Food induced anaphylaxis in young age group is increasing. We aimed to analyze clinical characteristics of anaphylaxis in Korean infants.
A retrospective medical record review was performed on infants (0~2 years old) diagnosed with anaphylaxis between 2009 and 2013 in 23 tertiary hospitals in South Korea
363 anaphylaxis cases (66.9% male) were identified. Cutaneous symptoms (98.6%) were the most common symptoms followed by respiratory (83.2%), gastrointestinal (29.8%), and neurologic (11.6%). Cardiovascular symptoms were rare (7.7%). 338 cases (93.1%) of anaphylaxis was induced by foods. 185 cases (51.0%) of anaphylaxis occurred within 30 minutes after offending food exposure. The most common trigger food was milk (44.3%) followed by egg (22.0%), walnut (8.3%), wheat (7.7%), peanut (4.8%), other nuts (3.0%), and fish (2.1%). The median value of specific IgE (sIgE) by immunoCAP to milk was 6.80 (range 0.37 ~ 427.00) kUA/L. 51.7% of infants under 12 months of age and 55.9% of infants aged 12 months and over had their symptoms even under the levels of milk-sIgE diagnostic decision points. The median value of egg-sIgE was 10.40 (range 1.03~100.00) kUA/L. 93.2% of egg-induced anaphylaxis cases had egg-sIgE levels above diagnostic decision points.
Milk was the most common trigger food of anaphylaxis in Korean infants. Half of the cases of anaphylaxis occurred within 30 minutes after exposure. Even in very low level (0.37 kUA/L) of milk-sIgE, anaphylaxis could occur and more than half of the infants with milk anaphylaxis showed milk-sIgE levels under the diagnostic decision point.