Document Detail

Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study.
MedLine Citation:
PMID:  22732173     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children.
METHODS: We conducted a prospective, 5-site observational study of 512 infants aged 3 to 15 months with documented or likely allergy to milk or egg, and collected data prospectively examining allergic reactions.
RESULTS: Over a median follow-up of 36 months (range: 0-48.4), the annualized reaction rate was 0.81 per year (367/512 subjects reporting 1171 reactions [95% confidence interval: 0.76-0.85]). Overall, 269/512 (52.5%) reported >1 reaction. The majority of reactions (71.2%) were triggered by milk (495 [42.3%]), egg (246 [21.0%]), and peanut (93 [7.9%]), with accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Foods were provided by persons other than parents in 50.6% of reactions. Of 834 reactions to milk, egg, or peanut, 93 (11.2%) were attributed to purposeful exposures to these avoided foods. A higher number of food allergies (P < .0001) and higher food-specific immunoglobulin E (P < .0001) were associated with reactions. Of the 11.4% of reactions (n = 134) that were severe, 29.9% were treated with epinephrine. Factors resulting in undertreatment included lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration.
CONCLUSIONS: There was a high frequency of reactions caused by accidental and nonaccidental exposures. Undertreatment of severe reactions with epinephrine was a substantial problem. Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of nonaccidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers.
David M Fleischer; Tamara T Perry; Dan Atkins; Robert A Wood; A Wesley Burks; Stacie M Jones; Alice K Henning; Donald Stablein; Hugh A Sampson; Scott H Sicherer
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2012-06-25
Journal Detail:
Title:  Pediatrics     Volume:  130     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-09-10     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e25-32     Citation Subset:  AIM; IM    
National Jewish Health, Denver, Colorado 80206, USA.
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MeSH Terms
Dermatitis, Atopic / drug therapy,  epidemiology,  etiology
Egg Hypersensitivity / drug therapy,  epidemiology,  etiology
Epinephrine / therapeutic use
Follow-Up Studies
Food Hypersensitivity / drug therapy,  epidemiology*,  etiology
Health Surveys
Milk Hypersensitivity / drug therapy,  epidemiology,  etiology
Peanut Hypersensitivity / drug therapy,  epidemiology,  etiology
Poisson Distribution
Prospective Studies
Regression Analysis
Severity of Illness Index
Sympathomimetics / therapeutic use
United States / epidemiology
Grant Support
Reg. No./Substance:
0/Sympathomimetics; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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