@article{2999894,
    title = "Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry",
    author = "Maris, I. and Dölle-Bierke, S. and Renaudin, J.-M. and Lange, L. and Koehli, A. and Spindler, T. and Hourihane, J. and Scherer, K. and Nemat, K. and Kemen, C. and Neustädter, I. and Vogelberg, C. and Reese, T. and Yildiz, I. and Szepfalusi, Z. and Ott, H. and Straube, H. and Papadopoulos, N.G. and Hämmerling, S. and Staden, U. and Polz, M. and Mustakov, T. and Cichocka-Jarosz, E. and Cocco, R. and Fiocchi, A.G. and Fernandez-Rivas, M. and Worm, M. and Network for Online Registration of Anaphylaxis (NORA)",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2021",
    volume = "76",
    number = "5",
    pages = "1517-1527",
    publisher = "John Wiley and Sons Inc",
    doi = "10.1111/all.14683",
    keywords = "antihistaminic agent;  beta 2 adrenergic receptor stimulating agent;  corticosteroid;  epinephrine;  food allergen;  epinephrine, adolescent;  anaphylaxis;  Article;  asthma;  cashew nut;  child;  child hospitalization;  cohort analysis;  comorbidity;  disease registry;  disease severity;  drug self administration;  egg allergy;  emergency treatment;  European;  European Anaphylaxis Registry;  female;  hazelnut;  human;  major clinical study;  male;  milk allergy;  nut allergy;  peanut allergy;  preschool child;  school child;  tertiary care center;  anaphylaxis;  Arachis;  peanut allergy;  register, Adolescent;  Anaphylaxis;  Arachis;  Child;  Epinephrine;  Humans;  Peanut Hypersensitivity;  Registries",
    abstract = "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 = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .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 = .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 = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .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. © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd."
}