Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 8;34(13):e106.
doi: 10.3346/jkms.2019.34.e106.

Infantile Anaphylaxis in Korea: a Multicenter Retrospective Case Study

You Hoon Jeon  1 , Sooyoung Lee  2 , Kangmo Ahn  3 , So Yeon Lee  4 , Kyung Won Kim  5 , Hyun Hee Kim  6 , Jeong Hee Kim  7 , Hye Yung Yum  8 , Woo Kyung Kim  9 , Yong Mean Park  10 , Tae Won Song  9 , Jihyun Kim  3 , Yong Ju Lee  1 , Gwang Cheon Jang  11 , Kyunguk Jeong  12 , Yoon Hee Kim  5 , Taek Ki Min  13 , Bok Yang Pyun  14 ; Food Allergy and Atopic Dermatitis (FAAD) Study Group in the Korean Academy of Pediatric Allergy and Respiratory Disease
Affiliations

Infantile Anaphylaxis in Korea: a Multicenter Retrospective Case Study

You Hoon Jeon et al. J Korean Med Sci. .

Abstract

Background: Anaphylaxis is increasing in young children. The aim of the present study was to analyze the clinical characteristics of anaphylaxis in Korean infants, with a focus on food triggers.

Methods: The study analyzed the medical records of infants aged 0 to 2 years old who had been diagnosed with anaphylaxis in 23 secondary or tertiary hospitals in Korea.

Results: We identified 363 cases of infantile anaphylaxis (66.9% male). Cutaneous symptoms were most prevalent (98.6%), followed by respiratory (83.2%), gastrointestinal (29.8%), and neurologic (11.6%) symptoms. Cardiovascular symptoms were noted in 7.7% of the cases. Most of the cases of anaphylaxis (338; 93.1%) were induced by foods. The most common trigger food was cow's milk and cow's milk products (43.8%), followed by hen's eggs (21.9%), walnuts (8.3%), wheat (7.7%), peanuts (4.8%), other nuts (3.0%), and fish (2.1%). In cow's milk-induced anaphylaxis cases, more than half the cases had cow's milk specific immunoglobulin E (sIgE) levels that were lower than the diagnostic decision points (DDPs), which is 5 kUA/L for those under the age of 1 and 15 kUA/L for those over the age of 1. In anaphylaxis induced by hen's egg, most of the cases (91.8%) had hen's egg sIgE levels that were higher than the DDP, which is 2 kUA/L for those under the age of 2 and 7 kUA/L for those over the age of 2. Of the infantile anaphylaxis cases, 46.8% had been treated with epinephrine, and 25.1% had been prescribed an epinephrine auto-injector.

Conclusion: Cow's milk is the most frequent trigger food of anaphylaxis in Korean infants. However, we found no significant correlation between the sIgE level and clinical severity. Education is required regarding the importance of epinephrine as the first line therapy for anaphylaxis and on properly prescribing epinephrine for infants with a history of anaphylaxis.

Keywords: Anaphylaxis; Epinephrine; Food; Infant.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Annual variation of anaphylaxis in infants. (A) The number and (B) common trigger food.
Fig. 2
Fig. 2. Clinical manifestation of 338 food-induced infant anaphylaxis. Percentage of (A) each clinical symptom and (B) clinical manifestation by trigger food.
Fig. 3
Fig. 3. Differences between food and drug anaphylaxis. (A) Involved organs and (B) clinical course.
Fig. 4
Fig. 4. The DDP for food allergy by Sampson and sIgE of anaphylaxis infants. (A) More than half of the cow's milk anaphylaxis cases developed the anaphylactic symptoms in value less than the value of DDP. (B) In hen's egg anaphylaxis, most of the cases had hen's egg white sIgE levels above the DDP.
DDP = diagnostic decision point, sIgE = specific immunoglobulin E.
See this image and copyright information in PMC

Comment in

References

    1. Lieberman P, Camargo CA, Jr, Bohlke K, Jick H, Miller RL, Sheikh A, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol. 2006;97(5):596–602. - PubMed
    1. Wood RA, Camargo CA, Jr, Lieberman P, Sampson HA, Schwartz LB, Zitt M, et al. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol. 2014;133(2):461–467. - PubMed
    1. Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin North Am. 2012;32(1):35–50. - PubMed
    1. Poulos LM, Waters AM, Correll PK, Loblay RH, Marks GB. Trends in hospitalizations for anaphylaxis, angioedema, and urticaria in Australia, 1993–1994 to 2004–2005. J Allergy Clin Immunol. 2007;120(4):878–884. - PubMed
    1. Turner PJ, Gowland MH, Sharma V, Ierodiakonou D, Harper N, Garcez T, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992–2012. J Allergy Clin Immunol. 2015;135(4):956–963.e1. - PMC - PubMed

MeSH terms