. 2021 May;76(5):1517-1527.

doi: 10.1111/all.14683. Epub 2021 Jan 3.

Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Ioana Maris¹, Sabine Dölle-Bierke², Jean-Marie Renaudin³, Lars Lange⁴, Alice Koehli⁵, Thomas Spindler⁶, Jonathan Hourihane^{7

8}, Kathrin Scherer⁹, Katja Nemat¹⁰, C Kemen¹¹, Irena Neustädter¹², Christian Vogelberg¹³, Thomas Reese¹⁴, Ismail Yildiz¹⁵, Zsolt Szepfalusi¹⁶, Hagen Ott¹⁷, Helen Straube¹⁸, Nikolaos G Papadopoulos^{19

20}, Susanne Hämmerling²¹, Ute Staden²², Michael Polz²³, Tihomir Mustakov²⁴, Ewa Cichocka-Jarosz²⁵, Renata Cocco²⁶, Alessandro Giovanni Fiocchi²⁷, Montserrat Fernandez-Rivas²⁸, Margitta Worm²; Network for Online Registration of Anaphylaxis (NORA)

Collaborators, Affiliations

Collaborators

Network for Online Registration of Anaphylaxis (NORA):
J Grünhagen, M Wittenberg, K Beyer, A Henschel, S Küper, A Möser, T Fuchs, F Ruëff, B Wedi, G Hansen, T Buck, J Büsselberg, R Drägerdt, L Pfeffer, H Dickel, C Körner-Rettberg, H Merk, S Lehmann, A Bauer, A Nordwig, S Zeil, C Hannapp, N Wagner, E Rietschel, N Hunzelmann, I Huseynow, R Treudler, S Aurich, F Prenzel, L Klimek, O Pfaar, N Reider, W Aberer, E Varga, B Bogatu, P Schmid-Grendelmeier, R Guggenheim, F Riffelmann, B Kreft, K Kinaciyan, L Hartl, C Ebner, F Horak, R Brehler, J Witte, M Buss, S Hompes, T Bieber, S Gernert, M Bücheler, U Rabe, W Brosi, S Nestoris, T Hawranek, R Lang, R Bruns, C Pföhler, P Eng, S Schweitzer-Krantz, S Meller, H Rebmann, J Fischer, G Stichtenoth, S Thies, M Gerstlauer, P Utz, I Neustädter, J Klinge, S Volkmuth, S Plank-Habibi, B Schilling, A Kleinheinz, A Brückner, K Schäkel, I Manolaraki, M Kowalski, K Solarewicz-Madajek, S Tscheiller, J Seidenberg, V Cardona, B Garcia, M Bilo, N Cabañes Higuero, A Vega Castro, I Poziomkowska-Gęsicka, S Büsing, C Virchow, G Christoff, U Jappe, S Müller, F Knöpfel, A-K Correard, B Rogala, A Montoro, A Brandes, A Muraro, N Zimmermann, D Hernandez, P Minale, J Niederwimmer, B Zahel, L Dahdah, S Arasi, A Reissig, F Eitelberger, R Asero, F Hermann, S Zeidler, S Pistauer, M Geißler, L Ensina, A Plaza Martin, J Meister, S Stieglitz, E Hamelmann

Affiliations

¹ Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland.
² Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Allergy Vigilance Network, Vandoeuvre les Nancy, France.
⁴ Department of Paediatrics, St. Marien-Hospital, Bonn, Germany.
⁵ Division of Allergology, University Children's Hospital Zurich, Zürich, Switzerland.
⁶ Department of Paediatrics, Medical Campus Hochgebirgsklinik Davos, Davos, Switzerland.
⁷ Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
⁸ Children's Health Ireland, Dublin, Ireland.
⁹ Medical Faculty, University of Basel, Basel, Switzerland.
¹⁰ Practice for paediatric pneumology and allergology, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany.
¹¹ Department of Paediatrics, Children's Hospital WILHELMSTIFT, Hamburg, Germany.
¹² Department of Paediatrics, Hallerwiese Cnopfsche Kinderklinik, Nuremberg, Germany.
¹³ Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technical University, Dresden, Germany.
¹⁴ Department of Paediatrics, Mathias-Spital Rheine, Rheine, Germany.
¹⁵ Department of Paediatrics, Friedrich-Ebert-Krankenhaus, Neumuenster, Germany.
¹⁶ Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Competence Center Paediatrics, Medical University of Vienna, Vienna, Austria.
¹⁷ Division of Paediatric Dermatology and Allergology, Epidermolysis bullosa-Centre Hannover, Children's Hospital AUF DER BULT, Hanover, Germany.
¹⁸ Division of Allergology, Darmstädter Kinderkliniken Prinzessin Margaret, Darmstadt, Germany.
¹⁹ Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
²⁰ Division of Infection, Immunity& Respiratory Medicine, University of Manchester, Manchester, UK.
²¹ Division of Paediatric Pulmonology and Allergology, University Children`s Hospital Heidelberg, Heidelberg, Germany.
²² Paediatric Pneumology & Allergology, Medical practice Klettke/Staden, Berlin, Germany.
²³ Department of Paediatrics, GPR Klinikum, Rüsselsheim, Germany.
²⁴ Chair of Allergy, University Hospital Alexandrovska, Sofia, Bulgaria.
²⁵ Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
²⁶ Division of Allergy, Clinical Immunology and Rheumatology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil.
²⁷ Paediatric Hospital Bambino Gesù IRCCS, Rome, Holy See.
²⁸ Allergy Department, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain.

