Global patterns in anaphylaxis due to specific foods: A systematic review

Conrado, Alessia Baseggio; Patel, Nandinee; Turner, Paul J.

doi:10.1016/j.jaci.2021.03.048

Cited by 58 publications

(49 citation statements)

References 84 publications

(103 reference statements)

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“… 66 , 67 In reality, there are different phenotypes and children with persisting cow’s milk allergy may be more at risk of severe reactions: indeed, cow’s milk is the single most common cause of fatal anaphylaxis in children in the United Kingdom 68 and a common cause of fatal and near-fatal reactions elsewhere. 21 …”

Section: Cow’s Milkmentioning

confidence: 99%

“…Data suggest that egg tends to cause less anaphylaxis (lower respiratory symptoms) and more gastrointestinal symptoms compared with other allergens. 83 There are only 2 fatalities to egg reported in the literature, 21 , 68 , 84 despite egg being one of the most common food allergens in preschool children.…”

Section: Hen’s Eggmentioning

confidence: 99%

“…IgE-mediated wheat allergy is a relatively uncommon food allergy with a prevalence of under 0.5% in both children and adults 21 ; celiac disease and non–IgE-mediated wheat allergy are more common. However, near-fatal and fatal anaphylaxis have been reported.…”

Section: Wheatmentioning

confidence: 99%

“…However, near-fatal and fatal anaphylaxis have been reported. 21 , 85 , 86 Furthermore, wheat anaphylaxis may be more associated with anaphylactic shock (involving cardiovascular compromise) than other food allergens. 85 Ten studies were identified, representing 348 positive FCs (at least 90% in children) ( Table E7 , available in this article’s Online Repository at www.jaci-inpractice.org ).…”

Section: Wheatmentioning

confidence: 99%

“… 20 Although fatal reactions can theoretically occur to any allergen, the vast majority of fatal reactions reported in the literature are due to peanut, tree nuts, seafood, and cow’s milk. 21 Furthermore, such severe reactions are usually due to the consumption of nonprepacked foods (foods from restaurants, bakeries, takeaway or fast-food outlets, etc.) 20 , 22 ; these foods are unlikely to have had a PAL statement in the same way as is the case with prepacked foods.…”

mentioning

confidence: 99%

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Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Turner

Patel

Ballmer‐Weber

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed “reference doses,” below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure.

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Section: Cow’s Milkmentioning

confidence: 99%

Section: Hen’s Eggmentioning

confidence: 99%

Section: Wheatmentioning

confidence: 99%

Section: Wheatmentioning

confidence: 99%

mentioning

confidence: 99%

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Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Turner

Patel

Ballmer‐Weber

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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Management of Food Allergies and Food-Related Anaphylaxis

Iglesia,

Kwan,

Virkud

et al. 2024

JAMA

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ImportanceAn estimated 7.6% of children and 10.8% of adults have IgE-mediated food-protein allergies in the US. IgE-mediated food allergies may cause anaphylaxis and death. A delayed, IgE-mediated allergic response to the food-carbohydrate galactose-α-1,3-galactose (alpha-gal) in mammalian meat affects an estimated 96 000 to 450 000 individuals in the US and is currently a leading cause of food-related anaphylaxis in adults.ObservationsIn the US, 9 foods account for more than 90% of IgE-mediated food allergies—crustacean shellfish, dairy, peanut, tree nuts, fin fish, egg, wheat, soy, and sesame. Peanut is the leading food-related cause of fatal and near-fatal anaphylaxis in the US, followed by tree nuts and shellfish. The fatality rate from anaphylaxis due to food in the US is estimated to be 0.04 per million per year. Alpha-gal syndrome, which is associated with tick bites, is a rising cause of IgE-mediated food anaphylaxis. The seroprevalence of sensitization to alpha-gal ranges from 20% to 31% in the southeastern US. Self-injectable epinephrine is the first-line treatment for food-related anaphylaxis. The cornerstone of IgE-food allergy management is avoidance of the culprit food allergen. There are emerging immunotherapies to desensitize to one or more foods, with one current US Food and Drug Administration–approved oral immunotherapy product for treatment of peanut allergy.Conclusions and RelevanceIgE-mediated food allergies, including delayed IgE-mediated allergic responses to red meat in alpha-gal syndrome, are common in the US, and may cause anaphylaxis and rarely, death. IgE-mediated anaphylaxis to food requires prompt treatment with epinephrine injection. Both food-protein allergy and alpha-gal syndrome management require avoiding allergenic foods, whereas alpha-gal syndrome also requires avoiding tick bites.

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Platelet‐activating factor as an endogenous cofactor of food anaphylaxis

Pałgan,

Tretyn

2023

BioFactors

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Anaphylaxis is a severe, acute, life‐threatening generalized or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing worldwide, with medications and food contributing to most cases. Physical exercise, acute infections, drugs, alcohol, and menstruation are the external cofactors associated with more severe systemic reaction. The aim of this review is to show that platelet‐activating factor contributes to the development of severe anaphylactic reaction, and even to anaphylactic shock.

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Global patterns in anaphylaxis due to specific foods: A systematic review

Cited by 58 publications

References 84 publications

Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Management of Food Allergies and Food-Related Anaphylaxis

Platelet‐activating factor as an endogenous cofactor of food anaphylaxis

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