Report from AAAAI/WAO 2018: Severe Anaphylaxis in Children
This weekend, representatives from FARE are attending a joint congress of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the World Allergy Organization (WAO) in Orlando, FL. We’re reporting on selected abstracts from the meeting that address diverse topics in food allergy. Read on to learn more about featured findings about anaphylaxis.
Anaphylaxis is a severe, potentially life-threatening allergic reaction that can affect multiple organ systems. To better understand the burden of anaphylaxis on children and their families, researchers examined 1,989 anaphylaxis admissions to pediatric intensive care units (PICUs) in North America between 2010 and 2015. All of the young patients were critically ill. Researchers identified the most common anaphylaxis triggers, characterized which patients were most likely to suffer from anaphylaxis, and determined how likely a child was to die as a result.
Food was the most common specified trigger of anaphylaxis. Peanut caused about 45 percent of food-induced anaphylaxis admissions to pediatric intensive care, followed by tree nuts and seeds (19 percent) and milk (10 percent).Other common triggers included drugs, blood products and venoms. Admissions were most likely to occur during the fall and in the Northeast and Western regions of the United States.
Anaphylaxis accounted for roughly 3 of every 1,000 PICU admissions. About 1 in 5 of the anaphylaxis patients required tracheal intubation, that is, a flexible plastic tube placed down the windpipe to keep the airway open. One in every 100 pediatric patients died following admission to pediatric intensive care with anaphylaxis. Reactions to peanut and milk caused the greatest number of food-induced anaphylaxis deaths.
Compared to the overall PICU population, anaphylaxis occurred more often in children aged 6 to 18 years old. Intubation was least common in young children (2 to 5 years of age). Asian children were overrepresented among pediatric anaphylaxis patients, but the mortality rate did not vary based on any demographic factors.
“The burden of pediatric anaphylaxis was higher than what we anticipated,” reported principal investigator Carla Davis. “This means food-induced anaphylaxis should be considered a serious medical condition and aggressively prevented and treated. Physicians should identify at-risk patients and frequently review avoidance measures.”
Davis, an assistant professor of pediatrics at the Baylor College of Medicine and director of the Texas Children’s Hospital Food Allergy Program, is a member of FARE’s Clinical Advisory Board.