Food-induced anaphylaxis in early childhood and factors associated with its severity

Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6‐18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

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Phenotypes and natural history of food protein‐induced enterocolitis syndrome in the east Mediterranean region

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200078 ◽

2020 ◽

Vol 41 (6) ◽

pp. 420-427 ◽

Cited By ~ 1

Author(s):

Melike Ocak ◽

Ayşegül Akarsu ◽

Umit Murat Sahiner ◽

Ozge Soyer ◽

Bulent Enis Sekerel

Keyword(s):

Clinical Symptoms ◽

Emergency Department Visits ◽

Interquartile Range ◽

Cow’S Milk ◽

Food Protein ◽

Cow's Milk ◽

Hen’S Egg ◽

History Of ◽

Ige Mediated ◽

East Mediterranean Region

Background: Food protein‐induced enterocolitis syndrome (FPIES) is a rare non-IgE mediated food allergy. Objective: To delineate the differences in the spectrum of culprit foods, remission patterns, and predictors among varying cultures. Methods: We reviewed demographics, culprit foods, outcomes, and predictors in 81 children with a diagnosis of FPIES who were followed up between 2015 and 2020. Results: Eighty-one patients (55.6% boys) were enrolled, including 72 with acute FPIES and 9 with chronic FPIES. Hen’s egg was the most common culprit food (36.6%), followed by fish (26.9%), and cow’s milk (21.5%). Interestingly, cow’s milk was significantly prevalent in chronic FPIES cases (p = 0.006). The most common clinical symptoms were vomiting (100%), pallor (63.4%), and lethargy (55.9%). Emergency department visits were noted in 39 patients (41.9%), of whom 37 (39.8%) were treated with intravenous (IV) fluid. The subjects were followed up for a median (interquartile range) of 19.4 months (12.3‐41.2 months), and 26 subjects (32.1%) achieved tolerance. The median (interquartile range) age at tolerance was 2.5 years (2.1‐3.2 years). With regard to the culprit foods, hen’s egg was observed more frequently in the subjects with resolved FPIES cases (p = 0.008), whereas fish FPIES cases were high in the persistent group (p = 0.001). IgE sensitization of the culprit food was found to be an independent risk factor for the persistence of FPIES (odds ratio 4.855 [95% confidence interval, 1.131‐20.844]; p = 0.034). Conclusion: In our cohort, unlike other published series, hen’s egg and fish were the two most common culprit foods. Fish differed from other culprit foods, with significantly delayed onset and persistence, and may create a model that allows for the understanding of the disease.

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The Relationship Between Cow's Milk and Stores of Vitamin D and Iron in Early Childhood

PEDIATRICS ◽

10.1542/peds.2012-1793d ◽

2012 ◽

Vol 131 (1) ◽

pp. X29-X29

Keyword(s):

Vitamin D ◽

Early Childhood ◽

Cow’S Milk ◽

Cow's Milk ◽

The Relationship

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Performance of a Component-Based Allergen-Microarray in the Diagnosis of Cow's Milk and Hen's Egg Allergy

PEDIATRICS ◽

10.1542/peds.2011-2107bb ◽

2011 ◽

Vol 128 (Supplement 3) ◽

pp. S109.1-S109

Author(s):

Edwin Kim ◽

A. Wesley Burks

Keyword(s):

Cow’S Milk ◽

Egg Allergy ◽

Cow's Milk ◽

Hen’S Egg ◽

Allergen Microarray

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Natural history of immunoglobulin E-mediated cow’s milk allergy in a population of Argentine children

Archivos Argentinos de Pediatria ◽

10.5546/aap.2017.eng.331 ◽

2017 ◽

Vol 115 (04) ◽

Keyword(s):

Natural History ◽

Immunoglobulin E ◽

Cow’S Milk Allergy ◽

Cow’S Milk ◽

Milk Allergy ◽

Cow's Milk ◽

Cow's Milk Allergy ◽

History Of

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Risk factors associated with early childhood caries – a case control study

Revista Odonto Ciência ◽

10.15448/198-6523.2016.2.21496 ◽

2016 ◽

Vol 31 (2) ◽

pp. 83

Author(s):

Marina De Deus Moura Lima ◽

Zacarias Soares Brito-Neto ◽

Heylane Oliveira Amaral ◽

Cacilda Castelo Branco Lima ◽

Marcoeli Silva de Moura ◽

...

Keyword(s):

Risk Factors ◽

Early Childhood ◽

Early Childhood Caries ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Factors Associated ◽

History Of ◽

Control Study ◽

Childhood Caries

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.

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