Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

Abstract

There are wide differences in estimated incidence and prevalence of anaphylaxis because of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. We aimed to estimate the incidence of food anaphylaxis based on the database of Piemonte Region (Italy) Reference Center for Severe Allergic Reactions. All cases of severe food allergic reactions reported in 2010 were studied. Clinical data associated to the reports were evaluated according to National Institute of Allergy and Infectious Disease and Food Allergy and Anaphylaxis Network diagnostic criteria of anaphylaxis. 75 % of the 778 cases were classified as food anaphylaxis (incidence of 13/100,000 personyears, ranging from 9.9 in adults to 29/100,000 person-years in children). Nuts were the most frequent foods causing anaphylaxis. Milk and eggs were responsible for anaphylaxis more often in children, while peach, vegetables and crustaceans were in adults. Cardiovascular symptoms were more frequent in adults. Gastrointestinal involvement was more frequent in children. A high prevalence of respiratory allergic comorbidities was observed. Food is an important cause of anaphylaxis, particularly in subjects with respiratory allergic comorbidities. Children and adults differ in triggers and clinical presentation of anaphylaxis.Keywords: Anaphylaxis, Food allergy, Epidemiology, Allergy Introduction Population-based studies estimate the incidence of anaphylaxis in western countries to be in the range of 4-50 per 100,000 person-years [1, 2], with a true lifetime prevalence in the range of 0.05-2 % [3]. Foods are reported to be the most important trigger of anaphylaxis, being responsible for 33.2-56 % of all anaphylaxis cases [4]. The other two principal triggers of anaphylaxis are insect stings and drugs [1,5]. The relative contribution of each of these triggers to anaphylaxis may differ according to the study design, study population, or geographic area. The wide differences in the estimated incidences and prevalences of anaphylaxis are the direct result of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. For this reason in 2005 the National Institute of Allergy and Infectious Disease (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) developed a very useful preliminary definition, based on diagnostic criteria [6]. The symposium defined anaphylaxis as: "a serious allergic reaction that is rapid in onset and may cause death". Clinically, involvement of at least two organs (skin or mucosal tissue, cardiovascular apparatus, breathing apparatus, gastrointestinal tract) is required, or a sudden reduced blood pressure along with a temporal relationship (generally minutes) to a potential causative agent. A problematic issue with this definition, which may explain the under-reporting or misreporting of anaphylaxis cases, is the failure to agree among health care providers on the severity threshold for classi...

Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes

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“…The proportion of anaphylaxis induced by fruits and vegetables has been reported to vary from 9% to 20%. 5 6 20 25 …”

“…This pattern is different from other countries and regions. The most common food allergen in children from the US, 25 Canada, 4 and European countries 9 20 is peanut. In adult population in the U.S. 5 and Hong Kong, 11 shellfish is the most common food trigger.…”

“…In adult population in the U.S. 5 and Hong Kong, 11 shellfish is the most common food trigger. An Italian group 20 found that fruits and vegetables are the most common food allergen causing anaphylaxis in adults. Differences in food allergens are related not only to local diets, environment, and genetic factors, but also to differences in patient source and study methods.…”

Anaphylaxis in pediatric population: A 1-year survey on the Medical Emergency Service in Liguria, Italy

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