Introduction
The population-level burden of childhood food allergy (FA) is increasing, with growing epidemic and severity of reactions. Over the last decade several review articles have reported a significant increase in food induced anaphylaxis related Emergency Department visits in children (1)(2).
Peanut is one of the major food allergens in children, with increasing prevalence. In the United States, the prevalence of peanut allergy more than tripled between 1997 and 2008, with a recent study finding another 21% increase since 2010 (3). In the UK, reported rates of peanut allergy in 3- to 5-year-old children increased from 0.5% in 1989, to 1.2% in 2001–2002 in the same geographical area (4).
Peanut allergy affects 1.4-4.5% of children and nearly 50% of peanut allergic individuals have had a past severe reaction (5). The European Anaphylaxis Registry reports peanut as an elicitor for anaphylaxis from infancy to young adulthood, triggering nearly one third of food induced anaphylaxis in the paediatric cohort (6).
Reactions are unpredictable in relation to occurrence, severity and outcome and occur despite the appropriate allergen avoidance. Uncertainty results in a perception of risk that adversely affects health-related quality of life (HRQoL) (7). Also absence of evidence regarding reliable severity predictor markers contributes to patient’s and parents’ lack of control over their environment with further consequences on HRQoL.
This study aimed to provide a comparison between anaphylaxis to peanut and other food triggers in European children and adolescents, with regards to atopic history, previous reactions, co-factors, symptoms timing and severity, emergency and long-term management.