Anaphylaxis in children

Farbman, Karen S.; Michelson, Kenneth A.

doi:10.1097/mop.0000000000000340

Cited by 18 publications

(7 citation statements)

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“…The 2010 National Institute of Allergy, Immunology, and Infectious Diseases (NIAID) guidelines reported a lack of evidence for using glucocorticoids and antihistamines as routine medications for anaphylaxis [24]. However, in the clinical setting, glucocorticoids and antihistamines are frequently administered [25]. The effects of glucocorticoids are wellestablished for asthma or airway edema [26].…”

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confidence: 99%

“…A recent study showed a reduced risk of prolonged hospitalization in pediatric anaphylaxis cases who received glucocorticoids [27]. While histamine 1 (H 1 ) blockers such as diphenhydramine can reduce urticaria, they do not alter the underlying pathophysiology of anaphylaxis [25]. Therefore, the administration of antihistamines as adjuvant treatment has been shown to be reasonable in providing improved comfort, especially for patients with urticaria or angioedema [25].…”

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confidence: 99%

“…While histamine 1 (H 1 ) blockers such as diphenhydramine can reduce urticaria, they do not alter the underlying pathophysiology of anaphylaxis [25]. Therefore, the administration of antihistamines as adjuvant treatment has been shown to be reasonable in providing improved comfort, especially for patients with urticaria or angioedema [25]. In addition, there are no previous studies examining the efficacy of histamine 2 (H 2 ) blockers for anaphylaxis [28], and the effect of such use is not clear [29].…”

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Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea

Lee

Jung

et al. 2020

BioMed Research International

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Anaphylaxis is a serious life-threatening allergic disease in children. This study is aimed at determining the characteristics of pediatric patients who experienced anaphylaxis along with treatments administered in order to determine the usefulness of tryptase level assessment as a marker of anaphylaxis in Korean children. A total of 107 patients who were diagnosed with anaphylaxis in a single pediatric emergency center over a 3-year period were included in the study. Patient clinical characteristics, symptoms, signs, allergy history, trigger factors, treatments, and laboratory findings, including serum tryptase levels, were included in the analysis. Food allergies (39.3%) were the most commonly reported patient allergic history, and 58 patients (54.2%) were triggered by food. Among this group, nuts and milk exposure were the most common, affecting 15 patients (25.9%). History of anaphylaxis and asthma were more common in severe anaphylaxis compared to mild or moderate anaphylaxis cases. Epinephrine intramuscular injection was administrated to 76 patients (71.0%), and a self-injectable epinephrine was prescribed to 18 patients (16.8%). The median tryptase level was 4.80 ng/mL (range: 2.70–10.40) which was lower than the 11.4 ng/mL value commonly documented for standard evaluation in adults with anaphylaxis. The most common cause of pediatric anaphylaxis was food including nuts and milk. The rate of epinephrine injection was relatively high in our pediatric emergency department. The median tryptase level associated with anaphylaxis reactions in children was lower than 11.4 ng/mL. Further studies are needed to help improve diagnostic times and treatment accuracy in pediatric patients who develop anaphylaxis.

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Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea

Lee

Jung

et al. 2020

BioMed Research International

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“…Repeat dosing may be necessary as frequently as every 5 minutes. 15 It should be noted that adjunctive therapies such as glucocorticoids and histamine 2 receptor antagonist (H2RA) are unable to stop anaphylactic reactions. At most, these medications are considered supportive.…”

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confidence: 99%

Peanut (Arachis hypogaea) Allergen Powder-dnfp: The First FDA-approved Oral Immunotherapy for Desensitization of Peanut Allergy in Children

Smith¹,

Hilas²

2021

The Journal of Pediatric Pharmacology and Therapeutics

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Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia, Aimmune™ Therapeutics, Inc.; Brisbane, CA) is the first FDA-approved oral immunotherapy indicated for the mitigation of allergic reactions, including anaphylaxis, in patients with peanut allergy. It may be initiated in individuals 4 to 17 years of age and continued for maintenance in those 4 years of age and older. Initiation and dose titration require a stepwise approach and the supervision of a health care professional. Patients taking Peanut (Arachis hypogaea) Allergen Powder-dnfp should also follow a peanut-avoidant diet. In addition, patients should have an injectable epinephrine product in case of drug-related anaphylaxis. Commonly reported adverse reactions include gastrointestinal, respiratory, and dermatologic manifestations that are frequently associated with allergic reactions.

