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.