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    Food-induced anaphylaxis in early childhood and factors associated with its severity
    (OceanSide Publications Inc., 2021) Aydoğan, Metin; Topal, Erdem; Yakıcı, Nalan; Acar, Hazal Cansu; Hızlı Demirkale, Zeynep; Arga, Mustafa; Uysal, Pınar; Aydemir, Sezin; Eser Şimşek, Işıl; Tamay, Zeynep; Çekiç, Şükrü; Çavkaytar, Özlem; Kaplan, Fatih; Kıykım, Ayça; Çoğurlu, Müjde Tuğba; Süleyman, Ayşe; Yücel, Esra; Akkelle, Emre; Hancıoğlu, Gonca; Yaşar, Adem; Tuncel, Tuba; Nacaroğlu, Hikmet Tekin; Aydoğmuş, Çiğdem; Güler, Nermin; Çokuğraş, Haluk; Sapan, Nihat; Yüksel, Hasan; Sancak, Recep; Erdoğan, Mehmet Sarper; Özdemir, Öner; Özdemir, Cevdet; Orhan, Fazıl
    Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods:We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6-18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.