Small percentage of anaphylactic reactions treated with epinephrine during food challenges in Dutch children

Johanna P.M. van der Valk*, Irene Berends, Roy Gerth van Wijk, Nicolette J.T. Arends, Maurits S. van Maaren, Hans de Groot, Harry J. Wichers, Joyce A.M. Emons, Anthony E.J. Dubois, Nicolette W. de Jong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Background: Severe allergic reactions, including anaphylaxis, occur during oral food challenges (OFCs) and the first-line treatment of anaphylaxis is epinephrine. Objective: To evaluate the percentage of anaphylactic reactions treated with epinephrine during OFCs and to identify associated factors for the administration of epinephrine. Methods: Children who underwent an OFC with peanut, hazelnut, cow's milk, hen's egg, or cashew nut from 2005 through 2015 in the Netherlands were evaluated. Children with reactions meeting the criteria for anaphylaxis according to the European Academy of Allergy and Clinical Immunology guidelines for food allergy and anaphylaxis were included. Children with an anaphylactic reaction treated with vs without epinephrine were compared. Possible factors associated with the administration of epinephrine, such as age, sex, symptoms consistent with asthma, history of an allergic reaction to the tested allergen, and symptom types during the anaphylactic reaction, were evaluated using logistic regression analysis. Results: Eighty-three children in clinical and research settings (43% boys; median age, 7 years; range, 1-17) who met the criteria for anaphylaxis were included in this study. Thirty-two of 83 children (39%) with anaphylaxis were treated with epinephrine. Respiratory symptoms during the OFC were treated significantly more often with epinephrine than gastrointestinal symptoms (P = .01). Conclusion: Only 39% of children with anaphylaxis, according to the guideline criteria, were treated with epinephrine during the OFC and most of these children had respiratory symptoms. There is need for an easy-to-use international guideline for the treatment of allergic symptoms during OFCs.
Original languageEnglish
Pages (from-to)300-303
JournalAnnals of Allergy, Asthma and Immunology
Volume120
Issue number3
Early online date7 Oct 2017
DOIs
Publication statusPublished - Mar 2018

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    van der Valk, J. P. M., Berends, I., van Wijk, R. G., Arends, N. J. T., van Maaren, M. S., de Groot, H., Wichers, H. J., Emons, J. A. M., Dubois, A. E. J., & de Jong, N. W. (2018). Small percentage of anaphylactic reactions treated with epinephrine during food challenges in Dutch children. Annals of Allergy, Asthma and Immunology, 120(3), 300-303. https://doi.org/10.1016/j.anai.2017.08.018