Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
Ann Allergy Asthma Immunol. 2024 Jul;133(1):81-85.e2. doi: 10.1016/j.anai.2024.03.008. Epub 2024 Mar 16.
Egg is the third most common food allergy in children; however, data on pediatric egg-induced anaphylaxis are sparse.
To describe the clinical characteristics, management, and outcomes of pediatric egg-induced anaphylaxis.
Children presenting with anaphylaxis were recruited from 13 emergency departments as part of the Cross-Canada Anaphylaxis Registry, from which data on anaphylaxis triggered by egg were extracted. Multivariate logistic regression was used to determine factors associated with prehospital epinephrine autoinjector (EAI) use and to compare anaphylaxis triggered by egg with other triggers of food-induced anaphylaxis (FIA).
We recruited 302 children with egg-induced anaphylaxis. The mean age was 2.6 years (SD = 3.6), and 55.3% were male. Only 39.4% had previously been diagnosed with an egg allergy. Prehospital EAI use was 32.1%, but this was not significantly lower than in other triggers of FIA (P = .26). Only 1.4% of patients required hospital admission. Relative to other triggers of FIA, patients with egg-induced anaphylaxis were significantly younger (P < .001) and exhibited more vomiting (P = .0053) and less throat tightness (P = .0015) and angioedema (P < .001).
To the best of our knowledge, this is the largest published cohort of pediatric egg-induced anaphylaxis. In this cohort, prehospital EAI use was very low. In addition, we identified certain symptoms that distinguish egg-induced from other triggers of FIA. Taken together, high suspicion is crucial in identifying egg-induced anaphylaxis, given the younger patient demographic and frequent lack of FIA history.
鸡蛋是儿童中第三大常见食物过敏物；然而，关于儿童鸡蛋诱发过敏反应的数据却很少。
描述儿科鸡蛋诱发过敏反应的临床特征、管理和结局。
从加拿大过敏反应登记处的 13 个急诊部招募出现过敏反应的儿童，从中提取鸡蛋诱发过敏反应的数据。采用多变量逻辑回归来确定与院前肾上腺素自动注射器（EAI）使用相关的因素，并比较鸡蛋诱发过敏反应与其他食物诱发过敏反应（FIA）的诱因。
我们招募了 302 例鸡蛋诱发过敏反应的儿童。平均年龄为 2.6 岁（标准差=3.6），55.3%为男性。仅有 39.4%的患儿此前被诊断为鸡蛋过敏。院前 EAI 使用比例为 32.1%，但与其他 FIA 诱因相比，这一比例并无显著降低（P=.26）。仅 1.4%的患者需要住院治疗。与其他 FIA 诱因相比，鸡蛋诱发过敏反应的患儿显著更年轻（P<.001），且呕吐更多（P=.0053），咽喉紧绷（P=.0015）和血管性水肿（P<.001）更少。
据我们所知，这是发表的最大型儿科鸡蛋诱发过敏反应队列研究。在该队列中，院前 EAI 使用非常低。此外，我们发现了一些可区分鸡蛋诱发与其他 FIA 诱因的症状。综合来看，鉴于患者年龄更小且常无 FIA 病史，高度怀疑对识别鸡蛋诱发过敏反应至关重要。
