Pouessel Guillaume, Egea Claire, Divaret-Chauveau Amandine, Beaumont Pascale, Bradatan Eléna, Dumond Pascale, Diesnis Rémy, Tscheiller Sélina, Van der Brempt Xavier, Braun Camille, Sabouraud-Leclerc Dominique
CH Roubaix, Department of Paediatrics, Children's Hospital, Roubaix, France.
CHU Lille, Paediatric Pulmonology and Allergy Department, Pôle Enfant, Hôpital Jeanne de Flandre, Lille, France.
Clin Exp Allergy. 2025 Jul;55(7):532-540. doi: 10.1111/cea.70089. Epub 2025 May 29.
Gaining a better understanding of the risk factors for severe anaphylaxis represents a crucial challenge for physicians. This survey aimed to analyse cases of severe food anaphylaxis and assess potential risk factors for severity.
We retrospectively analysed food anaphylaxis cases recorded by the French-speaking Allergy-Vigilance Network (2002-2021) and compared the main characteristics of grade 3 (Ring classification) and grade 4 cases using univariate and multivariate statistical analyses.
Of the 2621 food anaphylaxis cases reported, 731 (27.9%) were considered severe (grade 3, n = 687 [94%] and grade 4, n = 44 [6%]; 19 deaths). Overall, 56.1% of cases were adults (mean age: 28.3 years) and 53.7% were male. The most frequent triggers were peanut (13.9%), wheat (9.4%), cashew (5.8%), shrimp (5.3%), and cow's milk (4.6%). More grade 4 anaphylaxis cases occurred in children than in adults (26 vs. 18; p = 0.01). In univariate analysis, individuals with grade 4 anaphylaxis were more likely to have a history of allergy to the culprit food (71.1% vs. 42.1%; p < 0.001), asthma diagnosis (59.5% vs. 30.4%; p < 0.001), and peanut as the culprit food (34.1% vs. 12.6%; p < 0.001). In multivariate analysis, factors predictive of grade 4 anaphylaxis were asthma diagnosis (OR [95% CI]: 3.41 [1.56-7.44]; p = 0.002) and peanut as the culprit trigger (OR [95% CI]: 3.46 [1.28-9.34]; p = 0.014).
Our data highlight the risk factors for severe food anaphylaxis, notably a history of asthma and peanut as the culprit food. These individuals should benefit from personalised management strategies.
更好地了解严重过敏反应的风险因素是医生面临的一项关键挑战。本调查旨在分析严重食物过敏反应病例，并评估严重程度的潜在风险因素。
我们回顾性分析了法语过敏警戒网络（2002 - 2021年）记录的食物过敏反应病例，并使用单变量和多变量统计分析比较了3级（林氏分类）和4级病例的主要特征。
在报告的2621例食物过敏反应病例中，731例（27.9%）被认为是严重的（3级，n = 687例[94%]，4级，n = 44例[6%]；19例死亡）。总体而言，56.1%的病例为成年人（平均年龄：28.3岁），53.7%为男性。最常见的诱发因素是花生（13.9%）、小麦（9.4%）、腰果（5.8%）、虾（5.3%）和牛奶（4.6%）。4级过敏反应病例在儿童中比在成年人中更常见（26例对18例；p = 0.01）。在单变量分析中，4级过敏反应患者更有可能有对致病食物过敏的病史（71.1%对42.1%；p < 0.001）、哮喘诊断（59.5%对30.4%；p < 0.001）以及致病食物为花生（34.1%对12.6%；p < 0.001）。在多变量分析中，4级过敏反应的预测因素是哮喘诊断（OR[95%CI]：3.41[1.56 - 7.44]；p = 0.002）和致病诱因是花生（OR[95%CI]：3.46[1.28 - 9.34]；p = 0.014）。
我们的数据突出了严重食物过敏反应的风险因素，特别是哮喘病史和致病食物为花生。这些个体应受益于个性化的管理策略。
