ОСОБЕННОСТИ ПИЩЕВОЙ АНАФИЛАКСИИ У ДЕТЕЙ, ВОЗНИКАЮЩЕЙ ПРИ АЛЬТЕРНАТИВНЫХ ПУТЯХ ПОСТУПЛЕНИЯ АЛЛЕРГЕНА

Abstract

Objective of the study: to determine the frequency, spectrum of allergens, symptoms, and the severity of food anaphylaxis in children, occurred during transdermal or inhalation routes of allergen intake. Materials and methods of the research: the study included 110 children (a total of 227 episodes of anaphylaxis) aged 5 months to 18 years with a history of episodes of systemic reactions to food allergens that meet the clinical criteria for anaphylaxis. The collection of patient data was carried out by filling out a questionnaire. Allergological examination included determination of the concentration of SiGe antibodies to the putative triggers of food anaphylaxis (ImmunoCAP Phadia AB, Sweden). Results: 18 patients (16,4%) had systemic reactions after skin contact with an allergen or inhalation of trigger, the frequency of these reactions among the total number of episodes of anaphylaxis was 6,6% and 3,9%, respectively. The dominant triggers in the development of anaphylaxis during skin contact were fish/seafood allergens (46%) and cow's milk (33%), with inhalation intake – fish/seafood allergens (89%), the average level of sensitization to the latter was 100 kUA/l (95% CI: 22,59–100). The concentration of sIgE to triggers did not correlate with the severity of anaphylaxis (p>0,05, Rs=0,18). The proportion of severe reactions after inhaled injection of the trigger was slightly higher (33%), compared to anaphylaxis during skin contact (20%) (p>0,05). Patients with anaphylactic reactions at the same time both with transdermal and inhalation routes of allergen, were characterized by their severe course. Conclusion: food anaphylaxis in children resulting from skin contact with or inhalation of the trigger is most frequently developed in fish/seafood and is characterized by high sensitization to the allergen. Up to 1/3 of these systemic reactions are severe, and it is always important to consider the possibility of death.