Anaphylaxis in Infants
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Waheeda Samady, MD, MSCI, Jennifer Trainor, MD, Diane Houdek, Briget Marie Smith, PhD, Ruchi S. Gupta, MD MPH
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.