Anaphylaxis in Infants

RATIONALE: Recommendations to introduce peanut products to infants makes a focused assessment of anaphylaxis in this population necessary. This study compares food-induced anaphylaxis between the <13 months old and 13-24 months old cohort.

METHODS: Retrospective review between June 2015-June 2017 of patients <25 months old presenting with food-induced anaphylaxis at a tertiary children’s hospital Emergency Department (ED).

RESULTS: 116 patients were identified. Patients were 60% White, 4% Black, 10% Asian, 20% other, 19% Hispanic and 60% male. 12% had public insurance. Fifty-two were <13 months old (range 2-12 months old, mean 10.2 months). There were no differences in race between <13 month and 13-24 months cohorts; but younger cohort was more likely female (52% vs 30% p=0.015). Both cohorts had similar rates of eczema (24% vs 18% p=0.45) and food allergy (23% vs 29% p=0.55), but past anaphylaxis was only present in older cohort (9% vs 0% p=0.04). The allergen was known in 32 patients in the younger cohort; the most common allergen was peanut (25%). Both cohorts presented frequently with skin symptoms (46% vs 54% p=0.58), but the younger cohort was more likely to have gastrointestinal symptoms (69% vs 50% p=0.04). Both cohorts had low respiratory (27% vs 17% p=0.22) and cardiovascular involvement (5% vs 2% p=0.42). IE was administered at home more in the older cohort (15% vs 33% p=0.03) as were antihistamines (31% vs 63% p<0.01).

CONCLUSIONS: Patients <13 months old presented more commonly with GI symptoms and were less likely to have had past anaphylaxis or received medications at home.