BACKGROUND: Little is known about the cause of food-induced anaphylaxis in children or about the factors that might affect its clinical severity. OBJECTIVE: The aim of this study was to investigate the cause of food-induced anaphylaxis in children in Italy and to identify factors that could influence the appearance of symptoms and the severity of anaphylaxis. METHODS: One hundred and sixty-three children with anaphylaxis consecutively attending 29 outpatient allergy clinics throughout Italy were enrolled in this prospective study. Information about past anaphylaxis episodes was collected with a standardized questionnaire. Food sensitization was evaluated by skin-prick test. RESULTS: A clinical history of asthma increased the risk of wheezing [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5] and respiratory arrest (OR 6.9; 95% CI 1.4-34.2). A clinical history of chronic/relapsing gastrointestinal symptoms increased the risk of vomiting (OR 2.1; 95% CI 0.9-4.3), hypotension (OR 7.9; 95% CI 1.9-32.0), and bradycardia/cardiac arrest (OR 9.2; 95% CI 0.9-91.3). The severity of present and previous episodes was similar only in patients with mild or moderate anaphylaxis. Peanut and egg were the most frequent causes of severe anaphylaxis. CONCLUSIONS: A clinical history of asthma and chronic/relapsing gastrointestinal symptoms (probably linked to food allergy) may predict the development of respiratory and gastrointestinal symptoms and the severity of anaphylaxis.
Risk factors for severe food anaphylaxis in Italy / Calvani M.; Cardinale F.; Martelli A.; Muraro A.; Pucci N.;Savino F.; Zappala`D.; Panetta V.; & the Italian Society of Pediatric Allergy and Immunology (SIAIP) anaphylaxis’ study group; (Alamazza A. ; Alessandri C.; BertiI. ; Boccardo G.; Bonazza P. ; Bove D. ; Caffarelli C. ; Cavagni G. ; Chiappa L.; Duse M; Flacco V. ; Frediani T. ; Ghiglioni D. ;Giovane R. ; Indirli G.C. ; La Grutta S. ; Landi L. ;Indinnimeo L. ;Martini M. ; Mazzoleni S. ;Miceli Sopo S. ; Monti G.; Nardella D. ; Pingitore G. ;Radzik D. ; Ricci G. ;Roman B. ;Semenzato R. ; Tripodi S. ; Varin E. ; Zicari A.M.. - In: PEDIATRIC ALLERGY AND IMMUNOLOGY. - ISSN 0905-6157. - STAMPA. - 22:8(2011), pp. 813-819. [10.1111/j.1399-3038.2011.01200.x]
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