Association Between Allergen Sensitization and Anaphylaxis in Patients Visiting a Pediatric Emergency Department

• Published in: Frontiers in pediatrics Vol. 9; p. 651375
• Main Authors: Lee, Won Seok, Cha, Lily Myung-Jin, Han, Man Yong, Lee, Kyung Suk
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 08.06.2021
• Subjects: allergen; anaphylaxis; children; emergency department; Pediatrics; sensitization
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2021.651375

Background and Objectives: Anaphylaxis, a severe allergic disease, can be triggered by various causes. This study investigated the association between allergic sensitization and anaphylactic symptoms and the severity of anaphylaxis in children. Patients and Methods: A retrospective review of 107 pediatric patients with anaphylaxis was performed between January 1, 2015, and December 31, 2017; 74 patients underwent allergen testing for specific immunoglobulin E. Allergic sensitizations and associations with anaphylactic symptoms and severity were investigated. Results: Overall, 64 (86.5%) patients were sensitized to food or inhalant allergens. In children under 2 years of age, 90.5% were sensitized to food ( P = 0.001); in those over 6 years of age, 84.6% were sensitized to inhalant allergens ( P = 0.001). Milk sensitization was significantly associated with severe anaphylaxis ( P = 0.036). The following symptoms showed significant associations with certain allergen sensitizations: facial edema with food; wheezing with milk; dyspnea with mite, etc. Certain allergen sensitizations presenting as risk factors for anaphylactic symptoms: wheat (adjusted odds ratio [aOR] = 4.644, P = 0.044) and nuts (aOR=3.614, P = 0.041) for wheezing, nuts (aOR=5.201, P = 0.026) for dyspnea, and milk (aOR=4.712, P = 0.048) for vomiting. Conclusion: The allergen sensitization status differed according to the age of the children experiencing anaphylaxis. The severity, symptoms, and signs of anaphylaxis differed depending on the allergen sensitization status.