A survey study of index food-related allergic reactions and anaphylaxis management

作者：Jacobs Tammy S; Greenhawt Matthew J; Hauswirth David; Mitchell Lynda; Green Todd D^*

来源：Pediatric Allergy and Immunology, 2012, 23(6): 582-589.

DOI：10.1111/j.1399-3038.2012.01315.x

• anaphylaxis
• food hypersensitivity
• epinephrine
• emergency treatment

To cite this article: Jacobs TS, Greenhawt MJ, Hauswirth D, Mitchell L, Green TD. A survey study of index food-related allergic reactions and anaphylaxis management. Pediatr Allergy Immunol 2012: 23: 582589. Abstract Background: Initial food-allergic reactions are often poorly recognized and under-treated. Methods: Parents of food-allergic children were invited to complete an online questionnaire, designed with Kids with Food Allergies Foundation, about their childrens first food-allergic reactions resulting in urgent medical evaluation. Results: Among 1361 reactions, 76% (95% CI 7479%) were highly likely to represent anaphylaxis based on NIAID/FAAN criteria. Only 34% (95% CI 3137%) of these were administered epinephrine. In 56% of these, epinephrine was administered by emergency departments; 20% by parents; 9% by paramedics; 8% by primary care physicians; and 6% by urgent care centers. In 26% of these, epinephrine was given within 15 min of the onset of symptoms; 54% within 30 min; 82% within 1 h; and 93% within 2 h. Factors associated with a decreased likelihood of receiving epinephrine for anaphylaxis included age <12 months, milk and egg triggers, and symptoms of abdominal pain and/or diarrhea. Epinephrine was more likely to be given to asthmatic children and children with peanut or tree nut ingestion prior to event. Post-treatment, 42% of reactions likely to represent anaphylaxis were referred to allergists, 34% prescribed and/or given epinephrine auto-injectors, 17% trained to use epinephrine auto-injectors, and 19% given emergency action plans. Of patients treated with epinephrine, only half (47%) were prescribed epinephrine auto-injectors. Conclusions: Only one-third of initial food-allergic reactions with symptoms of anaphylaxis were recognized and treated with epinephrine. Fewer than half of patients were referred to allergists. There is still a need to increase education and awareness about food-induced anaphylaxis.

• 出版日期2012-9