Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Pediatr Allergy Immunol. 2020 Nov;31(8):954-961. doi: 10.1111/pai.13320. Epub 2020 Aug 6.
The literature includes scarce data on infants with food-induced anaphylaxis (FIA).
Medical records of the patients diagnosed with FIA aged 0-6 years between 2015 and 2020 were retrospectively analyzed.
During the study period, there were 451 instances of FIA in 314 patients, of which 175 (38.8%) occurred in 160 infants (50.9%). The median (IQR) age of infants was 7 months (6-9 months) with a male predominance (67.5%), of which 7.5% had multiple instances (≥2) and 60% atopic dermatitis. The most common triggers were cow's milk (51.4%), tree nuts (16.6%), and hen's egg (15.4%), whereas tree nut was the most common trigger in toddlers (35.8%) and preschool children (35.2%). Skin and neurologic symptoms, and nausea-vomiting occurred more frequently (P = .003, P ≤ .001, and P = .003, respectively), whereas respiratory symptoms occurred less commonly in infants compared to toddlers and preschool children (P ≤ .001). In infants, 65 (37.1%) mild, 92 (52.6 %) moderate, and 18 (10.3%) severe episodes of anaphylaxis were detected. History of recurrent wheezing (OR: 6.837 [95% CI: 1.940-24.097], P = .003) and tree nut allergy (OR: 2.849 [95% CI: 1.056-7.688], P = .039) were found to be independent risk factors for moderate-to-severe anaphylactic reactions. 40.6% of the infants received adrenaline, which was lower than the toddlers (49.7%) and preschool children (57.6%) (P = .005).
There is no doubt that food-induced anaphylaxis is a medical emergency, specifically in young children. Pediatricians should be aware of the distinct features of infant anaphylaxis, particularly gastrointestinal and neurologic symptoms to provide effective treatment as soon as possible.
文献中关于食物诱发过敏反应（FIA）的婴儿数据较少。
回顾性分析了 2015 年至 2020 年间诊断为 FIA 的 0-6 岁患者的病历。
研究期间，314 例患者中有 451 例 FIA，其中 175 例（38.8%）发生在 160 例婴儿（50.9%）中。婴儿的中位（IQR）年龄为 7 个月（6-9 个月），男性居多（67.5%），其中 7.5%有多次发作（≥2 次），60%患有特应性皮炎。最常见的触发因素是牛奶（51.4%）、坚果（16.6%）和鸡蛋（15.4%），而树坚果是幼儿（35.8%）和学龄前儿童（35.2%）中最常见的触发因素。皮肤和神经系统症状以及恶心呕吐更为常见（P=0.003、P≤0.001 和 P=0.003），而与幼儿和学龄前儿童相比，呼吸道症状较少（P≤0.001）。在婴儿中，65 例（37.1%）为轻度，92 例（52.6%）为中度，18 例（10.3%）为重度过敏反应。反复喘息史（OR：6.837[95%CI：1.940-24.097]，P=0.003）和坚果过敏史（OR：2.849[95%CI：1.056-7.688]，P=0.039）被发现是中重度过敏反应的独立危险因素。40.6%的婴儿接受了肾上腺素治疗，低于幼儿（49.7%）和学龄前儿童（57.6%）（P=0.005）。
毋庸置疑，食物诱发过敏反应是一种医疗急症，特别是在幼儿中。儿科医生应了解婴儿过敏反应的独特特征，特别是胃肠道和神经系统症状，以便尽快提供有效治疗。
