5. Division of Allergology, University Children’s Hospital Zurich, Zürich, Switzerland;6. Department of Paediatrics, Medical Campus Hochgebirgsklinik Davos, Davos, Switzerland;7. Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland Children’s Health Ireland, Dublin, Ireland;8. Medical Faculty, University of Basel, Basel, Switzerland;9. Practice for paediatric pneumology and allergology, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany;10. Department of Paediatrics, Children’s Hospital WILHELMSTIFT, Hamburg, Germany;11. Department of Paediatrics, Hallerwiese Cnopfsche Kinderklinik, Nuremberg, Germany;12. Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technical University, Dresden, Germany;13. Department of Paediatrics, Mathias-Spital Rheine, Rheine, Germany;14. Department of Paediatrics, Friedrich-Ebert-Krankenhaus, Neumuenster, Germany;15. Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Competence Center Paediatrics, Medical University of Vienna, Vienna, Austria;16. Division of Paediatric Dermatology and Allergology, Epidermolysis bullosa-Centre Hannover, Children’s Hospital AUF DER BULT, Hanover, Germany;17. Division of Allergology, Darmstädter Kinderkliniken Prinzessin Margaret, Darmstadt, Germany;18. Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece Division of Infection, Immunity& Respiratory Medicine, University of Manchester, Manchester, UK;19. Division of Paediatric Pulmonology and Allergology, University Children`s Hospital Heidelberg, Heidelberg, Germany;20. Paediatric Pneumology & Allergology, Medical practice Klettke/Staden, Berlin, Germany;21. Department of Paediatrics, GPR Klinikum, Rüsselsheim, Germany;22. Chair of Allergy, University Hospital Alexandrovska, Sofia, Bulgaria;23. Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland;24. Division of Allergy, Clinical Immunology and Rheumatology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil;25. Paediatric Hospital Bambino Gesù IRCCS, Rome, Holy See;26. Allergy Department, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain |
| Abstract: | BackgroundPeanut allergy has a rising prevalence in high-income countries, affecting 0.5%–1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents.MethodsData was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre.Results3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004).ConclusionsThe European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition. |
| Keywords: | anaphylaxis food allergy paediatrics |