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Peanut induced anaphylaxis in children and adolescents: data from the European Anaphylaxis Registry
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  • Ioana Maris,
  • Sabine Dölle,
  • Jean-Marie Renaudin,
  • Lars Lange,
  • Alice Koehli,
  • Thomas Spindler,
  • Jonathan Hourihane,
  • Kathrin Scherer,
  • Katja Nemat,
  • C Kemen,
  • Irena Neustaedter,
  • Christian Vogelberg,
  • T. Reese,
  • Ismail Yildiz,
  • Zsolt Szepfalusi,
  • Hagen Ott,
  • Helen Straube,
  • Nikolaos Papadopoulos,
  • Susanne Haemmerling,
  • Ute Staden,
  • M. Polz,
  • Tihomir Mustakov,
  • Ewa Cichocka-Jarosz,
  • Renata Cocco,
  • Alessandro Fiocchi,
  • Montserrat Fernandez-Rivas,
  • Margitta Worm
Ioana Maris
University College Cork
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Sabine Dölle
Charité – Universitätsmedizin Berlin
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Jean-Marie Renaudin
University Hospital Nancy
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Lars Lange
St. Marien-Hospital
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Alice Koehli
University Children’s Hospital Zurich
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Thomas Spindler
Hochgebirgsklinik Davos
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Jonathan Hourihane
Royal College of Surgeons in Ireland Faculty of Medicine and Health Sciences
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Kathrin Scherer
University of Basel
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Katja Nemat
Kinderzentrum Dresden-Friedrichstadt GbR
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C Kemen
Children's Hospital Wilhelmstift
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Irena Neustaedter
Hospital Hallerwiese
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Christian Vogelberg
Technical University Dresden
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T. Reese
Mathias-Spital Rheine
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Ismail Yildiz
Friedrich-Ebert-Hospital Neumünster
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Zsolt Szepfalusi
Medical University of Vienna
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Hagen Ott
Auf der Bult Children's Hospital
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Helen Straube
Darmstädter Kinderkliniken Prinzessin Margaret
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Nikolaos Papadopoulos
University of Manchester
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Susanne Haemmerling
University Children's Hospital Heidelberg
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Ute Staden
Medical practice Klettke/Staden
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M. Polz
GPR Klinikum Russelsheim
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Tihomir Mustakov
University Hospital Alexandrovska
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Ewa Cichocka-Jarosz
Jagiellonian University Medical College
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Renata Cocco
Federal University of Sao Paulo
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Alessandro Fiocchi
Ospedale Pediatrico Bambino Gesu
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Montserrat Fernandez-Rivas
Hospital Clinico San Carlos
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Margitta Worm
Charité - Universitätsmedizin Berlin
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Background: Peanut allergy has a rising prevalence in high-income countries, affecting 0.5–1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. Methods: Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food induced anaphylaxis cases in a tertiary paediatric allergy centre. Results: 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs 38%; p=0.001), asthma comorbidity (47% vs 35%; p<0.001), relevant co-factors (29% vs 22%; p=0.004) and biphasic reactions (10% vs 4%; p=0.001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs 56% and grade IV 1.1% vs 0.9%; p=0.001). Self-administration of intramuscular adrenaline was low (17% vs 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs 26%; p=0.003). Hospitalisation was higher for peanut anaphylaxis (67% vs 54%; p=0.004). Conclusions: The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g. presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.

Peer review status:Published

27 Jul 2020Submitted to Allergy
06 Aug 2020Submission Checks Completed
06 Aug 2020Assigned to Editor
06 Aug 2020Reviewer(s) Assigned
26 Aug 2020Review(s) Completed, Editorial Evaluation Pending
28 Aug 2020Editorial Decision: Revise Minor
26 Oct 20201st Revision Received
27 Oct 2020Submission Checks Completed
27 Oct 2020Assigned to Editor
28 Oct 2020Reviewer(s) Assigned
08 Nov 2020Review(s) Completed, Editorial Evaluation Pending