Anaphylaxis in infancy and factors associated with severity

Abstract

AimIt is difficult to determine the diagnosis and clinical severity of anaphylaxis in the infant age group. The aims of this study were to evaluate demographic and clinical characteristics of infants diagnosed with anaphylaxis and identify predictive factors for severe anaphylaxis. MethodsChildren aged 1 month to 2 years who were diagnosed with anaphylaxis in the pediatric emergency department between 2015 and 2021 were retrospectively analyzed. According to the Sampson Rating Scale, severity of anaphylaxis were determined as mild, moderate and severe. ResultsThe study included 78 infants; 44 (56%) of them were male, the median age was 8 months. Nine (12%) of the patients diagnosed with mild anaphylaxis, 49 (63%) were moderate, and 20 (25%) were severe. Patients diagnosed as mild and moderate anaphylaxis were defined as group I, and patients diagnosed as severe anaphylaxis were defined as group II. The most common triggering factor for anaphylaxis was food (68/78), the most common foods were cow's milk (n=33) and eggs (n=19). Drug-induced anaphylaxis was associated with more severe outcomes compared with other anaphylaxis triggers (P=0.020). Gastrointestinal system signs were significantly more frequent in group I patients compared to group II (P=0.038). In our population of infants, respiratory and neurogical related symptoms were found to be independent factors associated with a more severe anaphylaxis (odds ratios 7 [95% confidence interval, 1.56–39.09] and 5 [95% confidence interval, 1.10–31.90, respectively). ConclusionFoods are the most common triggers for anaphylaxis in infants. Drug-related anaphylaxis cases were more severe compared to food-related cases. Respiratory and neurological system related symptoms were found to be independent factors associated with a severe anaphylaxis.