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Food‐Induced Anaphylaxis in Infants, as Compared to Toddlers and Preschool Children in Turkey

Melike Kahveci 

Background

The literature includes scarce data on infants with food‐induced anaphylaxis (FIA).

Materials and Methods

Medical records of the patients diagnosed with FIA aged 0‐6 years between 2015 and 2020 were retrospectively analyzed.

Results

  During the study period, there were 451 instances of FIA in 314 patients, of which 175 (38.8%) occurred in 160 infants (50.9%). The median (IQR) age of infants was 7 months (6‐9 months) with a male predominance (67.5%), of which 7.5% had multiple instances (≥2) and 60% atopic dermatitis. The most common triggers were cow’s milk (51.4%), tree nuts (16.6%), and hen’s egg (15.4%), whereas tree nut was the most common trigger in toddlers (35.8%) and preschool children (35.2%). Skin and neurological symptoms, and nausea‐vomiting occurred more frequently (p=0.003; p=<0 .001="" 1.940="" 18="" 6.837="" 65="" 92="" anaphylaxis="" and="" children="" commonly="" compared="" detected.="" episodes="" history="" i="" in="" infants="" less="" mild="" moderate="" of="" p="" preschool="" recurrent="" respectively="" respiratory="" severe="" style="box-sizing: border-box;" symptoms="" to="" toddlers="" were="" wheezing="" whereas="">= 

0.003) and tree nut allergy (OR: 2.849 [95%CI: 1.056‐7.688], P=0.039) were found to be independent risk factors for moderate to severe anaphylactic reactions. 40.6% of the infants received  adrenaline, which was lower than the toddlers (49.7%) and preschool children (57.6%) (p=0.005).

Conclusion

  There is no doubt that  food‐induced anaphylaxis is a medical emergency, specifically in young children. Pediatricians should be aware of the distinct features of infant anaphylaxis, particularly gastrointestinal and neurological symptoms to provide effective treatment as soon as possible.