Peanut induced anaphylaxis in children and adolescents: data from the
European Anaphylaxis Registry
Abstract
Background: Peanut allergy has a rising prevalence in high-income
countries, affecting 0.5–1.4% of children. This study aimed to better
understand peanut anaphylaxis in comparison to anaphylaxis to other food
triggers in European children and adolescents. Methods: Data was sourced
from the European Anaphylaxis Registry via an online questionnaire,
after in-depth review of food induced anaphylaxis cases in a tertiary
paediatric allergy centre. Results: 3514 cases of food anaphylaxis were
reported between July 2007 - March 2018, 56% in patients younger than
18 years. Peanut anaphylaxis was recorded in 459 children and
adolescents (85% of all peanut anaphylaxis cases). Previous reactions
(42% vs 38%; p=0.001), asthma comorbidity (47% vs 35%;
p<0.001), relevant co-factors (29% vs 22%; p=0.004) and
biphasic reactions (10% vs 4%; p=0.001) were more commonly reported in
peanut anaphylaxis. Most cases were labelled as severe anaphylaxis
(Ring&Messmer grade III 65% vs 56% and grade IV 1.1% vs 0.9%;
p=0.001). Self-administration of intramuscular adrenaline was low (17%
vs 15%), professional adrenaline administration was higher in
non-peanut food anaphylaxis (34% vs 26%; p=0.003). Hospitalisation was
higher for peanut anaphylaxis (67% vs 54%; p=0.004). Conclusions: The
European Anaphylaxis Registry data confirmed peanut as one of the major
causes of severe, potentially life-threatening allergic reactions in
European children, with some characteristic features e.g. presence of
asthma comorbidity and increased rate of biphasic reactions. Usage of
intramuscular adrenaline as first line treatment is low and needs to be
improved. The Registry, designed as the largest database on anaphylaxis,
allows continuous assessment of this condition.