Allergy Unit, Meyer Children's Hospital IRCCS, Florence, 50139, Italy.
Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS Catholic University of the Sacred Heart, Rome, Italy.
Ital J Pediatr. 2024 Mar 5;50(1):40. doi: 10.1186/s13052-024-01608-x.
Anaphylaxis is a life-threatening reaction characterized by the acute onset of symptoms involving different organ systems and requiring immediate medical intervention. The incidence of fatal food anaphylaxis is 0.03 to 0.3 million/people/year. Most fatal food-induced anaphylaxis occurs in the second and third decades of life. The identified risk factors include the delayed use of epinephrine, the presence of asthma, the use of recreational drugs (alcohol, nicotine, cannabis, etc.), and an upright position. In the United Kingdom (UK) and Canada, the reported leading causal foods are peanuts and tree nuts. In Italy, milk seems to be the most common cause of fatal anaphylaxis in children < 18 years. Fatal food anaphylaxis in Italian children and adolescents almost always occurs outside and is characterized by cardiorespiratory arrest; auto-injectable adrenaline intramuscular was available in few cases. Mortality from food anaphylaxis, especially in children, is a very rare event with stable incidence, but its risk deeply impacts the quality of life of patients with food allergy and their families. Prevention of fatal food anaphylaxis must involve patients and their families, as well as the general public, public authorities, and patients' associations.
过敏反应是一种危及生命的反应，其特征为症状突然发作，涉及不同的器官系统，并需要立即进行医疗干预。致命性食物过敏反应的发病率为 0.03 至 0.3/百万人/年。大多数致命性食物诱发的过敏反应发生在生命的第二和第三个十年。已确定的危险因素包括肾上腺素延迟使用、哮喘存在、使用娱乐性药物（酒精、尼古丁、大麻等）和直立姿势。在英国和加拿大，报告的主要致病食物是花生和树坚果。在意大利，牛奶似乎是 18 岁以下儿童致命性过敏反应的最常见原因。意大利儿童和青少年的致命性食物过敏反应几乎总是发生在户外，表现为心肺骤停；在少数情况下可使用肌肉内自动注射肾上腺素。食物过敏反应导致的死亡，尤其是在儿童中，是一种非常罕见的事件，发病率稳定，但它的风险深深影响了食物过敏患者及其家庭的生活质量。预防致命性食物过敏反应必须涉及患者及其家属，以及公众、公共当局和患者协会。
