Risk factors for severe pediatric food anaphylaxis in Italy

Pediatr Allergy Immunol. 2011 Dec;22(8):813-9. doi: 10.1111/j.1399-3038.2011.01200.x. Epub 2011 Sep 19.


Background: Little is known about the cause of food-induced anaphylaxis in children or about the factors that might affect its clinical severity.

Objective: The aim of this study was to investigate the cause of food-induced anaphylaxis in children in Italy and to identify factors that could influence the appearance of symptoms and the severity of anaphylaxis.

Methods: One hundred and sixty-three children with anaphylaxis consecutively attending 29 outpatient allergy clinics throughout Italy were enrolled in this prospective study. Information about past anaphylaxis episodes was collected with a standardized questionnaire. Food sensitization was evaluated by skin-prick test.

Results: A clinical history of asthma increased the risk of wheezing [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5] and respiratory arrest (OR 6.9; 95% CI 1.4-34.2). A clinical history of chronic/relapsing gastrointestinal symptoms increased the risk of vomiting (OR 2.1; 95% CI 0.9-4.3), hypotension (OR 7.9; 95% CI 1.9-32.0), and bradycardia/cardiac arrest (OR 9.2; 95% CI 0.9-91.3). The severity of present and previous episodes was similar only in patients with mild or moderate anaphylaxis. Peanut and egg were the most frequent causes of severe anaphylaxis.

Conclusions: A clinical history of asthma and chronic/relapsing gastrointestinal symptoms (probably linked to food allergy) may predict the development of respiratory and gastrointestinal symptoms and the severity of anaphylaxis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anaphylaxis / epidemiology*
  • Anaphylaxis / immunology
  • Arachis / adverse effects
  • Arachis / immunology
  • Asthma / epidemiology*
  • Asthma / immunology
  • Child
  • Child, Preschool
  • Disease Progression
  • Eggs / adverse effects
  • Female
  • Food Hypersensitivity / epidemiology*
  • Food Hypersensitivity / immunology
  • Humans
  • Infant
  • Infant, Newborn
  • Italy
  • Male
  • Prospective Studies
  • Recurrence
  • Risk Factors