PMID: 33274436
DOI: 10.1111/all.14683

Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Ioana Maris et al. Allergy. 2021 May.

. 2021 May;76(5):1517-1527.

doi: 10.1111/all.14683. Epub 2021 Jan 3.

Authors

Collaborators

Network for Online Registration of Anaphylaxis (NORA):
J Grünhagen, M Wittenberg, K Beyer, A Henschel, S Küper, A Möser, T Fuchs, F Ruëff, B Wedi, G Hansen, T Buck, J Büsselberg, R Drägerdt, L Pfeffer, H Dickel, C Körner-Rettberg, H Merk, S Lehmann, A Bauer, A Nordwig, S Zeil, C Hannapp, N Wagner, E Rietschel, N Hunzelmann, I Huseynow, R Treudler, S Aurich, F Prenzel, L Klimek, O Pfaar, N Reider, W Aberer, E Varga, B Bogatu, P Schmid-Grendelmeier, R Guggenheim, F Riffelmann, B Kreft, K Kinaciyan, L Hartl, C Ebner, F Horak, R Brehler, J Witte, M Buss, S Hompes, T Bieber, S Gernert, M Bücheler, U Rabe, W Brosi, S Nestoris, T Hawranek, R Lang, R Bruns, C Pföhler, P Eng, S Schweitzer-Krantz, S Meller, H Rebmann, J Fischer, G Stichtenoth, S Thies, M Gerstlauer, P Utz, I Neustädter, J Klinge, S Volkmuth, S Plank-Habibi, B Schilling, A Kleinheinz, A Brückner, K Schäkel, I Manolaraki, M Kowalski, K Solarewicz-Madajek, S Tscheiller, J Seidenberg, V Cardona, B Garcia, M Bilo, N Cabañes Higuero, A Vega Castro, I Poziomkowska-Gęsicka, S Büsing, C Virchow, G Christoff, U Jappe, S Müller, F Knöpfel, A-K Correard, B Rogala, A Montoro, A Brandes, A Muraro, N Zimmermann, D Hernandez, P Minale, J Niederwimmer, B Zahel, L Dahdah, S Arasi, A Reissig, F Eitelberger, R Asero, F Hermann, S Zeidler, S Pistauer, M Geißler, L Ensina, A Plaza Martin, J Meister, S Stieglitz, E Hamelmann

Affiliations

¹ Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland.
² Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Allergy Vigilance Network, Vandoeuvre les Nancy, France.
⁴ Department of Paediatrics, St. Marien-Hospital, Bonn, Germany.
⁵ Division of Allergology, University Children's Hospital Zurich, Zürich, Switzerland.
⁶ Department of Paediatrics, Medical Campus Hochgebirgsklinik Davos, Davos, Switzerland.
⁷ Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
⁸ Children's Health Ireland, Dublin, Ireland.
⁹ Medical Faculty, University of Basel, Basel, Switzerland.
¹⁰ Practice for paediatric pneumology and allergology, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany.
¹¹ Department of Paediatrics, Children's Hospital WILHELMSTIFT, Hamburg, Germany.
¹² Department of Paediatrics, Hallerwiese Cnopfsche Kinderklinik, Nuremberg, Germany.
¹³ Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technical University, Dresden, Germany.
¹⁴ Department of Paediatrics, Mathias-Spital Rheine, Rheine, Germany.
¹⁵ Department of Paediatrics, Friedrich-Ebert-Krankenhaus, Neumuenster, Germany.
¹⁶ Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Competence Center Paediatrics, Medical University of Vienna, Vienna, Austria.
¹⁷ Division of Paediatric Dermatology and Allergology, Epidermolysis bullosa-Centre Hannover, Children's Hospital AUF DER BULT, Hanover, Germany.
¹⁸ Division of Allergology, Darmstädter Kinderkliniken Prinzessin Margaret, Darmstadt, Germany.
¹⁹ Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
²⁰ Division of Infection, Immunity& Respiratory Medicine, University of Manchester, Manchester, UK.
²¹ Division of Paediatric Pulmonology and Allergology, University Children`s Hospital Heidelberg, Heidelberg, Germany.
²² Paediatric Pneumology & Allergology, Medical practice Klettke/Staden, Berlin, Germany.
²³ Department of Paediatrics, GPR Klinikum, Rüsselsheim, Germany.
²⁴ Chair of Allergy, University Hospital Alexandrovska, Sofia, Bulgaria.
²⁵ Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
²⁶ Division of Allergy, Clinical Immunology and Rheumatology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil.
²⁷ Paediatric Hospital Bambino Gesù IRCCS, Rome, Holy See.
²⁸ Allergy Department, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain.

PMID: 33274436
DOI: 10.1111/all.14683

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 = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .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 = .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 = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .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.

Keywords: anaphylaxis; food allergy; paediatrics.

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References

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Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Collaborators

Affiliations

Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Authors

Collaborators

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical