Food-induced Anaphylaxis in Children
Authors:
J. Chládková 1; O. Škopková 2
Authors‘ workplace:
Dětská klinika UK LF a FN, Hradec Králové
přednosta prof. MUDr. M. Bayer, CSc.
1; Klinika dětského lékařství FN, Ostrava
přednosta doc. MUDr. J. Slaný, CSc.
2
Published in:
Čes-slov Pediat 2009; 64 (3): 127-134.
Category:
Review Article
Overview
Children with food allergy are at great risk of anaphylaxis reaching 30%. Anaphylaxis is not always easy to recognize clinically. It may be mild and may disappear spontaneously as a result of endogenous production of epinephrine, angiotensin II, or endothelin; or it may be severe and progress within minutes to respiratory or cardiovascular compromise and death. Currently there is a lack of an optimal, readily available laboratory test to confirm the clinical diagnosis of an anaphylaxis episode and a lack of an optimal method of distinguishing between individuals who are sensitized to food allergens known to trigger anaphylaxis on exposure to these allergens, and those who are not only sensitized but also at increased risk of developing anaphylaxis. The probability of fatal outcome is higher if anaphylaxis occurs in the child with a history of asthma, food allergy to nuts, peanuts and fish and in the case of omission or delay in giving adrenaline injection.
Intramuscular adrenaline is the acknowledged first-line therapy for anaphylaxis, in hospital and in the community, and should be given as soon as the condition is recognized. There are no absolute contraindications to administering adrenaline in children. Absolute indications for prescribing self injectable adrenaline are prior cardiorespiratory reactions, exercise-induced anaphylaxis and idiopathic anaphylaxis. Calcium is no more used in pharmacotherapy of anaphylaxis.
Key words:
anaphylaxis, adrenaline, autoinjector device, children, food allergy
Sources
1. Muraro A, Roberts G, Clark A, et al. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology. Allergy 2007;62: 857–871.
2. Sicherer SH, Gupta R, Sheik A, et al. Time trends in allergic disorders in th UK. Thorax 2007;62: 91–96.
3. Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a meta-analysis. J. Allergy Clin. Immunol. 2007;120(3): 638–646.
4. Sampson HA. Update on food allergy. J Allergy Clin. Immunol. 2004;113: 805–807.
5. Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics 1987;79: 683–688.
6. Sampson HA. Food allergy. Part 1: Immunopathogenesis and clinical disorders. J. Allergy Clin. Immunol. 1999;103: 717–728.
7. Sampson HA. Anaphylaxis: Persistent enigma. Emergency Medicine Australasia 2006;18: 101–102.
8. Braganza SC, Acworth JP, McKinnon DR, et al. Paediatric emergency department anaphylaxis: different patterns from adults. Arch. Dis. Child. 2006;91: 159–163.
9. Simons FER, Sheikh A. Evidence-based management of anaphylaxis. Allergy 2007;62: 827–829.
10. Moneret-Vautrin DA, Morisset M, Flabbee J, et al. Epidemiology of life-threatening and lethal anaphylaxis: a review. Allergy 2005;60: 443–451.
11. Gupta R, Sheikh A, Strachan DP, et al. Time trends in allergic disorders in the UK. Thorax 2007;62: 91–96.
12. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities dues to anaphylactic reactions to foods. J. Allergy Clin. Immunol. 2001;107: 191–193.
13. Macdougall CF, Cant AJ, Colver AF. How dangerous is food allergy in childhood? The incidence of severe and fatal allergic reactions across the UK and Ireland. Arch. Dis. Child. 2002;86: 236–239.
14. Uguz A, Lack G, Pumphrey R, et al. Allergic reaction in the community: a questionnaire survey of members of anaphylaxis campaign. Clin. Exp. Allergy 2005;35: 746–750.
15. Bock SA, Munoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001–2006. J. Allergy Clin. Immunol. 2007;119: 1016–1018.
16. Petrů V, Krčmová I. Anafylaktická reakce. Farmakoterapie pro praxi. Vol. 18. Praha: Maxdorf, 2006: 31–73.
17. Sampson HA. Anaphylaxis: Persistent enigma. Emergency Medicine Australasia 2006;18: 101–102.
18. Sampson HA. Anaphylaxis and emergency treatment. Pediatrics 2003;111: 1601–1608.
19. Simons FER. Risk assessment in anaphylaxis: Current and future approaches. J. Allergy Clin. Immunol. 2007;120: S2–S24.
20. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N. Engl. J. Med. 1992;372: 380–384.
21. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J. Allergy Clin. Immunol. 2001;107: 891–896.
22. Varjonen E, Vainio E, Kalimo K. Life-threatening, reccurent anaphylaxis caused by allergy to gliadin and exercise. Clin. Exp. Allergy 1997;27: 162–166.
23. Pereira B, Venter C, Grundy J, et al. Prevalence of sensitization to food allergens, reported adverse reaction to foods, food avoidance and food hypersensitivity among teenagers. J. Allergy Clin. Immunol. 2005;116: 884–892.
24. Simons FER, Frew AJ, Ansotegui IJ, et al. Practical allergy (Practall) report: risk assessment in anaphylaxis. Allergy 2008;63: 35–37.
25. Shreffler WG. Evaluation of basophil activation in food allergy: present and future applications. Curr. Opin. Allergy Clin. Immunol. 2006;6: 226–233.
26. Simons FER. Anaphylaxis, killer allergy: long-term management in the community. J. Allergy Clin. Immunol. 2006;117: 367–377.
27. Sicherer SH, Simons FE. Section on Allergy and Immunology – American Academy of Pediatrics. Self-injectable epinephrine for first-aid management of anaphylaxis. Pediatrics 2007;119: 638–646.
28. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report – Second National Institute of Allergy and Infectious Disease/Food Allergy Anaphylaxis Network Symposium. J. Allergy Clin. Immunol. 2006;117: 391–397.
29. Fuchs M. Potravinová alergie. In: Špičák V, et al. Alergologie. Praha: Galén, 2004: 269–287.
30. Jarvinen KM, Sicherer SH, Sampson HA, et al. Use of multiple doses of epinephrine in food-induced anaphylaxis in children. J. Allergy Clin. Immunol. 2008;119: 133–138.
31. Kelso JM. A second dose of epinephrine for anaphylaxis: how often needed and how to carry. J. Allergy Clin. Immunol. 2006;117: 464–465.
32. Oren E, Banerji A, Clark S, et al. Food-induced anaphylaxis and repeat epinephrine treatments. Ann. Allergy Astma Immunol. 2007;99: 429–432.
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2009 Issue 3
Most read in this issue
- Insulinoma – the Cause of Relapsing Hypoglycemia in a 16-year Patient
- Disorder of Growth and Development in a Boy with X-bound Ichthyosis, Protracted Delivery and Low Level of Estriol in the Mother during Pregnancy
- Wiskott-Aldrich Syndrome – Disease Requiring Early Transplantation of Hemopoietic Stem Cells
- Food-induced Anaphylaxis in Children