Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland.
Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Allergy. 2021 May;76(5):1517-1527. doi: 10.1111/all.14683. Epub 2021 Jan 3.
Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents.
Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre.
3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004).
The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.
花生过敏在高收入国家的发病率不断上升，影响 0.5%-1.4%的儿童。本研究旨在更好地了解与其他食物过敏原引发的过敏反应相比，欧洲儿童和青少年中花生过敏反应的情况。
本研究通过在线问卷调查，从欧洲过敏反应登记处获取数据，该问卷调查是在一家三级儿科过敏中心对食物诱发过敏反应病例进行深入审查后进行的。
2007 年 7 月至 2018 年 3 月期间报告了 3514 例食物过敏反应病例，其中 56%发生在 18 岁以下的患者中。在 459 例儿童和青少年（所有花生过敏反应病例的 85%）中记录了花生过敏反应。先前的反应（42%比 38%；p=0.001）、哮喘合并症（47%比 35%；p<0.001）、相关伴随因素（29%比 22%；p=0.004）和双相反应（10%比 4%；p=0.001）在花生过敏反应中更为常见。大多数病例被标记为严重过敏反应（Ring&Messmer 分级 III 65%比 56%和 IV 1.1%比 0.9%；p=0.001）。肌内注射肾上腺素的自我管理率较低（17%比 15%），非花生食物过敏反应中专业肾上腺素管理的比例较高（34%比 26%；p=0.003）。花生过敏反应的住院率较高（67%比 54%；p=0.004）。
欧洲过敏反应登记处的数据证实，花生是欧洲儿童严重、潜在危及生命的过敏反应的主要原因之一，具有一些特征性特征，例如存在哮喘合并症和双相反应发生率增加。作为一线治疗的肌内注射肾上腺素的使用率较低，需要加以改进。该登记处旨在成为最大的过敏反应数据库，可对该病症进行持续评估。
