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Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study.
- Source :
-
Pediatrics [Pediatrics] 2012 Jul; Vol. 130 (1), pp. e25-32. Date of Electronic Publication: 2012 Jun 25. - Publication Year :
- 2012
-
Abstract
- Objective: To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children.<br />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.<br />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.<br />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.
- Subjects :
- Dermatitis, Atopic drug therapy
Dermatitis, Atopic epidemiology
Dermatitis, Atopic etiology
Egg Hypersensitivity drug therapy
Egg Hypersensitivity epidemiology
Egg Hypersensitivity etiology
Epinephrine therapeutic use
Female
Follow-Up Studies
Food Hypersensitivity drug therapy
Food Hypersensitivity etiology
Health Surveys
Humans
Infant
Male
Milk Hypersensitivity drug therapy
Milk Hypersensitivity epidemiology
Milk Hypersensitivity etiology
Peanut Hypersensitivity drug therapy
Peanut Hypersensitivity epidemiology
Peanut Hypersensitivity etiology
Poisson Distribution
Prospective Studies
Regression Analysis
Severity of Illness Index
Surveys and Questionnaires
Sympathomimetics therapeutic use
United States epidemiology
Food Hypersensitivity epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 130
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 22732173
- Full Text :
- https://doi.org/10.1542/peds.2011-1762