Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence

Background: Little is known about anaphylaxis in Chinese children. This study aimed to determine the age-specific patterns of anaphylaxis in Chinese children. Methods: We conducted a retrospective study of anaphylaxis cases attending an allergy department in a tertiary children's hospital. Resu...

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Autores principales:	Nannan Jiang, MD, Wei Xu, MS, Li Xiang, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Anaphylaxis Food allergy Infancy Vaccine Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/f20cda721b974f2b80c824f6cc0da58e
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spelling	oai:doaj.org-article:f20cda721b974f2b80c824f6cc0da58e2021-11-20T05:05:22ZAge-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence1939-455110.1016/j.waojou.2021.100605https://doaj.org/article/f20cda721b974f2b80c824f6cc0da58e2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1939455121000995https://doaj.org/toc/1939-4551Background: Little is known about anaphylaxis in Chinese children. This study aimed to determine the age-specific patterns of anaphylaxis in Chinese children. Methods: We conducted a retrospective study of anaphylaxis cases attending an allergy department in a tertiary children's hospital. Results: A total of 279 anaphylactic reactions in 177 patients were analyzed. Overall, 57.6% (102/177) of first anaphylaxis events occurred in infants (0–2 ys). Foods were the most common culprits (88.5%), followed by food + exercise/exercise (4.7%), and drugs (4.3%). The main food allergens were cow's milk (32.9%), egg (21.4%), and wheat (20.7%) in infants, compared with fruits/vegetables at 35.9% in preschool-age children (3–6 ys) and 31.6% in school-age children (7–12 ys). The most commonly implicated drug triggers were vaccines (n = 5, comprising DTaP n = 2, group A + C meningococcal polysaccharide vaccine n = 1, Sabin vaccine n = 1, and not specified n = 1). Among the 5 vaccine-induced anaphylaxis patients, 4 had severe cow's milk allergy. The clinical manifestations were mainly mucocutaneous (86.0%), followed by respiratory (68.8%), gastrointestinal (23.7%), neurological (10.4%), and cardiovascular (0.7%). Compared with patients of other ages, infants had higher rates of hives (0-2ys 77.4%, 3-6ys 50%,7-12ys 57.9%, 13-17ys 38.9%, p = 0.016) and vomiting (0-2ys 20.7%, 3-6ys 1.6%,7-12ys 8.8%, p < 0.001), while wheezing was more frequent in school-age children (0-2ys 21.4%, 3-6ys 25%, 7-12ys 38.6%, 13-17ys 5.6%, p = 0.017) and abdominal pain was more common in adolescents (0-2ys 2.1%,3-6ys 15.6%, 7-12ys 14.0%, 13-17ys 72.3%, p < 0.001). Regarding treatment, 9.3% of anaphylaxis events and 24.1% of life-threatening reactions were treated with epinephrine. Conclusions: We observed age-related clinical patterns of anaphylaxis in this study, with hives and vomiting most commonly reported in infants and cardiovascular symptoms rarely reported in children. Wheat was the third most culprit food allergen after egg and milk in infancy. Education regarding more aggressive use of epinephrine in the emergency setting is clearly needed. Recognition of age-related symptoms in anaphylaxis can aid physicians in prompt diagnosis and acute management.Nannan Jiang, MDWei Xu, MSLi Xiang, MDElsevierarticleAnaphylaxisFood allergyInfancyVaccineImmunologic diseases. AllergyRC581-607ENWorld Allergy Organization Journal, Vol 14, Iss 11, Pp 100605- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anaphylaxis Food allergy Infancy Vaccine Immunologic diseases. Allergy RC581-607
spellingShingle	Anaphylaxis Food allergy Infancy Vaccine Immunologic diseases. Allergy RC581-607 Nannan Jiang, MD Wei Xu, MS Li Xiang, MD Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
description	Background: Little is known about anaphylaxis in Chinese children. This study aimed to determine the age-specific patterns of anaphylaxis in Chinese children. Methods: We conducted a retrospective study of anaphylaxis cases attending an allergy department in a tertiary children's hospital. Results: A total of 279 anaphylactic reactions in 177 patients were analyzed. Overall, 57.6% (102/177) of first anaphylaxis events occurred in infants (0–2 ys). Foods were the most common culprits (88.5%), followed by food + exercise/exercise (4.7%), and drugs (4.3%). The main food allergens were cow's milk (32.9%), egg (21.4%), and wheat (20.7%) in infants, compared with fruits/vegetables at 35.9% in preschool-age children (3–6 ys) and 31.6% in school-age children (7–12 ys). The most commonly implicated drug triggers were vaccines (n = 5, comprising DTaP n = 2, group A + C meningococcal polysaccharide vaccine n = 1, Sabin vaccine n = 1, and not specified n = 1). Among the 5 vaccine-induced anaphylaxis patients, 4 had severe cow's milk allergy. The clinical manifestations were mainly mucocutaneous (86.0%), followed by respiratory (68.8%), gastrointestinal (23.7%), neurological (10.4%), and cardiovascular (0.7%). Compared with patients of other ages, infants had higher rates of hives (0-2ys 77.4%, 3-6ys 50%,7-12ys 57.9%, 13-17ys 38.9%, p = 0.016) and vomiting (0-2ys 20.7%, 3-6ys 1.6%,7-12ys 8.8%, p < 0.001), while wheezing was more frequent in school-age children (0-2ys 21.4%, 3-6ys 25%, 7-12ys 38.6%, 13-17ys 5.6%, p = 0.017) and abdominal pain was more common in adolescents (0-2ys 2.1%,3-6ys 15.6%, 7-12ys 14.0%, 13-17ys 72.3%, p < 0.001). Regarding treatment, 9.3% of anaphylaxis events and 24.1% of life-threatening reactions were treated with epinephrine. Conclusions: We observed age-related clinical patterns of anaphylaxis in this study, with hives and vomiting most commonly reported in infants and cardiovascular symptoms rarely reported in children. Wheat was the third most culprit food allergen after egg and milk in infancy. Education regarding more aggressive use of epinephrine in the emergency setting is clearly needed. Recognition of age-related symptoms in anaphylaxis can aid physicians in prompt diagnosis and acute management.
format	article
author	Nannan Jiang, MD Wei Xu, MS Li Xiang, MD
author_facet	Nannan Jiang, MD Wei Xu, MS Li Xiang, MD
author_sort	Nannan Jiang, MD
title	Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
title_short	Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
title_full	Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
title_fullStr	Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
title_full_unstemmed	Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence
title_sort	age-related differences in characteristics of anaphylaxis in chinese children from infancy to adolescence
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/f20cda721b974f2b80c824f6cc0da58e
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Age-related differences in characteristics of anaphylaxis in Chinese children from infancy to adolescence

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