Jiang Nannan, Xu Wei, Huang Huijie, Hou Xiaoling, Xiang Li
Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health; Key Laboratory of Major Diseases in Children, Ministry of Education; National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.
J Asthma Allergy. 2022 May 16;15:633-643. doi: 10.2147/JAA.S363113. eCollection 2022.
Pollen sensitization is increasing in children. However, there is little evidence regarding the characteristics of anaphylaxis in individuals with pollen sensitization.
We conducted a retrospective study of patients with anaphylaxis combined with pollen sensitization who attended an allergy department in a tertiary children's hospital from 2014 to 2021.
A total of 157 anaphylaxis events in 108 patients were analyzed; the mean age at the reaction was 5.8 ± 4.17 years. A total of 99.1% (107/108) of the patients came from northern China. The most common sensitizing pollen was mugwort (93.5%,101/108), followed by ragweed (68.5%, 74/108) and birch (40.7%, 44/108). A total of 76.9% (83/108) of the patients showed polysensitization to pollen. Allergic rhinitis/conjunctivitis was the most common comorbidity (87.0%, 94/108). Children with severe anaphylaxis were more likely to have a history of recurrent urticaria (16.1% vs 3.9%, p = 0.028). The most frequently implicated foods were fruits/vegetables (22.3%, 35/157), followed by wheat (8.9%, 14/157) and milk (8.3%, 13/157), and the most common fruit allergen was peach (n = 7). Of 14% (22/157) exercise-induced reactions, 63.6% (14/22) occurred in pollen season. Skin symptoms were the most frequent (86.0%, 135/157) symptoms, followed by respiratory (73.9%, 116/157) and gastrointestinal (21%, 33/157) symptoms. Regarding acute management, only 7.4% of the patients were treated with epinephrine.
Our findings revealed the characteristics of anaphylaxis in children with pollen sensitization. Fruits/vegetables accounted for a substantial percentage of anaphylaxis triggers. The suboptimal use of epinephrine highlights the need for educational programs promoting the use of epinephrine.
儿童花粉致敏情况日益增多。然而，关于花粉致敏个体过敏反应特征的证据较少。
我们对2014年至2021年在一家三级儿童医院过敏科就诊的合并花粉致敏的过敏反应患者进行了一项回顾性研究。
共分析了108例患者的157次过敏反应事件；反应时的平均年龄为5.8±4.17岁。共有99.1%（107/108）的患者来自中国北方。最常见的致敏花粉是艾蒿（93.5%，101/108），其次是豚草（68.5%，74/108）和桦树（40.7%，44/108）。共有76.9%（83/108）的患者对花粉呈现多敏状态。变应性鼻炎/结膜炎是最常见的合并症（87.0%，94/108）。重度过敏反应患儿更易有慢性荨麻疹病史（16.1%对3.9%，p=0.028）。最常涉及的食物是水果/蔬菜（22.3%，35/157），其次是小麦（8.9%，14/157）和牛奶（8.3%，13/157），最常见的水果过敏原是桃子（n=7）。在14%（22/157）的运动诱发反应中，63.6%（14/22）发生在花粉季节。皮肤症状是最常见的症状（86.0%，135/157），其次是呼吸道症状（73.9%，116/157）和胃肠道症状（21%，33/157）。关于急性处理，仅7.4%的患者接受了肾上腺素治疗。
我们的研究结果揭示了花粉致敏儿童过敏反应的特征。水果/蔬菜在过敏反应诱因中占相当比例。肾上腺素使用不足凸显了开展促进肾上腺素使用的教育项目的必要性。
