Anaphylaxis Linked to Increased Burden of Peanut and Food Allergy


Prior to the investigation, peanut allergy was often linked to high rates of anaphylaxis, with its prevalence in children and adolescents surpassing that found in adult patients.

Antonella Muraro, MD, PhD

Antonella Muraro, MD, PhD

A recent investigation reported the risks of anaphylaxis contributed the overall burden of peanut and food allergy in children and their families.

Peanut allergy has often been linked to high rates of anaphylaxis, and the prevalence of anaphylaxis in children and adolescents has surpassed cases recorded in adult populations, with pediatric incidences rising over time.

Though peanut allergy has been the subject of multiple studies in the past, the investigators of the present study were compelled to determine the rate of anaphylaxis in high-risk populations of children and adolescents with the condition.

Antonella Muraro, MD, PhD, Food Allergy Referral Center Veneto Region, Department of Woman and Child Health, Padua University, and colleagues performed a systematic literature review and analysis using peer-reviewed published data to assess the incidence of peanut-induced anaphylaxis in children and adolescents with allergies.

The Methods

Investigators initially conducted a literature search using the PubMed database and several other supplemental methods.

Formal study eligibility and inclusion criteria involved: print or e‐publication date from January 1, 2000, through May 15, 2019, with a focus on studies that met the 2006 publication of the Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) symposium guidelines, peer‐reviewed studies published in English, studies including children or adolescents aged 4–17 years, report of the incidence rate, or number of incident cases, of anaphylaxis, report of the sample size; andreport of the average or median length of follow‐up.

Medical Subject Headings (MeSH) and non‐MeSH terms were such as peanut allergy, accidental exposure, children, pediatrics, and more were applied to identify eligible publications.

Studies were included if incidence rate data specific to the type of allergy such as peanut allergy were reported.

Pooled incidence rates were calculated among 3 populations of interest including children and adolescents with peanut allergy, those with food allergy, and those with peanut allergy who experienced accidental exposure.

The Findings

Overall, Muraro and colleagues’ PubMed search yielded 830 records, though 822 were excluded for failure of meeting the criteria expressed in the review.

The pooled data of the remaining 8 articles estimated that the incidence rate of anaphylaxis among children and adolescents with food allergies was 3.72 incident cases of anaphylaxis per 100 person‐years (95% CI = 2.35, 5.10), with 95.5% heterogeneity.

Regarding children and adolescents with peanut allergy, Incidence rates ranged from 1.57 incident cases of anaphylaxis per 100 person‐yearsto 8.37 cases per 100 person‐years. The data was supported by 4 studies that focused exclusively on peanut allergy

Finally, a pooled meta-analysis of incidence rates of accidental exposure to peanut allergy was 12.28 cases per 100 person‐years (95% CI = 11.51, 13.05), with 0.0% heterogeneity.

The studies included in the current meta‐analysis showed a higher range of peanut‐induced anaphylaxis cumulative incidence in preschool and older children (14.7%–15.5%) than in adolescents (6.9%) with food allergy.

Investigators believed these data helped clarify the risks and burdens of peanut allergy, and could be used to aid physicians in counseling patients and caregivers.

However, further research was recommended.

“Additional confirmatory data and analyses on the incidence of anaphylaxis in pediatric PA in the light of the small number of available studies are needed,” the team wrote.

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