Food-induced Anaphylaxis in Infants and Children

Publication date: Available online 1 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Waheeda Samady, Jennifer Trainor, Bridget Smith, Ruchi Gupta
BackgroundRecent recommendations to introduce peanut products to infants for peanut allergy prevention requires a focused assessment of infant anaphylaxis.ObjectiveThis study describes the symptomatology of food-induced anaphylaxis (FIA) in infants (<12 months) compared to older pediatric cohorts.MethodsRetrospective review between June 2015 and June 2017 of children presenting with FIA at a large urban children's hospital emergency department (ED).ResultsA total of 357 cases of FIA were evaluated: 47 in infants (<12 months), 43 in toddlers (12 to 24 months), 96 in young children (2 to 6 years), and 171 in school-aged children (>6 years). Infants presented with gastrointestinal (GI) involvement more frequently than any other age group (89% vs 63% [P = .003], 60% [P <.001], and 58% [P <.001]). Additionally, infants and young children presented with skin involvement more frequently than school-aged children (94% and 91% vs 62% [P <.001]). Respiratory symptoms were more common in older cohorts (17% in infants vs 44% in young children [P <.001] and 54% in school-aged children [P <.001]). Egg and cow's milk were more common causes of FIA in infants compared to school-aged children (egg, 38% vs 1% [P <.001]; milk, 17% vs 7% [P =.03]). Only 21% of infants with FIA had eczema and 36% had a history of food allergy.ConclusionInfants with FIA primarily presented with GI and skin manifestations. Egg was the most common food trigger in infants. Most infants with FIA did not have eczema or a history of food allergy.



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