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Food allergies elicit anaphylaxis in patients younger than 10 years

Patients aged younger than 10 years were more likely to experience an anaphylactic reaction through food rather than insect venom, according to recent research.

“The European Anaphylaxis Registry confirmed food as the major elicitor of anaphylaxis in children, specifically hen’s egg, cow’s milk, and nuts,” Linus B. Grabenhenrich, MD, MPH, of the Institute for Social Medicine, Epidemiology and Health Economics at Charité Universitätsmedizin Berlin, and colleagues wrote. “Reactions to insect venom were seen more in young adulthood. Intensive care unit admissions and grade 4/fatal reactions were rare. The registry will serve as a systematic foundation for a continuous description of this multiform condition.”

Grabenhenrich and colleagues evaluated 1,970 patients with anaphylaxis aged 18 years or younger who were admitted to one of 90 tertiary allergy centers in 10 European countries between 2007 and 2015, according to the abstract. The researchers analyzed the symptoms, elicitors, emergency treatment and long-term management of patients with anaphylaxis at these centers.

One-third of patients had previously experienced anaphylaxis. Forty-six percent of anaphylaxis events occurred in private homes, whereas 19% occurred outdoors, according to the abstract. The most common elicitors of an anaphylactic event were food (66%) and insect venom (19%). Specifically, the most common foods triggering anaphylaxis included cow’s milk and hen’s eggs in children aged younger than 2 years, cashews and hazelnuts in preschool-aged children and peanuts in all-aged children. For children aged up to 10 years, there was a continuous shift from food-based triggers of anaphylaxis to venom-based triggers. The researchers noted few changes after that point.

Patient reported symptoms included cough and vomiting during the first 10 years and more subjective symptoms such as throat tightness, nausea and dizziness later in life, according to the abstract.

Of the 30% of patients given lay treatments, 10% received an epinephrine auto-injector.

Grabenhenrich and colleagues found the use of intramuscular epinephrine during emergency cases increased from 12% in 2011 to 25% in 2014. Twenty-six patients (1.3%) were admitted to the intensive care unit during the study period or had grade 4/fatal reactions. – by Jeff Craven

Disclosure: Grabenhenrich reports no relevant financial disclosures. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.