| Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study. | |
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MedLine Citation:
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PMID: 22732173 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study Date: 2012-06-25 |
Journal Detail:
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Title: Pediatrics Volume: 130 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-07-03 Completed Date: 2012-09-10 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: e25-32 Citation Subset: AIM; IM |
Affiliation:
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National Jewish Health, Denver, Colorado 80206, USA. fleischerd@njhealth.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Dermatitis, Atopic
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drug therapy,
epidemiology,
etiology Egg Hypersensitivity / drug therapy, epidemiology, etiology Epinephrine / therapeutic use Female Follow-Up Studies Food Hypersensitivity / drug therapy, epidemiology*, etiology Health Surveys Humans Infant Male Milk Hypersensitivity / drug therapy, epidemiology, etiology Peanut Hypersensitivity / drug therapy, epidemiology, etiology Poisson Distribution Prospective Studies Questionnaires Regression Analysis Severity of Illness Index Sympathomimetics / therapeutic use United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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UL1 RR029884/RR/NCRR NIH HHS; UL1 RR029887/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Sympathomimetics; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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