Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry.

Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition. © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

Citation

Ioana Maris, Sabine Dölle-Bierke, Jean-Marie Renaudin, Lars Lange, Alice Koehli, Thomas Spindler, Jonathan Hourihane, Kathrin Scherer, Katja Nemat, C Kemen, Irena Neustädter, Christian Vogelberg, Thomas Reese, Ismail Yildiz, Zsolt Szepfalusi, Hagen Ott, Helen Straube, Nikolaos G Papadopoulos, Susanne Hämmerling, Ute Staden, Michael Polz, Tihomir Mustakov, Ewa Cichocka-Jarosz, Renata Cocco, Alessandro Giovanni Fiocchi, Montserrat Fernandez-Rivas, Margitta Worm, Network for Online Registration of Anaphylaxis (NORA). Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry. Allergy. 2021 May;76(5):1517-1527

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PMID: 33274436

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