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Anaphylaxis admissions in pediatric intensive care units: Follow‐up and risk of recurrence

Background Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow‐up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis. Methods We conducted a telephone survey of 166...

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Bibliographic Details
Published in:Pediatric allergy and immunology 2019-05, Vol.30 (3), p.341-347
Main Authors: Pouessel, Guillaume, Cerbelle, Valentine, Lejeune, Stephanie, Leteurtre, Stephane, Ramdane, Nassima, Deschildre, Antoine, Tourneux, P, Boussicault, G, Thiriez, G, Brissaud, O, Garenne, A, Jokic, M, Petit, I, Semama, D, Bergounioux, J, Debillon, T, Wroblewski, I, Dorkenoo Morgan, RA, Mallet, E, Javouhey, E, Vanel, B, Vialet, R, Michel, F, Cambonie, G, Milesi, C, Boussard, N, Joram, N, Dupont, D, Tissières, P, Dauger, S, Renolleau, S, Leger, PL, Mansir, T, Saulnier, JP, Bednarek, N, Tirel, O, Blanc, T, Patural, H, Astruc, D, Marcoux, MO, Amadieu, R, Chantreuil, J
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Language:English
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Summary:Background Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow‐up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis. Methods We conducted a telephone survey of 166 children (≤18 years) hospitalized from 2003 to 2013. Results In all, 106 (64%) completed the survey (boys, 59%; mean age [SD]: 15.3 years [5.5]). The main index triggers were drugs (45%) and foods (37%). The mean duration follow‐up was of 7.7 years (SD: 2.4). Thirty‐eight (36%) children experienced 399 new allergic reactions during a follow‐up period of 282 patient‐years (incidence rate: 1.4/100 patients/y; 95% CI: 0.64‐2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/y; 95% CI non‐calculable). Food was the trigger for 79% of recurrent reactions and drugs for 8%. The food trigger was previously known in 83%, the same as the index trigger in 69%. Overall, 1.5% of the recurrent reactions were treated with adrenaline injection and 8% an emergency hospital admission. Patients with recurrence had more likely a history of food allergy (P 
ISSN:0905-6157
1399-3038
DOI:10.1111/pai.13015