Guillaume Pouessel1,2,3, Charlotte Jean-Bart1, Antoine Deschildre2,3, Xavier Van der Brempt3,4, Luciana Kase Tanno3,5,6,7, Pascale Beaumont3,8, Pascale Dumond3,9, Dominique Sabouraud-Leclerc3,10, Etienne Beaudouin11, Nassima Ramdane12, Valérie Liabeuf13, Jean-Marie Renaudin3,14. 1. Department of Pediatrics, Children's Hospital, Roubaix, France. 2. Pediatric Pulmonology and Allergy Department, CHU Lille, Lille, France. 3. Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France. 4. Allergopôle, Clinique Saint-Luc, Bouge, Belgium. 5. University Hospital, Montpellier, France. 6. INSERM UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Université, Paris, France. 7. Hospital Sírio Libanês, São Paulo, Brazil. 8. Medical office, Saint-Maur des Fossés, France. 9. Pediatric Allergology Department, Children's hospital, University Hospital Nancy, Vandoeuvre-lès-Nancy, France. 10. Pediatric Department, American Memorial Hospital, Reims, France. 11. Department of Allergology and Clinical Immunology, Mercy Hospital, Metz-Thionville, France. 12. EA 2694, Public health epidemiology and quality of care, University of Lille, Lille, France. 13. Department of Dermatology, La Timone Hospital, Aix-Marseille University, Marseille, France. 14. Pediatric Allergy Care Unit University Hospital, Vandoeuvre-lès-Nancy, France.
Abstract
OBJECTIVE: Little is known regarding food anaphylaxis in infancy. We aimed to describe specificities of food anaphylaxis in infants (≤12 months) as compared to preschool children (1-6 years). METHODS: We conducted a retrospective study of all food anaphylaxis cases recorded by the Allergy Vigilance Network from 2002 to 2018, in preschool children focusing on infants. RESULTS: Of 1951 food anaphylaxis reactions, 61 (3%) occurred in infants and 386 (20%) in preschool children. Two infants had two anaphylaxis reactions; thus, we analyzed data among 59 infants (male: 51%; mean age: 6 months [SD: 2.9]); 31% had a history of atopic dermatitis, 11% of previous food allergy. The main food allergens were cow's milk (59%), hen's egg (20%), wheat (7%) and peanut (3%) in infants as compared with peanut (27%) and cashew (23%) in preschool children. Anaphylaxis occurred in 28/61 (46%) cases at the first cow's milk intake after breastfeeding discontinuation. Clinical manifestations were mainly mucocutaneous (79%), gastrointestinal (49%), respiratory (48%) and cardiovascular (21%); 25% of infants received adrenaline. Hives, hypotension and neurologic symptoms were more likely to be reported in infants than in preschool children (P = .02; P = .004; P = .002, respectively). Antihistamines and corticosteroids were more often prescribed in preschool children than in infants (P = .005; P = .025, respectively). CONCLUSION: Our study found that in infants presenting with their first food allergy, in a setting with a high rate of infant formula use, the most predominant trigger was cow's milk. As compared to older preschool children, hives, hypotonia and hypotension were more likely to be reported in infants. We believe that this represents a distinct food anaphylaxis phenotype that can further support developing the clinical anaphylaxis criteria in infants.
OBJECTIVE: Little is known regarding food anaphylaxis in infancy. We aimed to describe specificities of food anaphylaxis in infants (≤12 months) as compared to preschool children (1-6 years). METHODS: We conducted a retrospective study of all food anaphylaxis cases recorded by the Allergy Vigilance Network from 2002 to 2018, in preschool children focusing on infants. RESULTS: Of 1951 food anaphylaxis reactions, 61 (3%) occurred in infants and 386 (20%) in preschool children. Two infants had two anaphylaxis reactions; thus, we analyzed data among 59 infants (male: 51%; mean age: 6 months [SD: 2.9]); 31% had a history of atopic dermatitis, 11% of previous food allergy. The main food allergens were cow's milk (59%), hen's egg (20%), wheat (7%) and peanut (3%) in infants as compared with peanut (27%) and cashew (23%) in preschool children. Anaphylaxis occurred in 28/61 (46%) cases at the first cow's milk intake after breastfeeding discontinuation. Clinical manifestations were mainly mucocutaneous (79%), gastrointestinal (49%), respiratory (48%) and cardiovascular (21%); 25% of infants received adrenaline. Hives, hypotension and neurologic symptoms were more likely to be reported in infants than in preschool children (P = .02; P = .004; P = .002, respectively). Antihistamines and corticosteroids were more often prescribed in preschool children than in infants (P = .005; P = .025, respectively). CONCLUSION: Our study found that in infants presenting with their first food allergy, in a setting with a high rate of infant formula use, the most predominant trigger was cow's milk. As compared to older preschool children, hives, hypotonia and hypotension were more likely to be reported in infants. We believe that this represents a distinct food anaphylaxis phenotype that can further support developing the clinical anaphylaxis criteria in infants.
Authors: Lacey B Robinson; Anna Chen Arroyo; Rebecca E Cash; Susan A Rudders; Carlos A Camargo Journal: Allergy Asthma Proc Date: 2021-05-01 Impact factor: 2.587
Authors: Fabiana A Nunes; Fábio Zanini; Camilla de S Braga; Andreza L da Silva; Fátima R Fernandes; Dirceu Solé; Gustavo F Wandalsen Journal: World Allergy Organ J Date: 2022-08-21 Impact factor: 5.516
Authors: Alberto Martelli; Mauro Calvani; Thomas Foiadelli; Mariangela Tosca; Giuseppe Pingitore; Amelia Licari; Alessia Marseglia; Giorgio Ciprandi; Carlo Caffarelli Journal: Acta Biomed Date: 2021-11-29
Authors: Alberto Martelli; Rosario Ippolito; Martina Votto; Maria De Filippo; Ilaria Brambilla; Mauro Calvani; Fabio Cardinale; Elena Chiappini; Marzia Duse; Sara Manti; Gian Luigi Marseglia; Carlo Caffarelli; Claudio Cravidi; Michele Miraglia Del Giudice; Maria Angela Tosca Journal: Acta Biomed Date: 2020-09-15