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“…Based on several studies, the estimated prevalence of anaphylaxis is 0.3-5.1% and the estimated incidence is between 50-112 episodes per 100.000 personyears (6). The mechanism involves the release of mediators from certain types of white blood cells triggered by other immunologic or non-immunologic mechanisms (7).…”

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confidence: 99%

Risk factors, clinical symptoms, diagnostic methods, management and treatment of patients with anaphylaxis in Tehran

Mohsenzadeh

Sohrabi

Movahedi

et al. 2021

Preprint

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Introduction: Recent studies have evaluated the risk factors, clinical symptoms, diagnostic methods, management and treatment of anaphylaxis in different populations, but the results of various studies are contradictory. The aim of this study was to evaluate the risk factors, clinical symptoms, diagnostic methods, management and treatment of anaphylactic patients referred to the Children's Medical Center of Tehran during the years 2015-2016.Materials and Methods: In this cross-sectional study, 30 patients with anaphylaxis were studied. The study population included all patients who had been diagnosed with anaphylaxis without age limitation and during the period from 2015 to 2016 to undergo serum beta-tryptase examination were referred to the laboratory of the Children's Medical Center of Tehran. The sampling method was census-based and the information was collected through a pre-designed questionnaire by examining patient files or telephone contacts with patients. After collecting data, the data were entered into SPSS 22 software and analyzed statistically. Finally, P<0.05 was considered statistically significant.Results: In our study, we investigated 30 patients with anaphylaxis, an average age of 25±15 years (range 2 to 60 years) among which 13 (43%) were men and 17 (57%) women.The most important cause of anaphylaxis in the studied patients was foods (57%), followed by drugs (20%), unknown (20%) and pollen plants (3%). About 33.7% of patients had allergies to specific allergens. The most routes of exposure with allergens were, oral (56.3%), intravenous (18.7%), unknown (12.6%) and cutaneous (3.1%), respectively. 33.6% of them had positive skin tests. The most common symptoms of anaphylaxis in order of frequency were respiratory (72.9%), cutaneous (48.8%), cardiovascular (18.6%) and gastrointestinal symptoms (6%). Eighty percent of anaphylaxis occurred at home. The most commonly prescribed medications were corticosteroids (83.3%), antihistamine (76%), epinephrine (60%) and beta-agonists (3%). Only 30% of the patients had access to Epipen.Conclusion: According to the results of this study, since most anaphylactic reactions occur in the home and more than one-third of patients had allergic to certain allergens and two-thirds of patients had a history of anaphylaxis, it seems that by providing the necessary training and knowledge to individuals with regard to allergenic substances or allergenic drugs, as well as increased access for patients to Epipen, we can prevent the occurrence and risk of subsequent anaphylaxis in these people.

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Anaphylaxis in children

Abstract: Purpose of review-Anaphylaxis is a serious allergic reaction that can be life threatening. We will review the most recent evidence regarding the diagnosis, treatment, monitoring, and prevention of anaphylaxis in children.

Cited by 18 publications

References 34 publications

Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea

Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea

Peanut (Arachis hypogaea) Allergen Powder-dnfp: The First FDA-approved Oral Immunotherapy for Desensitization of Peanut Allergy in Children

Risk factors, clinical symptoms, diagnostic methods, management and treatment of patients with anaphylaxis in Tehran

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