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61% of anaphylactic events occur in the home
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BOSTON — Although parental concern about anaphylaxis is high when children are at school or other public areas, 61% of anaphylactic events occur within the home, according to a recent presentation at the American College of Allergy, Asthma and Immunology’s Annual Scientific Meeting.
According to Sara Anvari, MD, MS, FAAP, assistant professor of pediatrics in the section of immunology, allergy and rheumatology at Texas Children’s Hospital and Baylor College of Medicine, and colleagues, the majority of these anaphylactic events were reactions to food.
To assess frequent causes, clinical features and locations of anaphylactic events in the researchers’ patient population, Anvari and colleagues conducted a retrospective case-note review. All data were collected from children aged between 0 and 18 years, and the researchers reviewed all information between January and December 2016.
For the first 46 children included in the review (age = 4 months to 16 years; median age = 8.5 years), food was the cause of 43% of all anaphylactic events. Reactions assessed were induced by tree nuts (40%), eggs (15%), drugs (17%), venom (13%), immunotherapy (4%), vaccinations (2%) and unknown (19%).
Of these children, 26% had previously experienced anaphylaxis and 21% had epinephrine available for treatment. The majority of anaphylactic events occurred in the home (61%), with all other events occurring in medical facilities (15%), school or day care (11%), restaurants (4%), cinemas (2%) and churches (2%). A small amount had unrecorded locations (2%).
Skin reactions were the most commonly reported symptom, with cutaneous symptoms reported in 91% of cases. Other reported symptoms of anaphylaxis included respiratory (69%), gastrointestinal (17%) and cardiovascular (8%) symptoms. Reactions typically occurred within 5 minutes (46%), whereas 8% occurred within 5 to 30 minutes, 4% within 30 to 120 minutes, 6% in more than 2 hours. Time of onset was not recorded in 35% of cases.
Epinephrine was administered to nearly all children, with 91% receiving the drug. A significant number of patients (17%) required two doses of epinephrine.
“The incidence of anaphylaxis has increased,” Anvari told Infectious Diseases in Children. “Therefore, proper recognition and timely treatment remain paramount.”–by Katherine Bortz
Reference:
Anvari S, et al. P008. Anaphylaxis: Closer to home? Presented at: The ACAAI Annual Meeting; Oct. 26-30, 2017; Boston, MA.
Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.