Clinical and treatment evaluation of anaphylaxis in children aged 0-2 years: multicenter study

Abstract

Background: Diagnosing anaphylaxis in children within the first 2 years of life can be difficult due to the often confusing and nonspecific signs and symptoms. Objective: This study focuses on the phenotype of anaphylaxis in children within the first 2 years of life and aims to increase awareness of anaphylaxis in this age group. Methods: The study included children between 0 and 2 years who were diagnosed as having anaphylaxis by pediatric allergists in 11 tertiary hospitals. Results: A total of 402 anaphylaxis episodes experienced by 360 patients (68.7% males) were included in the study. Food was the most common causative agent (n = 374, 93%), with the most common foods being cow’s milk (n = 179, 44.6%). Drugs were the second most common trigger (n = 15, 3.7%). The most common clinical findings were cutaneous (95%) and respiratory (72%); nonspecific symptoms such as weakness (n = 63, 15.6%) and hoarseness (n = 14, 3.4%) were also reported. There was a biphasic course in 3 infants (0.8%). Only 3 of the 41 parents who had an adrenaline autoinjector used it during anaphylaxis. Conclusion: Infants experience anaphylaxis most often when they are at home with their mothers, and the most common triggers are foods, particularly cow’s milk and egg. Greater awareness of anaphylaxis symptoms and autoinjector use among mothers can facilitate management. Impact: Infant anaphylaxis cases may present with different symptoms compared to classic presentations, potentially leading to diagnostic oversight. The study elucidates the clinical course of anaphylaxis in children under 2 years of age. It details the treatment strategies employed in managing these cases. Anaphylaxis triggers were identified over several years. Cases from 11 regions of Turkey were included, representing a population reflective of national data. The study highlights the distinctiveness of anaphylaxis cases in children within the first 2 years of life. © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2024.