Differences in oral food challenge reaction severity based on increasing age in a pediatric population
| Autor: | Zachary Spergel, Peter Capucilli, Jonathan M. Spergel, Stacy Dorris, Katie Kennedy, Maria Katerina Alfaro |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Pediatrics medicine.medical_specialty Allergy Adolescent Immunology Administration Oral Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Clinical history Food allergy medicine Immunology and Allergy Humans 030212 general & internal medicine Grading (education) Child Anaphylaxis Asthma Retrospective Studies business.industry Oral food challenge Infant Allergens medicine.disease Epinephrine 030228 respiratory system Desensitization Immunologic Food Child Preschool Female business Food Hypersensitivity Pediatric population medicine.drug |
| Zdroj: | Annals of allergy, asthmaimmunology : official publication of the American College of Allergy, Asthma,Immunology. 127(5) |
| ISSN: | 1534-4436 |
| Popis: | Background Food allergy reactions range from mild to severe with differences in age appearing to be an important factor associated with reaction severity. Objective To define differences in oral food challenge (OFC) reaction severity in pediatric patients from infancy to adolescence using objective clinical outcomes and standardized reaction grading tools. Methods Retrospective review of all positive OFC results at 2 large institutions between September 2016 and February 2019. Reaction severity was defined by presence of cardiovascular, neurologic, lower respiratory, or laryngeal symptoms, epinephrine requirement, and grading using 2 established food allergy reaction scales. Results Infants and toddlers had fewer reactions involving cardiovascular, neurologic, lower respiratory, or laryngeal symptoms compared with older age groups. Epinephrine was also required less frequently during reactions in infants and toddlers, compared with older age groups. There was no difference in reaction severity in infants and toddlers based on clinical history of eczema. Increasing age was significantly correlated with increased epinephrine requirement (R2 = 0.12, P = .002), elevated Consortium of Food Allergy Research score (R2 = .012, P = .003), and approached significance for increased Practical Allergy score (R2 = .005, P = .05). History of asthma and sesame allergy were identified to be positively correlated with more severe reactions. Conclusion Infants and young toddlers have less severe reactions during OFCs compared with older age groups supporting early food introduction practices. In children under 12 months of age, severe reactions are most rare calling into question screening practices using specific allergy testing before food introduction. Standardized reaction grading tools may be valuable instruments to categorize reaction severity during OFCs. |
| Databáze: | OpenAIRE |
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