Food-induced anaphylaxis in infants and children

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Waheeda Samady, Jennifer Trainor, Bridget Smith, Ruchi Gupta

Abstract

Background

Recent recommendations to introduce peanut products to infants for peanut allergy prevention requires a focused assessment of infant anaphylaxis.

Objective

This study describes the symptomatology of food-induced anaphylaxis (FIA) in infants (<12 months) compared with older pediatric cohorts.

Methods

Retrospective review between June 2015 and June 2017 of children presenting with FIA at a large urban children's hospital emergency department (ED).

Results

A total of 357 cases of FIA were evaluated: 47 in infants (<12 months), 43 in toddlers (12-24 months), 96 in young children (2-6 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 with 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.

Conclusion

Infants 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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